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Dwindling doctor numbers will result in physician talent gap, study says

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A decade from now there won't be enough primary care doctors in Minnesota to provide quality care if state and federal lawmakers don't make changes to current medical education policies, a new study says.

The study, conducted for the Minnesota Hospital Association by Towers Watson, a global professional services company, 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."

The study found that there could be a shortage of 850 primary care doctors in Minnesota by 2024. This is a national trend – the Association of American Medical Colleges projects a shortfall of 45,000 primary care physicians and 46,000 surgeons and medical specialists nationally by 2020, according to a news release.

This is due to the lack of growth in medical education programs across the country. Towers Watson says residency programs face funding and clinical space challenges. After students graduate from medical school, they encounter a "bottleneck" – there aren't enough residency training program slots available.

This is because Congress capped the number of residency training positions in 1997 – and unless there are more positions created, new doctors won't be able to complete their training to practice on their own, the New York Times reported last week.

The newspaper says this bottleneck of doctors is just one reason "the current medical education system is ill-equipped to train the number of professionals needed" nationwide.

“The lack of an adequate primary-care infrastructure in the U.S. is a huge obstacle to creating a high-performing health-care system,” David Blumenthal, president of the Commonwealth Fund, a health-care research foundation, told the Washington Post.

The dwindling number of primary care doctors is noticeable already in rural and poor areas in Minnesota and nationwide.

“Many of our hospitals, especially those in greater Minnesota, already have difficulty attracting physicians,” Minnesota Hospital Association President Lawrence J. Massa said in a news release. “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.”

There are currently bills in Congress to increase the number of residency slots for new doctors by 15,000 over a five-year period, the New York Times reports. But the newspaper says, "whether Congress will appropriate the money needed for that purpose — on top of spending large sums to rehabilitate the Department of Veterans Affairs health system — is questionable."

“Given the challenges of moving additional spending proposals through Congress, solutions at the federal level may continue to be elusive,” Massa said, according to the St. Cloud Times. “More action at the state level is critical.”

Minnesota hospital officials intend to push for changes, which include lifting the 17-year freeze on residency positions. They oppose cuts to federal medical education funding, and they aim to develop a statewide health care workforce plan. They also plan to increase the use of tele-health technologies to relieve some demands on primary care physicians, a news release says.

Although the number of physicians is dwindling, the study did find that, if education programs for registered nurses continue to grow at the expected rate, the number of nurses will likely meet the demand in Minnesota 10 years from now.

Towers Watson used publicly available data from the U.S. Bureau of Labor Statistics and the state of Minnesota and workforce data provided by Minnesota hospitals to analyze the state of primary care physicians and registered nurse workforces in Minnesota. Read the complete study here.

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