Community Health Visioning 2017

1. Community Health Visioning 2017 Workforce Shortage Dr. Denise Heinemann

2. 2007 Medical Expenditure Panel Survey • Based on a sample of 15,000 US households • $1.13 Trillion Dollars expended: • Location of Care • 31.3% inpatient care • 23.5% office-based care • 20.7% prescription drugs • Patient Condition • 47% on chronic illness • 25% on acute illness • <8% each on trauma/poisoning, pregnancy/birth, preventive care, and “other”.

3. Healthcare Disciplines with Highest Vacancy % Now and 2015 (USDOL)

4. Colleges, universities, and clinical facilities are collaborating to address shortages of nurses and other health care professionals. The concierge form of medical practice may enhance physician and patient satisfaction at the expense of patients in the community who cannot access a primary care physician. Workforce Shortage

5. Key Accomplishments Health professions programs at all levels continue to receive more applications than the number of seats available. Salaries continue to remain attractive to licensed professionals. Edison State College has the largest capacity for educating RNs. At FGCU, new initiatives include the following degree programs: Doctor of Physical Therapy (DPT) MS in Occupational Therapy Acute Care Nurse Practitioner and Certified Nurse Anesthetist Private universities continue to offer the SW Florida market nursing, physician assistant, and health administration programs. FGCU and ESC clinical programs use simulation labs to prepare students to think critically, maximizing student performance in the limited clinical settings we share among all programs. 5

6. Barriers/Challenges • Physician Manpower • The shortage of primary care physicians and selected specialties continues, but medical schools expect a 30% increase in enrollments by 2015. • Continue Regional Planning and Cooperation among Programs Preparing Health Professionals • Decreased State Funding for New Facilities and Faculty Positions Limits Admissions and Threatens Program Accreditation • Optimize the Scope of Practice for all Providers • Florida is one of the last two states in the nation to restrict the prescriptive privileges of ARNPs 6

7. Opportunities Reliable manpower data available from DOL Interagency cooperation has increased between Lee and Collier County health providers with an emphasis on pediatric services Flexible Interdisciplinary Care Models Are Needed The FMA continues to lobby against full scope of practice for FL ARNPs, further limiting their role in primary care. Recognition and reward for the challenges generalist practitioners face in practice remain a serious concern. 7

8. Opportunities Reinvigorate the Public Health System: Reform Medicaid, increase community collaboration and care management targeting obesity, smoking, diabetes, and hypertension. Lobby for Federal Programs to Support Practitioners Willing to Invest in Becoming University Faculty Increasing numbers of primary care ARNPs from FL programs will further relieve the burden of primary care. The LMHS partnership with the FSU Medical School will bring primary care medical residents to the system in 2013, creating a pool of physicians who have a high probability of remaining in SWFL. 8

9. Questions 9