New med school aims to shrink doctor shortage

    Doctors are in high demand. By one estimate, the United States will be short about 150,000 physicians by the year 2025. If the stalled health bills in Congress ever manage to increase the number of Americans with health coverage, the demand for doctors could grow even more. WHYY looks at Pennsylvania’s approach to the workforce problem.

    Transcript
    Interactive: Doctors per 100K population
    Primary care doctors per 100K population

    Doctors are in high demand. By one estimate, the United States will be short about 150,000 physicians by the year 2025. If the stalled health bills in Congress ever manage to increase the number of Americans with health coverage, the demand for doctors could grow even more. WHYY looks at Pennsylvania’s approach to the workforce problem.

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    [audio:100216kgdoctors.mp3]

    This year The Commonwealth Medical College in Scranton opened its doors to its inaugural class.

    The school is in temporary quarters at Lackawanna College, but boasts some start of the art equipment. Robert D’Alessandri, the school’s president, picks up a life-like robot infant.

    Number of Physicians over age 60 (click to enlarge)
    Number of Physicians over age 60 (click to enlarge)
    D’Alessandri: This can be programmed to have an arrest. This is a baby…actually the baby’s breathing. Listen. Hear it?

    D’Alessandri: So you can acutally program this baby to have an arrest, a cardiac arrrest, whatever.

    Next year, the robot baby and the rest of the school will move down the road to a permanent home. Commonwealth is the first medical school to open in Pennsylvania in thirty years.

    D’Alessandri: A group of community people came together and were very concerned about physician workforce and they realized that every hospital, every practice was recruiting for physicians. And that within the next 10-15 years over half the doctors in the area were going to retire.

    D’Alessandri is pleased that 77 percent of the first class hails from Pennsylvania.

    D’Alessandri: Recruiting local people will increase the likelihood that they will stay in the state.

    Post-graduate training is an even bigger predictor of where a doctor will practice. The Commonwealth Medical College is also trying to establish regional residency programs. The hope is that students will stick around, and that they’ll choose to go into the most needy fields. One third of the doctor shortage estimated by the Association of American Medical Colleges is in primary care.

    Percentage of female physicians (click to enlarge)
    Percentage of female physicians (click to enlarge)
    The school immerses first-year students in primary care and family medicine. Janet Townsend, the college’s chair of family medicine and community health, doesn’t want the college to be typecast as solely a primary care educator.

    Townsend: But, we would consider ourselves not successful if we didn’t interest a significant number of our students to go in to primary care. Family medicine. General internal medicine. General pediatrics.

    Here’s the challenge in coaxing medical students into to choose primary care: money. Atul Grover is the chief advocacy officer for the Association of American Medical Colleges.

    Grover: Oftentimes people are making two times as much in a procedural sub-specialty as they are in a primary care specialty. And so that income differential is a huge driver in terms of people’s specialty choice.

    Another factor that complicates the workforce shortage is the rise of women in the profession. Less than a third of doctors are female. But half of the doctors in training are women. Grover says women doctors tend to work 10 percent fewer hours and to take longer leaves.

    Suzanne Steele is a family physician in Center City Philadelphia.

    Steele: …we have three treatment rooms. two small ones and one slightly larger…

    Female members of The American Academy of Family Physicians (click to enlarge)
    Female members of The American Academy of Family Physicians (click to enlarge)
    Steele recently opened up her own practice. As the mother of a toddler, she’s looking for more flexibility.

    Grens: Did you have to cut back your hours since you became a mom?

    Steele: Severely [laughs]. When I found out I was pregnant I increased my hours so that I’d be able to build up enough of a nest egg to provide for after I delivered.

    Steele says she went from about 50 hours a week to 20 after her daughter was born.

    So multiple factors are at play in the doctor shortage. That’s why Art Feldman, the chair of medicine at Thomas Jefferson University, doubts whether a new medical school really addresses Pennsylvania’s problem.

    Feldman: The reason why we don’t have enough physicians in Pennsylvania is not because we don’t train enough medical students. It’s because the vast majority of medical students that we train, over 90 percent, wind up practicing in another state.

    What Pennsylvania needs to retain its doctors, Feldman says, are more residency programs, fewer lawsuits and higher payments by insurers.

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