SPECIAL REPORT: The Doctor Is Out, Facing the Nation's Physician Shortage

By: Josh Sidorowicz Email
By: Josh Sidorowicz Email
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  "We're not replacing our primary care physicians at nearly the rate we're losing them."

- Dr. Fred Van Alstine, family physician

Lansing, Mich. (WILX) You could soon be waiting longer the next time you want to see your physician.

Within the next six years--by 2020--Michigan is on track to come up short nearly 5,000 physicians, and nationwide the number will be closer to 100,000, according to the American Association of Medical Colleges, AAMC.

It's an issue that will be even more pronounced in some rural areas across Mid-Michigan that are already considered "medically underserved" like in rural Owosso, where Dr. Fred Van Alstine--who is also president of the Michigan Academy of Family Physicians--has been practicing for more than 30 years.

"When I first started here there were probably 15-20 family physicians in the community and now we're down to 10," he said.

"The lines are growing, we have a waiting list for new patients, typically it takes about six weeks for us to see a new patient."

It's a perfect storm of sorts, happening across Mid-Michigan and nationwide: supply isn't keeping up with demand.

"I'm concerned, I'm concerned for the future and I'm concerned for our new graduates and that they're completely discouraged from going into primary care because of the economics," Van Alstine said.

Back in 1997, the federal government capped cash flow for residency programs. There are now just 26,000 residency spots nationwide for recent graduates, according to data from the AAMC.

But on top of that, of Michigan's roughly 5,400 family physicians, the Michigan Association of Family Physicians estimates about 45 percent plan to retire within the next 10 years.

All of this is happening as a growing number of older people will be needing more care--by 2020, those eligible for Medicare will increase 36 percent, according Dean Marsha Rappley, with Michigan State University's College of Human Medicine.

"We have this movement of physicians out, we have people getting older and needing more care, and then we have less money in the system to pay for all of our social services," Rappley said. "The government has to make some very difficult choices."

At MSU, the College of Human Medicine is graduating more students than ever before, there just aren't training spots to put them in afterward.

"It's going to take a concerted effort to put more money into the specialty training for our physicians, I think the medical schools have done their job in terms of graduating more students with a medical degree," Rappley said. "So we've got to do the same now with our residency training positions."

At Hayes Green Beach Memorial Hospital in Charlotte, combating the looming shortfall is two-fold, and one the hospital has a fairly positive outlook when it comes to dealing with it, according to Patrick Salow, the executive vice president of physician services and compliance.

"Nurse practitioners and physician assistants work very closely by way of a collaboration agreement with the attending physicians and our medical staff here has really accepted both those groups," Salow said.

The hospital is turning to more nurses and physician's assistants to fill the void, on top of an aggressive recruitment process.

"Our recruitment process, it starts years ahead of when we think we're going to need that person," Salow said.

It's an approach that's similar to Sparrow Hospital--which has campuses across Mid-Michigan from downtown Lansing, to St. Johns and Ionia--with an emphasis on recruitment in the more rural areas of the state.

"The majority of residents train in metropolitan areas," said Ted Glynn, vice president of medical education with Sparrow.

"We do know that 20 percent of the population lives in rurally designated area but unfortunately only about 10 percent of physicians work in these areas

It's a challenging issue, and one Glynn says he's concerned will be exacerbated with potential funding cuts at the state and federal levels.

Glynn says Sparrow already supports more residency spots--about 230--than they federal Medicare funding allows, but that comes at a costs to the hospital's bottom line. Federal funding covers about 160 of those positions.

"There's no room to move," Glynn said. 'That's why we need to work with our state and federal government leaders."

Sparrow along with McLaren and other institutions are now pushing hard for new legislation at the state level that would provide loan repayment plans to physicians who are willing to work in rural areas--many of these individuals are now graduating with more than $160,000 in student loan debt.

Senate Bill 648, which is sponsored by Sen. John Moolenaar, R-Midland, would increase the maximum annual repayment benefit for a doctor from $25,000 to $40,000 and create a lifetime cap of $200,000.

The legislation has been passed out of the Senate and is now waiting on a vote in the House.

"The hope is once they're exposed (to a more rural setting) they'll stay in these areas long term," Glynn said.

But that takes time, and for doctors like Dr. Van Alstine who plan for retire in the next few years, time is running out.

We're talking about systematic changes that will really take 4-6 years or more years to implement," he said. "In the near-term there's going to be a real crisis of access."


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