Dr. Alexa Rodin has been a primary care physician at Central Peninsula Internal Medicine for the past three years. Her husband, also a doctor, worked at Central Peninsula Hospital through a hospitalist contractor. The couple initially planned for it to be a temporary gig, but they eventually decided to make the peninsula their home.
Now though, they’re headed to Bozeman, Mont., where they’ll work for the local hospital system. Rodin said one of the biggest reasons they're leaving is to find better day care and school opportunities for their one-and-a-half year old.
“It took months of searching to find a nanny,” she said. “We hired a private nanny, we were financially able to and very fortunate, but we looked at daycare first and there was not a single daycare opening on the entire peninsula that could accept her.”
Looking forward, Rodin said she has a responsibility to give her daughter a good education, and just doesn’t feel like that’s available to her on the Central Peninsula.
She also said her husband’s night shifts at the hospital here meant they worked opposite schedules, which made child care difficult.
“I worked four 10-hour days, so I worked a pretty standard week, but he had 13-hour shifts, sometimes for 14 days in a row, which is not industry standard,” she said. “So that was a big factor, just being able to be present with our child and with each other.”
Rodin said doctors often come in pairs, which means it’s easy for a community to lose two at once. At least three doctors have recently left the hospitalist staff, two doctors left the practice where Rodin worked, and several other primary care providers and specialists have left the area over the last year. That’s putting a strain on the remaining providers, even as the hospital system works in overdrive to recruit new doctors.
Dr. John Bramante is a physician at Central Peninsula Internal Medicine, the hospital-run primary care practice where Rodin worked.
“As a guy who should be winding down, I had to look at this summer and say to myself, 'Okay, this is going to be one of my busiest summers ever, and I’ve just got to suck it up and deal with it,'" he said.
Bramante has been an internist in the Soldotna area for 30 years. He said the medical community has been generally growing over that time, and he’s just beginning to see a "small exodus."
He attributed that in part to the social impacts of COVID.
“It opened peoples' eyes up to the potential of opportunities elsewhere, or scaling back, or being closer to family,” he said.
That’s true for Dr. Libby Cummings and for her fiancé, who were both doctors at Central Peninsula Hospital, but now are headed back to Maine, where Cummings grew up.
“I had always wanted to get some rural medicine experience elsewhere and then bring what I learned back to Maine, and now was the right time in terms of career and life timeline for us to move back closer to family,” she said.
Bramante said Alaska also used to be able to attract doctors with better pay than the rest of the country, but he’s not sure that advantage exists anymore.
“I think, in general, physician pay in Alaska has tended to be higher than the Lower 48,” he said. “That was the case for many years.”
And he said medical school opportunities also play a part.
There’s only one med school in the state, and it’s a collaboration between the University of Alaska Anchorage and five other universities in the northwest. According to UAA, 60% of the students in that program go on to practice in Alaska, and graduates make up 14% of licensed physicians in the state. That program was one of the targets of Dunleavy’s budget vetoes in 2021, before he reversed course.
“And it probably met the biggest pushback, because it’s absolutely vital that we grow our own,” Bramante said. “People do tend to work in the place where they do their residency.”
A new residency program, founded by two clinicians at Bramante’s practice, is meant to address that issue. It’s a rural residency training program under the University of Washington medical school designed to train and recruit young doctors.
Bramante said the outflow of doctors is difficult, especially in a growing retirement-age community with increasingly complex medical needs. He said the hospital has been in overdrive trying to recruit new staff. This month alone, he said, he has seven meet-and-greet lunches with possible hires.
Practices are also considering a new solution of hiring for so-called physician extender positions, like nurse practitioners and physician assistants. And although he’s having a uniquely busy summer, Bramante is hopeful those efforts will pay off, and he’ll be able to relax for the next few.
Rodin isn’t so confident the clinic will be able to quickly attract new doctors.
“I’m extremely worried about my patients being able to find new primary care,” she said.
She said she gave her notice in the fall, and reached out to more than 50 residency programs to help find a replacement. But she got little to no response.