FAIRBANKS - A shortage of health care professionals afflicts Fairbanks and other towns across Alaska.
One way to start to improve this situation is a bill by Juneau Rep. Cathy Munoz, HB 235, to offer 25 percent to 50 percent forgiveness of one type of student loan for residents who become pharmacists, dentists or optometrists through the WICHE program.
This would cover from one-quarter to one-half of the annual “support fee” that Alaska students pay to attend schools under the Western Interstate Commission for Higher Education program.
Those support fees, for which the students can get low-interest loans from the state, range from about $10,000 to $22,000 per year, depending upon the field. The support fee, in general terms, represents the difference between the cost of resident and non-resident tuition at those schools.
I said this bill is a start because it does not go nearly far enough to attract health care workers who are much in demand everywhere.
While Alaska has done little to offer incentives, other states have a variety of programs, ranging from the payment of malpractice premiums in Oregon to loan repayments in many states.
Alaska subsidizes the education of 20 medical students per year through the WAMI program, but it does not offer incentives for dentistry, pharmacy, nursing, behavioral health and other fields. In contrast, there are incentives in Wyoming, Washington, Oregon, North Dakota, South Dakota, New Mexico and elsewhere.
Alaska once had a generous state educational loan forgiveness program under which 50 percent of any college loan could be forgiven if the graduate returned to work in Alaska and stayed for five years. This was done away with during the oil crash in the mid-1980s.
A targeted loan forgiveness program aimed at encouraging more doctors, physician’s assistants, nurses, dentists, pharmacists, psychiatrists etc. to treat Medicare patients, serve in the villages or take on a number of other challenging tasks could play a part in encouraging young people to establish themselves in Alaska.
A second bill, SB 139, by Sen. Donny Olson, would provide a three-year cash incentive of $20,000 to $47,000 each year, depending upon the job and its location, for 10 health care occupations. The idea is to attract 90 health care workers from across the country every year.
I don’t know what the right combination of incentives would be to make Alaska more competitive with other states, but that is the challenge.
In Southeast, Wrangell has lost both of its private dentists, Petersburg has lost one of its two private dentists and Ketchikan has lost one of its five private dentists, Dr. Gary Moeller, president of the Alaska Dental Society, wrote to the House Education Committee.
He said that all of those who left tried to find replacements to take over their practices, but couldn’t.
“In 44 states there are one or more incentive programs for health professionals. Alaska is one of six states without a program,” Moeller said. “Encouraging Alaska residents to seek careers in health care fields will pay several dividends.”
Dr. David Logan, a Juneau dentist, told lawmakers it is common for young people to leave dental school owing $250,000, which means they face immediate financial pressure that influences where they decide to work.
For a lot of reasons, they are not choosing to work in Alaska.
Amber Briggs, a pharmacist and president of the Alaska Pharmacists Association, said there is a shrinking national pool of pharmacists, and it is difficult to attract and keep them in Alaska.
Nancy Davis, executive director of the Alaska Pharmacists Association, said the average debt for pharmacy graduates is $150,000. Tuition for Alaska pharmacy students going to school Outside is about $50,000 higher than for in-state residents.
Davis said there is constant turnover among pharmacists, and on a per capita basis we need 137 more professionals to reach the national average of about 5 pharmacists for every 10,000 people. In Alaska, there are about three pharmacists for every 10,000 people. In Fairbanks, there are four hard-to-fill openings for pharmacists in two retail locations right now.
“Pharmacists are overworked, and it could lead to errors, which has become a safety issue,” said Davis.
Dr. George Schaffer, a dentist in Ketchikan for 32 years, said some Alaska students who go Outside drop their Alaska residency because they want to qualify for in-state tuition where they go to school.
For that reason, the Legislature should consider offering loan forgiveness not just to Alaska residents, but to others who might find this as the motivation they need to move to Alaska and stay.
During the years, many of the health care professionals in Fairbanks came here because of the military and had no intention to stay, but the place grew on them.
Part of improving health care in Alaska and remaining competitive is determining what incentives are needed and where.