In February, the New England Journal of Medicine ranked Oklahoma as the worst when it came to access to medical care. With help from a California Endowment Health Journalism Fellowship, Tulsa World reporter Shannon Muchmore sifted through reams of data to emerge with a three-part series helping readers better understand the state’s unique health care delivery challenges.
Fans of data analysis and numbers will want to dive straight into the first installment. According to Muchmore, 66 of Oklahoma’s 77 counties contain “Health Professional Shortage Areas, which means “they don’t meet the national standard of one physician for every 3,500 people.” And those doctor-patient ratios aren’t improving.
The state is facing a severe shortage of doctors as the population ages. Adding to that, as many as 180,000 people are poised to receive insurance when provisions of federal health-care reform kick in 2 1/2 years from now.
What’s behind that shortage? Muchmore enumerates the key drivers.
Medical schools are not increasing their class sizes, residency slots are hard to come by, and doctors are choosing to locate in other states.
The last two factors go hand-in-hand, as doctors often practice where they have their residencies. Without a connection, they have little reason to locate in a rural area.
The state is not well-positioned to handle a further deterioration in its health-care system. Oklahoma consistently ranks among the worst states for obesity, diabetes, smoking, heart disease and overall health. It has the least improvement in the country in age-adjusted death rate since 1990.
In the second installment, she examines the link between disparities in access to medical care and disparities in life expectancy and other indicators throughout the state, with a special focus on Oklahoma’s most rural counties.
In the final piece, Muchmore looks at the future of health care provision in Oklahoma and the key role that physician extenders, such as nurse practitioners and physician assistants, are poised to play.
Keep an eye on the AHCJ website for an upcoming “How I did it” article from Muchmore in which she shares how she did the reporting on this project.
