WASHINGTON – While a national nursing shortage has been well-documented, there’s also another looming health care crisis that’s less well known – the expected shortage of doctors in Minnesota and across most of the United States.
Dr. Randy Rice, a family medicine specialist in Moose Lake and the president of the Minnesota Medical Association (MMA), counts himself among the doctors who are considering an earlier retirement.
He said increasing red tape from health insurers, stress from the COVID-19 pandemic and the consolidations of medical practices have resulted in burnout and a loss of autonomy that is prompting doctors to leave their practices.
“It’s certainly a lot different now than it was when I started practice,” said Rice, 61.
The American Medical Association says the United States faces a projected shortage of between 37,800 and 124,000 physicians within 12 years. The impact of “medicine’s great resignation” will be felt soon, according to a study by the Mayo Clinic. It surveyed 20,000 respondents at 124 institutions across the country and found that one in five physicians plan to leave medicine altogether and one in three doctors plan to reduce their work hours.
“As a rural family physician, I have witnessed dimensions of burnout, including emotional exhaustion, depersonalization, and loss of personal accomplishment, up close – with my coworkers and in the mirror each morning,” Rice wrote in an opinion piece for the MMA newsletter.
He told MinnPost that many physicians have lost their drive to work long hours and make other sacrifices.
“A lot of them are feeling like they are punching the clock,” Rice said.
Even before the pandemic, health workers were experiencing high levels of burnout and Rice had begun to consider moving up his retirement date.
While many physicians who plan to leave their practice are older, many are far from retirement age, Rice said.
Minnesota is fortunate that it has more doctors per population than most other states. According to analysis of Bureau of Labor statistics and information from the Health Resources and Service Administration, Sterling Price of Value Penguin determined that Minnesota has more physicians per population than most other states. Only South Dakota and Massachusetts have more doctors per capita.
According to Sterling, Minnesota has nearly 34 physicians per 1,000 residents. But these doctors are heavily concentrated in certain towns, urban neighborhoods and suburban areas of the state. And the medical resignation will affect all of Minnesota as well as the rest of the nation.
“It will be harder for people to get appointments, harder for people to get the care they need and force people to drive longer to their appointments,” Rice said.
But Rice said doctor shortages will be felt most acutely in rural areas, like the one he serves in Moose Lake.
“One out of every three rural physicians report planning to leave their profession within the next five years,” said a recent report on health care workplace shortages by the Minnesota Department of Public Health.
Lower-income urban neighborhoods, which are already medically underserved, will also face shortages, Rice said.
The types of doctors who will be the most scarce will likely be primary physicians and those that treat mental illnesses.
Sterling predicted Minnesota will suffer a 34% shortage of primary care physicians. And the MDH report said the largest vacancies right now are in the areas of mental health and substance abuse care “where one in four jobs is currently vacant and open for hire.”
In fact, the Minnesota Department of Public Health said that already “providers are seeing workforce shortages across Minnesota.”
The MDH study cited several recommendations to stem the draining of health care professionals in the state, including implementation of a school loan forgiveness program for health care providers and pressing hospitals and other employers to make health care jobs “safe, flexible, well-paid and family friendly.”
Other solutions include establishing “rural clinical training tracks” to create a pipeline of primary care physicians and psychiatrists trained in greater Minnesota and new funding for mental health providers to pay for the supervised training they are required to complete before becoming licensed to practice.
Meanwhile, according to the American Association of Medical Colleges (AAMC), enrollment in the nation’s medical schools has crept up, but by just a few percentage points, over the past few years. The AAMC said graduate school enrollment stood at 95,475 for the 2021 -2022 school year.
In Minnesota graduate medical school enrollment was almost flat with a combined total of about 1,500 students at the University of Minnesota and the Mayo Clinic Alix School of Medicine in the past two school years.