James September-October 2024 web - Flipbook - Page 65
eorgia has a lot going
for it: a growing population, new industries and employers
and businesses attracted to the state
are putting down investments. Thanks
to sound fiscal management, we also
have a state surplus, putting the Peach
State in an enviable position.
However, Georgia’s healthcare
workforce must grow faster to match
these advancements. The fact that 40
states surpass Georgia in terms of physician workforce, with some specialties
like surgery being even more dire, is a
pressing issue that demands immediate
and urgent attention. Georgia’s active
physician numbers have not kept pace
with the state’s growing population,
painting a worrying and urgent picture
of Georgia’s healthcare system.
How often have you found yourself
struggling to secure a doctor’s appointment? Even after 13 years in healthcare, I still receive monthly (sometimes
weekly) calls from people desperate to
see a primary care physician, OBGYN,
neurologist, or another specialist. This
problem affects us all daily, causing
stress and uncertainty. The personal
effect of a statewide shortage of physicians on Georgians is profound and
cannot be overstated.
Why should Georgians have to
wait so long to get care? What is going
on? It’s time for Georgia to take immediate and decisive action to address
this pressing issue. The longer Georgia
waits, the more Georgians will suffer
from delayed care and increased stress.
Understanding that the solution
to a doctor shortage is more complex
than building more medical schools
is essential. Medical schools are only
part of training and retaining more
physicians. Georgia is a net exporter of
medical school graduates. (Every instate medical school, including Emory,
Medical College of Georgia, Mercer
and Morehouse, sees more MDs leave
the state for residency training than
stay in Georgia. (The only osteopathic
school, the Philadelphia College of
Osteopathic Medicine, also has more
DOs leaving the state than staying for
residency training in Georgia.)
Georgia can feel pride in students
who graduate and land residency
training slots in prestigious institutions like Johns Hopkins or Mayo. Still,
data from the American Association
of Medical Colleges show that once a
physician leaves Georgia for residency
training, there’s a less than 50 percent
chance they’ll return. If Georgia can
do a better job of keeping them in the
state to do undergraduate and graduate medical education (GME), that
“stick” rate goes to almost 75 percent.
Georgia has multiple ways to
immediately address the quantity
and quality of GME slots in the state,
including, among other things, 1)
changing the culture in our medical
schools that encourage MD graduates
to leave Georgia for GME training,
2) developing eight to ten funding
avenues, (mostly already available
matching federal dollars) to offset the
proposed additional funding for GME,
3) appointments by the state leadership (e.g., the governor and the House
and Senate), the University System of
Georgia, private medical schools and
our great Georgia hospitals to collaborate to structure new GME slots, 4)
providing housing, additional loan subsidies, contractual arrangements and
other enticements to keep Georgia’s
graduating physicians to complete
their GME (i.e., residencies) in Georgia.
To get physicians to stay in the state,
Georgia must immediately increase
the quantity and the quality of GME
offered. Rather than reinventing the
wheel, Georgia can look to other states
that have effectively tackled this issue
to see how they are growing their physician workforce with a much faster
per capita growth.
One excellent example is Florida.
In 2013, they had 13 percent fewer
medical residency positions per capita than Georgia. Florida had started
in the early 2000s by growing the
number of medical schools, but Florida
also found it needed to accompany
additional medical schools with GME
growth to accomplish its goal of more
physicians in the state.
A comparison of filled residency positions
In 2015, Florida began supplying
substantial startup grant funds for
GME programs. This, along with other
strategic funding mechanisms, mostly
from matching federal funds, led to
the significant expansion of residency
positions for Florida medical school
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