Thursday, January 19, 2006

The new doctor shortage - Michigan

The pipeline to produce physicians is so long, and the costs to students so great, that it is not at all surprising that we go through boom and bust cycles. In my career I've seen family practice cycle from startup to boom to bust. Unsurprisingly the cycle may be shifting again, though I wonder what role Michigan's economic and liability issues play in their pending shortage:
Crain's Detroit Business

... The Michigan Department of Community Health on Wednesday said it will create a data clearinghouse of medical professionals to help the state’s health care providers deal with a looming physician shortage.

According to a recent state survey, about 37 percent of Michigan’s physicians are 55 or older, and more than 38 percent of physicians say they plan to practice medicine for only one to 10 more years. A separate state study indicated that Michigan will need to fill more than 100,000 professional and health care jobs in the next decade.
Normal boom/bust cycles, atypical demographic cycles, and the possibly permanent decline in the appeal of primary care practice may conspire to make this coming shortage more severe than most.

The obvious approaches are to train more paramedical staff (NP and PAs), to encourage immigration of more physicians, to do more outsourcing of services overseas (radiology, dermatology, etc), and to move more care to 'disease management' programs. I am confident all these approaches will be tried and all will have a role. I also suspect that, within 10 years, we will reinvent the GP/FP/General Internist/Pediatrician once again -- though possibly under a different "brand".

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