The Key to Solving Wisconsin’s Physician Shortage May Be the “86 Percent Equation”

Mary Kay Grasmick, 608-274-1820, 575-7516

WCMEW report cover

MADISON (August 23, 2016) -----A new report from the Wisconsin Council on Medical Education and Workforce (WCMEW) warns that Wisconsin may face a shortage of more than 2,000 physicians by 2030, but the Wisconsin Hospital Association (WHA) says much is being done now to avert that forecasted deficit.

WHA President/CEO Eric Borgerding said his Association has focused its efforts on ensuring that as physicians graduate from medical school there is an opportunity for them to complete a medical residency in a Wisconsin community, and then establish practice there. The WHA 2011 Physician Workforce Report outlined how important medical residencies are to keeping physicians in Wisconsin.

“We know if a student growing up in Wisconsin attends a Wisconsin medical school and completes a residency here, there is an 86 percent chance that physicians who specialize in primary care will practice in Wisconsin,” he said. “We called it the ‘86 percent equation’ and we have been focusing on each of the components from a public policy perspective. It is a textbook example of identifying a problem, working with WHA members and physician leaders.”

On that front, WHA worked closely with the Walker Administration and the Wisconsin Legislature to create matching grant funding for new programs and to expand existing residency programs. Physician education is resource intensive, and while the state matching grants help defray some of the expenses, they do not cover all the costs associated with supporting a residency or a clinical rotation. In 2015, Wisconsin hospitals and health systems provided $177 million to fund physician medical education.

The programs are on track, according to Borgerding. By 2021, it is estimated Wisconsin will have 73 new medical residents as a result of the new WHA-backed program. The new residency positions have been focused on primary care, including general surgery and psychiatry, and rural medicine.

"We've struck the right path and it is shaping up to be a successful public-private model," said Borgerding. "As the WCMEW report shows, now we need to build on this 'grow our own' approach to make sure Wisconsin has enough caregivers for our future."

Wisconsin has also made significant progress expanding medical school class size at both the Medical College of Wisconsin (MCW), which has opened two new campuses, and the University of Wisconsin School of Medicine and Public Health (UWSMPH), which has gradually increased the class size of their program, the Wisconsin Academy of Rural Medicine (WARM) since its inception in 2007.

“We now increased our medical school capacity by about 50 physicians per year, but if these physicians are not able to match to a residency position in Wisconsin, and they leave the state to obtain their graduate education, we know it is much less likely they will return here to practice medicine,” according to Chuck Shabino, MD, WHA chief medical officer. “We know we can keep about 70 percent of the physicians regardless of where they grew up who attend Wisconsin medical school and complete an in-state residency. Where a physician completes a residency is the best predictor of where they will establish a practice.”

“The competition nationally to recruit physicians is fierce.”

Wisconsin is not the only state facing a physician shortage. Every state is working to increase its medical school capacity and add residency positions, in addition to recruiting established physicians from other states to their own.

“The competition nationally to recruit physicians is fierce. Wisconsin is consistently recognized for its high-quality, high-value health care, delivered by physicians and a team of medical professionals who set high standards for patient care, which makes us a target of sorts,” according to Shabino. “So when other states are scouting for physicians, it’s not surprising they look to Wisconsin.”

Shabino said Wisconsin must continue to focus on remaining competitive with other states by continuously monitoring the supply of and demand for physicians, while ensuring that the aspects of our state that attract physicians, such as a favorable medical malpractice environment are maintained. At the same time, work must continue in other areas to address physician burnout, offer a competitive and sustainable practice environment and minimize the regulatory burden.

“Wisconsin hospitals and health systems are leveraging technology, such as telemedicine, and using multi-disciplinary teams to deliver patient care to optimize their resources as they strive to make care as accessible and affordable as possible,” Borgerding said. “Great health care is one of the most important assets we have in our state, delivered by dedicated, highly-skilled professionals. We will work with our local stakeholders and elected officials to ensure that Wisconsin remains competitive with other states to recruit, and retain, our health care workforce.”

Read the WCMEW report here