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Michigan is experiencing a decline in the number of primary care physicians, with more shortages expected by 2030, particularly impacting residents in underserved areas.
The shortages can be curbed, in part, by beefing up state funding for existing programs to recruit, train and retain physicians in that field, a group of family medicine physicians said Monday.
Michigan has 269 health professional shortage areas, where either the proportion of family physicians and primary care physicians is too low or there are no primary care physicians whatsoever, according to Kaiser Family Foundation data, said Dr. Jennifer Aloff, a family physician at Midland Family Physicians.
She and others spoke during a roundtable with the Michigan Academy of Family Physicians, which represents more than 4,200 family physicians, family medicine residents, and medical students across the state.
Aloff said by 2030, the state will have a shortage of 860 primary care physicians.
Aloff said about 33% of the physician workforce in Michigan is comprised of primary care physicians, including family physicians, falling short of the “ideal amount that should be present in order to provide access to primary care and keep health care costs under control and improve long-term health outcomes.”
The goal should be at 40% or higher, she said.
“If we don’t address the shortage that we're experiencing here in Michigan, it's going to get worse,” Aloff said, noting that 3 million Michiganders currently don't have access to primary care because they are in medically underserved areas, including inner cities and rural areas. Some of these areas include northern Michigan and the Upper Peninsula.
Primary care physicians see patients from young to old and for ailments ranging from acute care needs to mental health.
The growing shortage, the family physicians said, means it will be more difficult for patients to get appointments with their primary care physician and will lead to more people seeking more expensive sources of care, such as the emergency room, or forgoing care altogether.
Studies show that people who regularly see their primary care physicians tend to live longer and are healthier, said Dr. Srikar Reddy, president of the Michigan Academy of Family Physicians and a family medicine physician at Ascension Medical Group in South Lyon.
Such patients also have lower annual health care costs, visit the doctor less, are prescribed fewer medications, and report less difficulty accessing care, according to a release from the Michigan Department of Health and Human Services.
It's estimated that two out of every five active physicians will be age 65 or older in the next decade, said Dr. Michael Bishop, program director of the family medicine residency at Mercy Health St. Mary's in Grand Rapids.
Bishop said the workforce needs to focus on increasing the number of graduating medical students who choose primary care for their residency training. Only about 27% of new medical school graduates are entering the primary care workforce each year, he said.
“Unfortunately for Michigan, many medical school graduates are leaving the state to receive their training in primary care,” he said. “Raising the number of primary care physicians both entering the field and staying in Michigan for that training will allow us to continue to focus on improving health care across Michigan's most underserved areas.”
The family physicians said they are asking state leaders for more investments to expand current programs to help address the shortage.
Bishop said the state-funded Michigan Doctors Improving Access to Care or MIDOCS program was established to expand primary care residency training in underserved areas of Michigan. Currently, he said, there are 52 physicians in training in MIDOCS community-based, primary care residency programs.
Dr. David Lick, program director at Beaumont Health's family medicine residency in Troy and a professor and interim chair of family medicine at Oakland University William Beaumont School of Medicine in Rochester, said more investment in the Michigan State Loan Repayment Program also would help.
The program helps employers recruit and retain primary care physicians in underserved areas by helping to reduce their medical school debt.
While Bishop said that program is one of the tops of its kind in the country, only 40% of those who apply get awards because of a lack of funds. Lick said Michigan Gov. Gretchen Whitmer has included more funding this program in her proposed budget for next year.
The family physicians said primary care physicians are on the lower end of the pay spectrum compared with other specialties and have more of a burden regarding documentation, quality, and other performance measures.