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Study: The doctor may not be in

By Don Davis and Anne Jacobson

Primary care doctors soon may be in short supply, a Minnesota Hospital Association report shows.

“Many of our hospitals, especially those in greater Minnesota, already have difficulty attracting physicians,” association President Lawrence J. Massa said. “I hope this new information will provide an impetus to policy makers to make the urgent decisions needed on both the state and federal levels to give our health professional students access to the clinical training and residency experience they need to become licensed to practice.”

The study written by Towers Watson, a professional services company, says the doctor shortage will appear in the next decade. It found that “the current pipeline of graduates barely appears adequate to replace retirements as they occur. That, coupled with projected increases in demand because of an aging population, will result in a significant talent gap for physicians.”

There could be a shortage of 850 primary care doctors in the state by 2024, the study shows.

The findings don’t surprise Dr. Tom Witt, CEO of Mayo Clinic Health System in Cannon Falls, Lake City and Red Wing. He indicated the study puts data behind the trend professionals have been anticipating and for some time.

Minnesota actually is in a stronger position, Witt believes, than many other states. That’s because the University of Minnesota Duluth medical school focuses on primary care, the University of Minnesota Twin Cities has a strong family medical program and Mayo Medical School has a growing family medicine department.

“We’re in pretty good shape. Nobody is going to say we’re in the best of shape,” Witt said.

The factors

The study blames the shortage on a growing and aging population, along with fewer family doctors graduating and increased retirements. Many fields are experiencing higher retirement numbers as baby boomers age.

The hospital study shows about 1,350 primary care doctors are expected to leave the profession in the next decade from the approximately 5,000 in Minnesota today. At the same time, 1,300 doctors are expected to begin practice. Combined with increased demand, that would leave an 850-doctor shortfall, the study shows.

“Minnesota health care organizations will need to take action to ensure they have access to the talent needed to successfully deliver quality care,” said the study’s chief author, Rick Sherwood of Towers Watson.

Witt said Mayo Clinic Health System’s team delivery system will be part of the answer.

“The question is: Are we going to need as many physicians in the future as opposed to teams of physician, physician assistant, nurse practitioner, advanced practitioner RNs? It’s really a matter of what the team’s going to look like,” he said.

The study said the registered nurse supply should remain strong.

Hospital association officials say they will ask federal and state lawmakers to make changes that would encourage more people to pursue physician degrees. Some laws discourage taking medical courses, while federal cuts are being discussed in the medical education field, the association reported.

The association suggests developing a statewide health care task force to look into the doctor situation. It also seeks more state medical education funding.

Salary is another factor, Witt said. The current compensation models puts family practice near the bottom of the physician scale. Specialists earn more.

“We have to align the incentives and that is both compensation and lifestyle,” Witt said.

People also need understand that physicians are mobile, changing jobs and locations in today’s world, just as the rest of society is, he added. “Doctors don’t stay in the community forever anymore.”

Finding replacements has become a standard part of managing hospitals and clinics everywhere. He noted that the local system, including its numerous auxiliary clinics, currently has three family physician openings.

“We’ve been fortunate. Overall, we have recruited 20-plus physicians to the corridor over the last two years … every site we’ve added family physicians” Witt said. The community environment, the existing staff and the Mayo Clinic affiliation are all part of what attracts doctors and their families here.

“We’ll continue to put together teams of providers to take care of our population,” he said.