Current Physician Shortages in U'S' and Michigan

1
Current Physician Shortagesin U.S. and Michigan
2
Introduction

• AAMC predicts a 20 shortage of physicians by
  2020
• Supply of physicians will be affected by
• Current physician characteristics
• Ability to train new physicians
• Shortage is not geographically homogeneous

3
Physician Shortage

• Growing U.S. population
• Between 1980-2005 population increased by 31
• No increase in number of physicians since 1980
• Increase in population gt 65 years of age
• 2011 first baby boomers turn 65
• Over 65 use 2 x physician services as under 65
• Greater life expectancy
• Increased public expectation of physician services

4
Physician Supply

• Aging of physicians
• 36 over age 55
• New generation of physicians want a balanced
  lifestyle
• Data shows that todays physicians under age 50
  work fewer hours
• Greater number of female physicians

5
First Year Medical School Enrollments per 100,000
Population

• It takes at least a decade to impact supply

6
Medical School Training

• Not keeping up with demand
• LCME has 126 accredited U.S. medical schools
• Only one new school in 25 years
• Three more at provisional stage
• All new programs in southern states
• 30 of all graduate residency positions are
  filled by international medical graduates
• 82 of top Caribbean medical school enrollments
  are U.S. citizens

7
Demand for Medical School 2007

• United States
• 42,315 students applied to U.S. medical schools
• 26.1 enrolled in home state
• 15.9 enrolled out of state
• 58 did not enroll in any LCME program
• In Michigan
• 1,582 students applied to U.S. medical schools
• 28.3 enrolled in Michigan schools
• 13.1 enrolled out of state
• 58.7 (928) did not enroll in any LCME program

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Demand

• There are large numbers of Americans who aspire
  to attend U.S. medical schools but have been
  unable to gain admission due in part to limited
  capacity. Many are so committed that they are
  willing to pay high tuition at schools with
  varying standards and leave the U.S. for several
  years to reach their goal
• AAMC (2006)

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AAMC recommendations

• Increase enrollment in LCME accredited medical
  schools by 30 by 2015
• Estimate that gt 3,000 U.S. citizens enter medical
  school outside the U.S.
• International concern that English-speaking
  countries are draining less developed countries
  of needed health care providers

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Geographic inequities

• Demand will exceed supply by 2020 across the U.S.
• But shortages will be seen earlier in underserved
  areas
• HPSAs (Health Professional Shortage Areas)

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HPSAs

• HPSAs are areas designated as having a shortage
  of primary medical care, dental or mental health
  providers. They may be urban or rural areas,
  population groups, or medical or other public
  facilities.
• As of June 30, 2008, there were
• 5,987 Primary Care HPSAs with 63 million people
  living in them. Collectively, it would take
  16,261 practitioners to meet their need for
  primary care providers (a population to
  practitioner ratio of 2,0001).

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Michigan HPSAs
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• A 2007 study found that the Michigan physician
  workforce shortage is 50 percent above the
  national average
• Center for Health Workforce Studies
• (Albany School of Public Health 2007)

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Michigan State Medical Society

• Michigan is 8th largest state
• 90 of physicians reside in 20 of Michigans 83
  counties
• Shortage of 900 physicians by 2010, 2,400 by
  2015, and up to 6,000 by 2020
• Shortage of 800 physicians in Flint, mid- and
  northern Michigan by 2020

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Conclusion

• Serious shortfall of physicians across country
• Certain geographic areas will be affected more
  than others
• Recognition of need to increase medical school
  training to meet this need