Being a partner of HLTH means MedCity News gets to bring programming to the conference annually. So it was this year with our ENGAGE at HLTH forum on Sunday, where we carefully curated a panel of experts who discussed three topics: cybersecurity, strict abortion measures, and where primary care can truly thrive — in retail settings or traditional sites of care.
The panel that I moderated explored the fact that strict abortion measures aren’t just negatively impacting women’s health. There’s a definite economic impact too, the true effect of which may as yet be known.
Take New Mexico, for instance, said Dr. Irene Agostini, an emergency medicine physician at the University of New Mexico and the former chief medical officer of the University of New Mexico Hospital. New Mexico allows abortion with no gestational limits.
“What we’ve done is billboards and a plan that we’ve put in Texas that actually recruits doctors to New Mexico so they can practice in a state where it’s safe to practice. So we are literally recruiting doctors [through] big billboards on the interstate to come to New Mexico.” Dr. Agostini said.
The campaign is called FreeToProvide and what is Texas’ loss in New Mexico’s gain.
“New Mexico is a poor state, and we need physicians, and so now this becomes a political as well as economic argument. Texas is, of course, very unhappy about that,” she explained.
There are other warning signs for states with strict abortion measures that their legislatures put in place once the Supreme Court threw the issue of abortion limits to states and removed federal protections when it overturned Roe.
For instance, in 2022-2023 there was a 11.7% decline in the number of OBGYN medical residency applications in abortion-banned states and a 6.3% decline in the states with gestational limits on abortion. Compare that to only a 5.2% decline in all states and a 5.3% decline in states where abortion was legal, according to a study done by the Association of American Medical Colleges (AAMC). Applications fell again by 6.7% in 2023-2024 in the states with complete abortion bans, whereas applications rose by 0.6% in all states and 0.4% in states where abortion was legal in the same time period.
Atul Grover, executive director, Research & Action Institute, Association of American Medical Colleges (AAMC) pointed out that the decline is not limited to OBGYN residency applications alone. For instance, Texas in 2020-2021 experienced a 4.5% increase in senior residency applications compared to the previous year. But in 2022-2023 — immediately after the state’s ban went into effect — applications fell by 5.4% compared to the previous cycle. The decline was steeper in 2023-2024, with an 11.7% reduction in applications from 2022-2023 cycle.
“Now, this data is just a snapshot of all the, you know, roughly 200 or so major academic health systems that I work with,” Grover said on the panel. “It’s about a three quarters of a trillion dollars in economic impact yearly. But the American Medical Association does these periodic studies where they look at the individual economic direct and indirect impact of practicing physicians on average, and it’s about a $1 million plus dollars a year that each physician brings to the community in terms of direct economic impact. Indirect impact may be about twice as much. So if you see a shift of 100 physicians moving from one state to the other, if you think about that being $100 or $200 million impact on state and local economies.”
There’s also the fear of the personal financial impact of being sued and the fear that their professions may be jeopardized.
“And for many physicians, they didn’t sign up for that, and they didn’t sign up to be lawyers,” Dr. Agostini declared. “They didn’t sign up to go to jail to practice medicine. So they can either stay and be somewhat warriors in those states, which physicians are doing, or they can say, ‘You know what, I can’t do this. I’m going to leave,’ which puts everybody at risk in those states…. That will be a problem for all people not just [those in] reproductive health years. As we move on through our lives, there just will not be [enough] physicians.”
Beyond the economic impact and worsening shortages of physicians is the toll on women and reproductive health in certain parts of the country.
“I’m going to keep bringing this up, but the areas of the country that have the biggest maternity deserts are also the ones that are banning abortions,” said Dr. Robbie Harriford, chief medical officer, Samuel U. Rodgers Health Center, a Federally Qualified Health Center.
Harriford sits in Kansas City, Missouri at the border of two states — Kansas, where abortion is legal due to a ballot measure residents passed in 2022 and Missouri, where it is illegal with no exceptions for rape or incest. Missourians however will get to weigh in on a ballot measure supporting the procedure in this year’s elections.
Grover echoed Harris’ thoughts about the areas of the country that have enacted strict abortion measures and therefore further worsening a physician shortage.
“Wyoming, Mississippi, Idaho, it’s not like they have plenty of doctors there that they can afford to lose,” he said.