The Baltimore Sun

Shortage of doctors already a dilemma

The Maryland Primary Care Coalition applauds The Sun for bringing the impending physician shortage crisis in Maryland to the attention of readers ("State lacks practicing physicians," Jan. 8).

Our national organizations predict a crisis in the primary care medical work force (pediatricians, general internists and family physicians), as well as in access to geriatricians and gynecologists.

These predictions are based on data reflecting a low level of interest in primary care by medical students as a result of the high level of debt that must be incurred to enter the field, the very high malpractice insurance premiums and the low starting salaries in Maryland for young physicians.

The Sun's article discusses an impending physician shortage. We believe there is already a serious shortage today - one evidenced by full practices, long waits for appointments and the inability of practices to recruit new doctors.

Under the current payment systems, many medical practices cannot even afford to hire more nurse practitioners and physician's assistants.

To address this crisis and prevent its expansion, the Maryland Primary Care Coalition is calling for concerted action by both the public and the private sector to increase resources for training and reimbursing primary care physicians.

Increased access to health insurance will not solve the problem of access to care if our citizens have no access to primary care doctors.

Dr. Mary Newman Dr. Mel Stern Dr. Joseph W. Zebley III


The writers are, respectively, governor of the Maryland chapter of the American College of Physicians, legislative chair of the Maryland chapter of the American Academy of Pediatrics and president of the Maryland chapter of the American Academy of Family Physicians.

Other states offer doctors better deal

The insightful column by Dr. Scott E. Maizel clearly illustrates the multifaceted problem facing the future of medical care in Maryland ("Disappearing doctors," Opinion

Commentary, Jan. 7).

As a physician in a surgical specialty who works in a busy private practice with close ties to academic institutions, my colleagues and I find it increasingly difficult to recruit new physicians to this area unless they have family ties here.

Low insurance reimbursements, relatively high malpractice premiums and an indifferent state legislature make the "grass greener," in the minds of the young medical school graduates, in just about any locale other than Maryland.

It is incumbent on legislators to recognize this problem and ensure Maryland citizens are protected against the flight of medical care from the state.

Dr. Michael Weiss

Owings Mills

State owes big debt to foreign doctors

Dr. Scott Maizel's excellent column "Disappearing doctors" (Opinion

Commentary, Jan. 7) calls attention to one of the problems facing health care in Maryland.

And indeed, if it were not for the fact that more than one-quarter of all physicians in Maryland are international medical graduates, the shortage of practicing physicians in this state would be far worse.

We citizens of Maryland owe a huge debt to India, the Philippines, Mexico and other poor nations that supply the bulk of the talented, dedicated international doctors in our state.

To replace the international medical graduates now serving Maryland with U.S. medical graduates would cost almost $2 billion.

Dr. Timothy Baker


The writer is a professor of international health policy at the Johns Hopkins Bloomberg School of Public Health.

Attack on Grasmick is purely partisan

Let me understand this: Maryland has one of the top school leaders in America who has led our schools to a rating of third-best in the country. And our esteemed governor wants to fire her ("Grasmick called a 'pawn' of GOP," Jan. 10)?

Give me a break. What an unbelievable act of chutzpah by the governor.

If the citizens of Maryland let Gov. Martin O'Malley get away with this kind of partisanship, they deserve what they get.

I hope the citizens are also appreciating the higher taxes we are now paying.

Allan Kaufman

Owings Mills

For a less cruel way to execute prisoners

I think the strongest arguments against legal executions involve the possibility, regardless of how remote, of executing a wrongfully convicted person. And I believe that the most rational way to end all executions in this country would be to enact a federal ban ("Queries fly in death penalty case," Jan. 8).

But, recognizing that some states do perform executions, I see a very simple solution to the lethal injection debate: Instead of the current three-drug "cocktail," the condemned should simply be injected with a lethal dose of a strong narcotic such as morphine.

The condemned person would quickly and painlessly drift away forever.

And in answer to those who would object to someone convicted of a heinous crime being afforded any comforts, I would make three points.

First, the condemned's brief, final sense of well-being would be mitigated by the awareness that he or she is about to die.

Second, rather than simply meting out punishment, the ethical intention of the death penalty should be to eliminate persons who are unable consistently to control their violent or unethical tendencies to hurt others.

And finally, the practice of offering condemned prisoners a final courtesy is in keeping with a long tradition of such gestures, which have included allowing the condemned to choose his or her last meal, smoke a last cigarette or have an opportunity to speak a few final words.

Jon Salkov


Primping for outing isn't front-page news

I'm just curious whether the world, the nation, state and metropolitan area were so utterly devoid of news this week that The Sun really had to run a front-page article detailing the primping habits of pre-teen girls prior to a Hannah Montana concert ("Night of guise and dolls," Jan. 9).

Kate Berliner


Supporting students through a tragedy

Carney is a small town in Baltimore County. And I consider Carney Elementary School to be the heart of our community.

Our collective hearts were broken when we learned of the horrific and senseless crash in Ohio caused by a drunken driver, which resulted in five deaths in the Griffin-Burkman family including those of two students from Carney Elementary ("Memorial for lost," Jan. 9).

I would like to commend Principal Eileen Roberta and the entire Carney Elementary School staff for their caring support not only for the family but also for all the students at Carney Elementary who lost classmates and friends.

Meg O'Hare


The writer is president of the Carney Improvement Association.

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