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Health experts worry about doctor shortage
LANSING — Michigan could face a more serious shortage of physicians by 2020, according to a report by the Michigan Center for Health Professions.
The report predicts that the top three shortages will be cardiologists, orthopedic surgeons and general surgeons.
Melanie Brim, deputy director of policy and planning at the Department of Community Health, said the gap of physicians is an overall problem that is compounded by the current distribution of professionals.
“The state doesn’t have enough physicians in general, much less getting them evenly distributed into not only rural areas, but also into urban Detroit,” Brim said.
For example, the ratio of residents to primary care doctors in Clinton County is 2,494:1, while the ratio in Ingham County is 762:1. The average ratio in Michigan is 874:1 and the national benchmark is 631:1, according to the County Health Rankings Project at the University of Wisconsin.
“The high ratio for Clinton County is because many primary care doctors that residents see are located in Ingham County where large health systems exist,” said Kimberly Singh, health officer of the Mid-Michigan District Health Department.
Multiple, complex factors affect the supply of physicians. Brim said one reason is the number of aging doctors.
“More and more physicians want to retire, and the pipeline to create new physicians is so slow that there is not an even match,” Brim said. “Becoming a doctor requires more training than most other jobs, usually at least 11 years. It is extremely hard to train enough physicians to keep up with the departures from the field.”
Another contributing factor is the cost of education and training, she said.
According to the department’s 2010 survey of physicians, about 35 percent are primary care doctors — that is, their primary specialty is family practice, general medicine, internal medicine or general pediatrics.
Although the proportion of physicians in primary care has remained constant over the past few years, fewer medical school graduates choose primary care specialties.
“When medical students graduate with $200,000 or more in debt, it is hard to get students to go into primary care where the salaries are not nearly as competitive as specialties,” Brim said.
Karla Garcia, legislative liaison for the department, said the state provides millions of dollars for hospitals to support residents after medical school.
“The residents get paid a pretty fair amount of money,” Garcia said. “Some students get paid approximately $50,000 a year to be a resident. I’m sure they are working terrible hours, but it does help offset what some of the costs would be if the state didn’t have that program.”
Steven Newman of Southfield, president of the Michigan State Medical Society, said his organization is very concerned about proposed cuts to state funding last year for graduate medical education.
A supplemental appropriations bill restored much of that funding, “which we were happy to see,” Newman said. “At the federal level, we are urging that the current caps on the number of medical residency slots be lifted so that students now in the medical school pipeline will have opportunities here in Michigan to continue their training.
“We must do all we can to keep physicians in Michigan,” he said