Physician Workforce Issues
Physicians Workforce Demand
- There are a total of 5,472 family physicians in Michigan. [1]
- In the next 10 years, 45 percent of Michigan’s physicians plan to retire.
- The average ratio of residents to primary care doctors in Michigan is 874:1, while the national average is 631:1.
Michigan faces a physician shortage greater than the national average, and the largest shortage is in primary care. According to the Association of American Medical Colleges, by 2020 there will be a shortage of 8,000 to 12,000 physicians in Michigan, of which 4,000 will be primary care physicians. This shortage will only grow when more than one million uninsured Michiganders are eligible to receive insurance coverage under the Affordable Care Act.
In order to lower health care costs and to meet the growing health care demands of our population, the state must invest in the primary care physician workforce.
Graduate Medical Education
Graduate medical education (GME) is a long-term economic investment. Investing in physician training ensures that our future workforce is adequate to provide efficient, effective health care delivery addressing access, quality and value to meet the growing demands we face.
- Of the doctors who completed both his or her undergraduate medical education and graduate medical education in Michigan, 66 percent will stay in the state to practice.
- Eighty-one percent of practicing physicians did all or part of their residency in Michigan.
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Health Professional Shortage Areas in Michigan
Some rural communities with a population of less than 80,000 are short 4 to 5 family physicians; however, this not solely a rural issue. There are 224 total Health Professional Shortage Areas (HPSA) designated in Michigan, including 10 counties, 19 service areas, 54 population groups and 141 facilities.
In 2009, a physician survey reported 34 percent of Michigan’s physicians are in primary care, specifically family medicine, general medicine, internal medicine or general pediatrics. The Council on Graduate Medical Education estimates 40 percent of physicians will need to be in primary care to address the growing health care needs of the population.
Michigan Student Loan Repayment Program
Physician supply is currently a direct result of the number of medical school graduates, but more graduates do not ensure an increased supply of primary care physicians. Results from the National Resident Match Program (NRMP) indicate a relatively low interest in primary care residencies among U.S. medical school seniors.
A lack of interest in primary care fields can be attributed to various social and cultural factors; however, the biggest deterrent for medical students tends to be mere economics. The average Michigan medical student graduates with a debt of $160,000, which is about equal to the median salary of a primary care physician. Faced with this reality, many medical students pass over primary care in favor of more lucrative specialties.
Loan forgiveness programs greatly help medical students choose primary care specialties like family medicine. From 1991 through 2008, the Michigan State Loan Repayment Program (MSLRP) placed 504 providers in 68 of Michigan’s 83 counties, with family medicine representing nearly half of all physicians.
More on Medical Student Debt »
[1] Data compiled by the Michigan Health Council, January 2012