Washington, D.C. must help with Kentucky’s growing doctor shortage | Opinion
With nearly one in five Kentuckians now over 65, chronic diseases are surging—and a dire shortage of healthcare workers is fueling the crisis. Kentucky ranks among the worst states for physician availability, projected to face a shortfall of almost 3,000 doctors by 2030. Shockingly, 107 of our 120 counties are designated health professional shortage areas, hitting rural and underserved communities hardest. The math is grim: we desperately need more doctors, but independent practices are drowning. Medicare reimbursements have plummeted 33% since 2001, even adjusted for inflation—a death knell for any small business, let alone those safeguarding our health. Worse, the federal government slashed Medicare payments every year under President Biden, culminating in a 2.93% payment cut just before he left office. Meanwhile, hospitals got reimbursement hikes, tilting the scales toward massive systems and away from community practices. Physicians, buried under administrative burdens and soaring inflation-worsened costs — from equipment upgrades to staff salaries and rent — are asking: “Can I expand to a rural area, or must I flee to Louisville or Lexington? Can I afford Medicare patients, or should I stop seeing them to save my practice? Should I instead sell out to a big chain—or just retire?”
These government-imposed price controls, ignoring inflation, are driving doctors away, worsening shortages and forcing Kentuckians to endure longer drives, higher out-of-pocket costs, and endless wait times. This sabotages the MAHA mission to conquer chronic disease and restore American health, especially for our rural communities.
Community practices can’t deliver quality, timely, affordable care under this broken system. Without urgent cost and/or compensation stabilization, independent physicians will collapse, shortages will explode, and patients will suffer most of all.
Fortunately, the Trump administration is fighting back with the proposed Medicare Physician Fee Schedule (MPFS) rule, offering a modest payment increase—the first in years. However, it’s a Band-Aid; we need lasting reform tying physician reimbursements to the Medicare Economic Index (MEI) for automatic inflation adjustments. While I do work in healthcare as a PhD, I don’t anticipate that would benefit me personally, it is the hard-working MDs, nurses, and sick patients of Kentucky who need this basic reform.
Congress must act now on bipartisan Medicare payment reform to stem the workforce crisis before it’s too late. Kentucky needs doctors more than ever — reform the system to keep them here, or we risk watching our communities pay the ultimate price. I urge lawmakers of both parties to introduce common sense legislation linking MPFS to inflation, ensuring payments match the real costs of care. Our future quite literally depends on it.
Dr. Lance Pearson is from Pewee Valley, KY and works in healthcare administration. He is also the President of the KY Liberty Caucus, a think tank seeking principled, market-based, and limited government solutions to community problems.