The Physician Shortage
Problem
- Healthcare Association of New York: Physician shortage "critically low"
- East End faces particular challenges recruiting specialists
- Seasonal population doubles demand July-August
- Mental health services severely limited
Workforce Development Solutions
Loan Forgiveness
- Expand federal loan forgiveness for physicians in underserved areas
- State programs targeting primary care, psychiatry, obstetrics
- Tie to multi-year service commitments
- Include nurse practitioners and physician assistants
Residency Expansion
- Increase residency slots at Stony Brook and regional hospitals
- Target specialties with greatest shortages
- Rural/community health tracks
- Loan repayment during training
Scope of Practice
- Allow nurse practitioners to practice independently
- Expand telehealth authority
- Community health worker certification and reimbursement
- Pharmacist prescribing for common conditions
Telehealth Expansion
Make Pandemic Flexibilities Permanent
COVID-19 demonstrated that telehealth can dramatically expand access. These flexibilities should be made permanent to serve Long Island residents.
- Make pandemic telehealth flexibilities permanent
- Insurance coverage parity with in-person visits
- Broadband investment for rural areas
- Telepsychiatry services to address mental health gap
Access Points
- School-based health centers: Reach children where they are
- Mobile health units: Serve underserved areas
- Urgent care expansion: Reduce emergency room burden
- 24/7 nurse hotlines: Triage and advice
Mental Health Focus
Mental health services are particularly strained on Long Island:
- Long wait times for appointments
- Limited providers accepting insurance
- Youth mental health crisis post-pandemic
- Substance use disorder treatment gaps
Solutions
- Telepsychiatry to increase access
- Integrated behavioral health in primary care
- School counselor expansion
- Crisis intervention teams
- Peer support programs