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 > 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 today’s 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

8. 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)

9. AAMC recommendations • Increase enrollment in LCME accredited medical schools by 30% by 2015 • Estimate that > 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

10. 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)

11. 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 2,000:1).

12. Michigan HPSA’s

13. 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)

14. Michigan State Medical Society • Michigan is 8th largest state • 90% of physicians reside in 20 of Michigan’s 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

15. 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