Fast-growing areas like Alabama’s Madison County face challenges from crowded roads to crowded classrooms. One of the biggest when 50,000 new residents show up in a decade is finding a family doctor.

It’s a challenge not only because of growth but also today’s changing medical market. Patient signup lists posted by physicians can change rapidly. A website’s “yes” to “taking new patients” can be out of date when you call. Or the answer seem more like, “Yes, but….”

“We do,” one Huntsville physician’s office said this week about new patients, “depending on medications needed and insurance.”

“Yes,” said another office, “but there’s a wait until the end of summer.”

“If an immediate family member is a patient,” said a third.

More frequent, however, was “not accepting,” “closed to new patients” and, “He doesn’t do that.”

Local business leaders are aware of the problem and say the issue isn’t confined to Huntsville. And it’s true the American Medical Association is also sounding the word about a national physician shortage. The association said in April it “will get worse if we don’t act fast” as a nation.

The medical association referenced a 2022 report by the Association of American Medical Colleges saying the country faces “a projected shortage of between 37,800 and 124,000 physicians within 12 years.” That could mean a big challenge for growing cities like Huntsville, for cities where demographics are trending toward older populations with more medical needs and for already underserved populations across the country.

“The Huntsville/Madison County Chamber is working closely with our hospitals and healthcare providers to make sure the health-related needs of our growing community are being met,” the chamber said in a Thursday statement. “Unfortunately, there is a nationwide shortage of physicians. Huntsville Hospital and Crestwood Medical Center have been recruiting doctors and continue to do so. Both hospitals also offer hotlines for families who are looking for physicians. The Madison County Medical Society also has a physician finder on its website.

“Additional private practices have recently opened offices in the region and Thrive Alabama has also expanded its services to include primary care,” the chamber said. “The Chamber communicates these services to our local employers, and in turn, we encourage them to share information with their team members.”

Thrive Alabama is a nonprofit organization with clinics in Huntsville, Florence, and Albertville. It provided healthcare and support services for 30 years to people living with HIV/AIDS in North Alabama and expanded its mission in 2019 to include connecting people with other health needs to physicians across north Alabama.

The Madison County Medical Society’s physician finder also offers some answers but also another view of the challenge. Of more than 650 physicians on its membership list, the finder shows 56 family medicine specialists accepting new patients, accepting Medicare and accepting TriCare, the health insurance for uniformed service members, retirees and their families. Results may vary during different months and depending on a family’s requirements.

“Fewer physicians are looking to do pure family medicine,” said Dr. Joshua Hewiett, senior vice president of physician services for Huntsville Hospital.

There are multiple reasons starting with the fact specialists also do meaningful work for potentially more money. Specialists can have offices, staff and files, but a general practitioner can easily have more stuff to manage.

Hewiett’s job is managing employee positions for Huntsville Hospital in Madison County. The hospital employs 335 physicians itself – primary care and specialists. “They’re not just hospital-based and they have offices,” Hewiett said. The majority work on the hospital’s downtown campus but also are “spread all throughout the county.”

“We could use more,” Hewiett said.

Hewiett’s team spends 80 percent of its time running the hospital’s clinics, but he is spending 50 percent of his own time “focusing on physician recruitment.”

“That has increased tremendously,” Hewiett said, “and that’s because the community is growing, so we need more physicians to accommodate all these people coming into the community.”

Hewiett has a recruiting edge. He knows many of the physicians he is recruiting because they are graduates or students at the University of Alabama in Birmingham’s Heersink School of Medicine campus in Huntsville.

The Huntsville Regional Medical Campus is one of four supporting the UAB medical school. It has a Family Medicine residency program rated one of the best in the Southeast and its physicians get an early look at Huntsville’s potential place in their futures.

“They know about Huntsville,” Hewiett said of the residents. “They know it’s the new No. 1 best place to live. We tout that quite a bit…. Because Huntsville’s such a great place to live, we’re still having success recruiting primary (care) physicians.”

“They produce just phenomenal physicians,” Hewiett said of the school, “and our recruiters have good relationships with a lot of the programs throughout the Southeast.”

But fewer medical students today want to be family doctors, Hewiett said. Statistics show family doctors are only about 30 percent of current medical school graduates. That’s part of the reason it’s harder to find one. “There’s fewer primary care doctors available,” Hewiett said, “so we’ve got to get more creative.”

That means more nurse practitioners working with doctors to manage more patients’ care. It means more telemedicine that expands doctor’s range and ability to see more patients each day.

“During COVID when everything shut down, that was our method for taking care of patients,” Hewiett said of telemedicine. “We went from doing very little telemedicine to almost exclusively telemedicine.”

Telemedicine’s numbers have dropped post-pandemic because many patients still want a traditional office visit. “But there’s a growing number of patients that are saying, ‘Can you just give me the telemedicine?’” Hewiett said. “It was a faster process for both the patient and, a lot of times, the provider and staff.”

By faster, he means no traditional registration and no waiting in the doctor’s waiting room.

Huntsville Hospital is “constantly putting an emphasis on recruiting,” Hewiett said. “With a growing community we’ve got to stay out in front of this and have a good pipeline. We had a really good 2023 so far. We’ve recruited 23 new physicians, which is great, and we’re only in May now.”

Most of those physicians have no ties to Alabama. But like many other new workers moving to Huntsville, Hewiett said, “They love the community and want to come here and work.”