State report on physician workforce shows pathway to better access to care

(Harrisburg, Pa. – April 20, 2015) A report on the physician workforce from the Pennsylvania Joint State Government Commission recommends six strategies to address projected future physician shortages, while also suggesting patient-centered medical homes and telemedicine care delivery models could help.

Issued on April 20, the six recommendations and other considerations are a step in the right direction, says Pennsylvania Medical Society president Karen Rizzo, MD.

“Pennsylvanians want access to the best educated, best trained health care professionals, and this report spells out how to grow our physician population,” Dr. Rizzo, a practicing otolaryngologist (ENT) from Lancaster.

The six recommendations include

1. Improve physician workforce data collection and analysis.
2. Establish a state pipeline program to prepare students for medical careers.
3. Encourage medical schools to implement programs aimed at increasing Pennsylvania’s physician supply.
4. Increase the number of residency positions in order to train more physicians in Pennsylvania.
5. Increase financial support for the Primary Health Care Practitioners Program within the Department of Health to make the Primary Care Loan Repayment Program a more appealing recruitment tool.
6. Ensure that Pennsylvania fully utilizes the tools available to recruit international medical graduates.
In addition, the report says the Advisory Committee that wrote the report supports the implementation of the patient-centered medical home and telemedicine care delivery models.

According to the report, there are 32,294 Pennsylvania physicians engaged in patient care with 10,916 practicing primary care.

But statistics about educating young physicians and then retaining them to practice full-time within the state appear to be a concern. The report says Pennsylvania ranks high in the number of future physicians it trains. There were 7,949 medical students during the 2012-’13 academic year taking classes at Pennsylvania medical schools, ranking the state 4th in the country for the number of medical students per 100,000 people.

In addition, as of December 31, 2011, there were 7,661 medical residents and fellows in accredited Pennsylvania programs, ranking the state 5th in the country per 100,000 people.

However, the report says Pennsylvania ranks 10th in the country for the number of patient care physicians and 18th for the number of primary care physicians.

“This is why many people believe Pennsylvania is a great exporter of physicians,” said Dr. Rizzo. “We need to do a better job of holding onto this young talent.”

Nationally, it’s believed that 66.6 percent of active physicians who completed medical educations and residencies in the same state practice in that state as well. Unfortunately, in Pennsylvania that percentage drops to 58.1 percent, ranking the state 34th.

“Clearly, home growing physicians is a proven winner to building physician populations across the nation, but Pennsylvania hasn’t done a good job of that despite being a major educator of future physicians,” says Dr. Rizzo, who is an example having completed both medical school and residency within the state. “The recommendations within the report should help improve this situation.”

Meanwhile, some lobby groups in Harrisburg claim nurse practitioners can fill the projected voids. However, national projections mentioned in the report show nurse practitioners will not be able to supplant projected physician shortages.

“This report is about growing the best trained, most educated providers, which are physicians,” says Dr. Rizzo. “Despite claims by the nurse practitioner public relations machine, they are not the answer to projected physician shortages. Nurse practitioners are valued members of health care teams, but they are not the leaders. And, the answer is to grow our physician population.”

The report from the Joint State Government Commission is available online at http://jsg.legis.state.pa.us/publications.cfm?JSPU_PUBLN_ID=411. It was developed by an Advisory Committee consisting of members from throughout the state and many different fields. State agencies, medical organizations, universities, training centers, health systems, and health insurance companies were represented on the committee. Both the Pennsylvania Medical Society and the Pennsylvania Psychiatric Society had representatives on the Advisory Committee. The Advisory Committee was established as a result of House Resolution 735 of the 2014 legislative session.

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