.bodytext {float: left; } .floatimg-left-hort { float:left; margin-top:10px; margin-right: 10px; width:300px; clear:left;} .floatimg-left-caption-hort { float:left; margin-bottom:10px; width:300px; margin-right:10px; clear:left;} .floatimg-left-vert { float:left; margin-top:10px; margin-right:15px; width:200px;} .floatimg-left-caption-vert { float:left; margin-right:10px; margin-bottom:10px; font-size: 10px; width:200px;} .floatimg-right-hort { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 300px;} .floatimg-right-caption-hort { float:left; margin-right:10px; margin-bottom:10px; width: 300px; font-size: 10px; } .floatimg-right-vert { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 200px;} .floatimg-right-caption-vert { float:left; margin-right:10px; margin-bottom:10px; width: 200px; font-size: 10px; } .floatimgright-sidebar { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 200px; border-top-style: double; border-top-color: black; border-bottom-style: double; border-bottom-color: black;} .floatimgright-sidebar p { line-height: 115%; text-indent: 10px; } .floatimgright-sidebar h4 { font-variant:small-caps; } .pullquote { float:right; margin-top:10px; margin-left:10px; margin-bottom:10px; width: 150px; background: url(http://www.dmbusinessdaily.com/DAILY/editorial/extras/closequote.gif) no-repeat bottom right !important ; line-height: 150%; font-size: 125%; border-top: 1px solid; border-bottom: 1px solid;} .floatvidleft { float:left; margin-bottom:10px; width:325px; margin-right:10px; clear:left;} .floatvidright { float:right; margin-bottom:10px; width:325px; margin-right:10px; clear:left;} Iowa ranks 44th in the nation in terms of physicians per capita and sixth in percentage of the population insured through the Medicare program. Michael Abrams points to these facts as motivation for the Iowa Medical Society’s latest project: an examination of the state’s health-care infrastructure to assess the adequacy of the Iowa physician work force and residents’ ability to access the medical care they need.

“The picture of the state is relatively elderly and that is, in some cases, dangerously understaffed with a physician work force,” said Abrams, the organization’s executive vice president, “so the Iowa Medical Society is very concerned about a collision in our state’s health-care system.”

The Iowa Medical Society Task Force on Iowa’s Health Care Infrastructure is the largest project the IMS has undertaken in the 11 years Abrams has been the administrative leader of the organization. Twelve physicians who serve on the committee began meeting last May and plan to submit a final report in April, which will include observations and recommendations based on research and five daylong discussions.

The four topics discussed in the meetings are Iowa’s physician work force and medical practice climate; medical education and training in Iowa; Iowa’s uninsured; and Iowa’s public health and medical delivery system.

Drake University’s Center for Professional Studies is helping facilitate the discussions and will be involved in putting together the final report. The IMS staff has been active in finding reports and other research for the doctors to review before each meeting.

“We want this to be not just a quick collection of thoughts,” Abrams said. “We want it to be deeply researched and very learned in terms of its approach. When this comes out, we expect it to be highly credible.”

The report is expected to be more comprehensive than other health-care studies that have been released recently. Michael Kitchell, a neurologist at the McFarland Clinic in Ames and IMS board chair, said the task force has used other reports, such as one from the University of Iowa that looked at the physician work force in Iowa and a state ranking by the Commonwealth Fund, but is looking at the system more broadly than just one issue.

Allen Zagoren, associate professor of public administration at Drake, noted that a similar study was done under Gov. Terry Branstad’s leadership 14 years ago, called the Iowa Health Reform Project. However, nothing significant resulted from the report, he said, in part because the economy and Iowa’s health-care system were strong at the time and health-care costs were relatively low. Zagoren said Iowa’s infrastructure is still strong, but potential dangers exist.

“It’s more than just combining work already done,” Abrams said. “It’s looking at every piece of work on this issue from around the country and state entities and developing our own recommendations based on what our instincts tell us from all the material.”

One of the biggest issues the task force is focusing on is the difficulty of attracting physicians to the state. Abrams attributes this in part to Iowa’s low Medicare reimbursement.

Physician recruitment particularly concerns Kitchell. For example, the McFarland Clinic has 23 physician openings in primary and specialty care, and in all of Iowa’s health-care facilities, there are 24 openings for neurologists.

“We’ve been recruiting for two neurologists for three and a half years,” he said, “and it’s getting pretty desperate right now.”

The task force is still in the information-gathering stage, but expects once the report is out next year and approved by the IMS board, it will help drive proposals for new legislation as well as actions the medical society can take as an organization.

By the time the report is made public, it likely will be too far into Iowa’s legislative session to have much impact next year. However, the IMS is working on encouraging other legislation, such as a policy that would require anyone who wants to sue a doctor to have the lawsuit reviewed by an expert prior to filing. Abrams said this is driven by the fact that 90 percent of jury verdicts in malpractice lawsuits favor the doctor. Once the study is released, Kitchell said, “I think it will help shape the future plans for health care in the state.”