The Wisconsin Hospital Association predicts that Wisconsin will have to add 100 new physicians a year in order to avoid a projected shortfall of 2,000 physicians by 2030.
The Wauwatosa-based Medical College of Wisconsin has begun a feasibility analysis of placing community-based medical school components in regions throughout the state.
“The issue is not unique for Wisconsin,” said Dr. John Raymond, president and chief executive officer of The Medical College of Wisconsin. “There is a national shortage of primary care providers. It’s been growing for a number of years.”
The development of the statewide community-based medical education program will help address the state’s impending physician shortage, Raymond said.
The project will be staged over a multi-year period with a goal of launching the first program as early as 2014 and no later than 2015.
Raymond and Medical College leaders have met with local government officials and leaders of 13 health care systems statewide to discuss the project. As the project progresses, the Medical College’s leadership expects to meet with leaders of health care systems, colleges and universities, technical colleges, and local government officials in the regions under consideration.
According to Raymond, the Medical College is looking in areas including: Green Bay, Fox River Valley, North Central Wisconsin, Northwest Wisconsin, Eau Claire, La Crosse, Janesville/Beloit, and Racine/Kenosha.
“Two important factors impact the success of the initiative,” said Raymond. “Local communities must be willing to work in partnership with the Medical College to support this program. Also, there must be the commitment of health care systems statewide to create new primary care residency training positions within their hospitals.”
The Medical College of Wisconsin has already received positive feedback from the communities they’ve conducted initial meetings in, Raymond said.
“We’ve identified plenty of enthusiastic and willing partners,” he said. “Next we’ll be looking for community health care systems and primary care practitioners, clinics or hospitals in the region to partner with.”
The physician shortage stems from a variety of different complex reasons, Raymond says.
“Medical students have a pretty significant debt burden after graduating,” Raymond said. “Students often times have families to take care of and specialty areas often have a higher compensation rate.”
Medicaid and Medicare reimbursement differences between primary care and specialty physicians has made the issue even more acute, Raymond said.
“Our goal is to do this in a responsible way,” Raymond said. “That’s why we’ve started with the feasibility study. We’re planning to focus on quality; starting with a small number of students.”
According to Raymond a successful expansion will need the support of local government and upfront support from philanthropy and businesses.
“Right now we’re doing a deep dive into exploring the Green Bay region,” Raymond said. “As I mentioned, we want to do this right. We don’t have the bandwidth to do a detailed expansion into all eight areas at once. And that’s ok. We’re looking to establish a successful model and develop a template for what works in one or two communities and then we can do the same analysis in other parts of the state.”
According to Raymond, the program will focus on preparing students for practice as primary care physicians and the curriculum would be based on an immersive model where students would live and learn in the communities where they would eventually complete residency training and begin their practice, he said.
In addition to setting up community-based sites throughout the state, the Medical College also plans to study the feasibility of conducting interdisciplinary education at the community-based sites in which courses offered to Medical College medical students would also include students in other health professions programs from other colleges and universities. This could include students preparing for careers in such fields as pharmacy, dentistry, physician assistants and nursing.
“We’re also going to explore the possibility of an accelerated MD program in primary care,” Raymond said. “The traditional medical curriculum is offered over a four-year period. The lifetime debt burden of students can be an obstacle for medical students choosing a career in primary care, a field in which compensation is lower than other medical specialties. A key goal of an accelerated program is to help reduce student debt.”
In addition to local health care systems, the Medical College will also seek partnerships with other colleges, universities, technical college systems, government and local businesses.
“The feasibility study will explore the use of existing tele-health education techniques and equipment,” Raymond said. “We don’t want to impose a financial burden on any of the communities we enter. We’re planning to use existing facilities at least to start with.”