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By Jack Bernard, contributing columnist
PEACHTREE CITY, Ga. | Today I write this from my position as chair of the Fayette County Board of Health.
Our home state of Georgia was ranked fifth worst place to practice medicine in a recent Medscape article (“Best and Worst Places to Practice 2024”).
Five criteria were used: physician compensation; cost of living; malpractice premiums; health of the state’s residents; physician burnout levels. We will detail our experiences of practices in Georgia. It emphasized particularly concerning is Georgia’s poor performance regarding health of the state’s residents and physician burnout levels. Both issues could be ameliorated via full expansion of Medicaid.
The article identified challenges that Georgia physicians encounter. Particularly concerning is Georgia’s poor performance regarding the health of the state’s residents and physician burnout levels. Both issues could be ameliorated via full expansion of Medicaid.
It is no surprise that three of the five worst ranked states to practice are among those that have not expanded Medicaid. Besides Georgia, there is Alabama and Florida. In Georgia, refusal to expand Medicaid means that nearly 12 percent of residents… well over a million people…are uninsured, significantly limiting their access to healthcare. Only in Texas is coverage worse.
Due solely to political concerns, Georgia chose to submit a Medicaid waiver and develop its own Medicaid expansion program called Pathways. It was projected by the Governor’s office to cover an additional 100,000 Georgians in its first year. But it has been an utter failure, with less than 3,500 covered at a cost to taxpayers of $26 million. Full Medicaid expansion would have added over 350,000 Georgians while cutting “state spending by $710 million.”
Without the ability to see a doctor regularly, chronic conditions worsen, and morbidity increases. Drs. Tracey L. Henry and Toby Terwilliger both practice in Atlanta and see this progression every day in their practices leaving us with the arduous task of addressing complex medical conditions in a state that makes necessary care inaccessible for so many.
Participating in vain in this struggle for Georgian’s patients’ lives often leads to moral fatigue, workplace stress, and burnout for medical providers. It’s one of the primary reasons that Georgia is not retaining more of its physician trainees.
The student-led non-profit organization, Health Students Taking Action Together (H-STAT), conducted a study this spring about the perspectives of medical trainees regarding their clinical experience in our state. Among other findings:
- 81 percent of respondents felt most Georgia residents do not have access to quality medical care;
- 80 percent believe that our high uninsurance rate contributes to physician burnout, and
- 60 percent would be more likely to stay in our state if options for better access to insurance coverage were available.
It then becomes clear that Medicaid expansion is not only good for patients but also for their doctors. And that increased insurance coverage would improve Georgia’s healthcare practice score.
It is limiting to think of our state as little more than a number in a ranking system. The Medscape analysis fails to consider Georgia’s growing economy, diverse patient populations, diverse people, and other remarkable aspects that drew us to and keep us as Georgians. However, the study does point out that we have significant work to do to make our state a more appealing place to practice. That effort must start with full Medicaid expansion.
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