Physician Shortage Deepens in All Areas of the State

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MADISON (November 10, 2008) – The wait to see a doctor could get longer if projections on the supply of and demand for physicians are accurate.  Wisconsin hospitals and physician clinics say recruiting physicians is more difficult than ever before, and they expect the situation to worsen according to a new report released today by the Wisconsin Council on Medical Education and Workforce (WCMEW).

 “Who Will Care For Our Patients?” is a report written by the Wisconsin Hospital Association on behalf of WCMEW.  One of its most alarming findings is that Wisconsin is short nearly 374 primary care physicians across 31 counties.  Milwaukee alone currently needs 20 additional primary care physicians to meet inner city demands.  Experts say this shortage can create a bottleneck in the health care system. 

“Primary care doctors have several key roles in health care:  They are the point of contact for people with undiagnosed health concerns, and they help patients navigate the health care system when they need on-going care or a referral to a specialist,” said WCMEW Chair Carl Getto, MD, senior vice president of medical affairs and associate dean for hospital affairs at the University of Wisconsin Hospitals and Clinics.  “When patients are sick and can’t get in to a physician, they enter the health care system through the hospital emergency room.”

The greatest increase in the demand for physicians centers on three specialties: family practice, internal medicine and the hospitalist – an expert in providing hospital-based care.

A Wisconsin Medical Society survey of 19 chief medical officers representing more than 5,000 physicians found that:

  • 63 percent said a shortage of physicians is requiring them to alter how they delivered services;
  • 53 percent said patient wait times have lengthened;
  • 26 percent indicated that they are limiting acceptance of new patients; and,
  • Nearly 60 percent said they have added advanced practice providers, such as nurse practitioners and physician assistants, to leverage physician services.

What is driving the shortage?

The report identifies several key factors that contribute to the physician shortage.  One is the nearly stagnant growth in the number of physicians graduated from Wisconsin’s two medical schools-the University of Wisconsin School of Medicine and Public Health (UWSMPH) and the Medical College of Wisconsin (MCW).  On average, 336 medical students have graduated each of the past six years (195 for MCW and 141 for UWSMPH), a number that has remained constant for two decades.   Only about

38 percent of graduates stay and practice medicine in Wisconsin.

The aging of Wisconsin’s population will have a dramatic impact on utilization, according to WHA Senior Vice President George Quinn, who authored the report on behalf of WCMEW.  Wisconsin’s population over the age of 75 will increase 68 percent from 2006 to 2030, while the number of people living here that are between the ages of 65 and 74 will grow by 94 percent.

“No single factor will impact our health care delivery system as much as the aging of our population,” Quinn said.  “Older people require more health care, and we’re expecting our graying demographics to drive up the number of physician office visits by 65 percent from 2006 through 2030.”

Tim Bartholow, MD, Wisconsin Medical Society senior vice president said, “This is a concerning and sobering report.  The health of our citizens is tied in part to our ability to access health care, plain and simple,” said. “The data in this report makes it clear that if we don’t take action to address the physician workforce shortage now, particularly in rural and inner city areas, the health of our children, our parents and our own health is at risk.”

How do we avoid a crisis?

The demand for physicians will grow by nearly 30 percent in the next 10 years, and more than double in two decades.  Yet the supply of physicians is projected to increase by just 13 percent in 10 years and

20 percent by 2030.  Worse still, demand for primary care physicians is even more acute.

To avoid a crisis, WCMEW made the following recommendations:

  • Enroll students in medical schools who will practice in Wisconsin

Develop a program within one of the Wisconsin medical schools to recruit and train individuals who are likely to practice in inner-city Milwaukee, modeled after the UW’s successful Wisconsin Academy for Rural Medicine (WARM), which focuses on admitting students likely to practice medicine in rural Wisconsin.

  • Develop new care delivery models

Even if efforts to increase the number of primary care physicians practicing in Wisconsin are successful, there will still be a shortage.  Advanced practice providers, which include but are not limited to nurse practitioners and physician assistants, have demonstrated that within their scope of practice they can deliver quality care with high patient satisfaction.

  • Attract physicians to Wisconsin, and keep them here

Competition among states is keen for physicians.  Making physicians aware of opportunities in Wisconsin is essential.  WCMEW took the first step in enhancing Wisconsin’s ability to recruit physicians with their recent launch of a career opportunity Web site, www.WisconsinPhysicianCareers.org.  Less than two months old, the site has already posted more than 600 positions for physicians in Wisconsin.

  • Target and enhance funding for medical education

The Wisconsin Medicaid program has significantly reduced funding for medical education, shifting that burden onto commercial payers.  The State Health Plan calls for “ensuring an adequate supply of primary care professionals.”  The State of Wisconsin could take a step toward meeting that stated goal by ensuring the medical education of primary care professionals is adequately funded.  The Wisconsin Medicaid program should fund graduate medical education and target it specifically at the greatest need-primary care.

  • Create an infrastructure to guide medical education in Wisconsin.

While WCMEW has served as a platform for addressing the physician workforce shortage, the single largest obstacle is finding good data to accurately forecast demand.  A data system must be designed that will help define and quantify the need for physicians in Wisconsin.

A copy of the report is at www.wha.org.

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