1

LOUISIANA PHYSICIAN WORKFORCE

4/29/16

Who Are The Experts and What Do They Say?

FACT: Recent study projected TOTAL PHYSICIAN shortfall of

between 61,700 and 94,700 by 2025

Projected shortfalls in primary care range between 14,900 and 35,600

physicians by 2025.

Projected shortfalls in non-primary care specialties range between 37,400

and 60,300 by 2025.

Authors Conclusion – the organization representing medical

schools says there is a shortage

The IOM, written by a 21-member committee co-chaired by

former CMS administrators Dr. Donald Berwick and Gail

Wilensky, says shortages are created by poor geographic

distribution of physicians and lopsided ratios of primary care and

specialty physicians and that recent research suggests the

answers lie in new technology and innovations in healthcare

delivery.

Speaker’s Conclusion: there is no shortage, just a maldistribution

5

Source: AMA Physician Characteristics & Distribution, Division of Survey & Data Resources, American Medical Association.1980 to 2015

Excludes Current Residents.

0

50

100

150

200

250

80 81 82 83 85 86 89 90 91 94 95 96 97 99 2000 01 02 03 04 05 06 07 08 09 10 11 12 13

PhysiciansPer

100kpopln

Year

Louisiana US

94.2

89.6

84.8 84.682.9

78.4 77.6 77.576.1 75.9 75.3

72.870.1

63.4

0

10

20

30

40

50

60

70

80

90

100

110

WV VA FL TN NC LA KY SC GA AR OK AL TX MS

RatePer

100kPop..

Northeast region states = 108.1 per 100,000 population

Western region states = 99 per 100,000 population

Central region states= 92 per 100,000 population

US Average = 90.1 per 100,000 population

Health Professional Shortage Areas Overwhelming majority of our state is classified as Primary

Care & Mental HPSA’s

Number of Physicians Needed to Catch up with US Average ( Red Bars)

& Physicians More than US Average ( Blue Bar) (OFFICE BASED + PHYSICIAN STAFF)

897170

5649

4541

3230

1610

30

-5-5-6-6-7

-13-13

-17-38

-75-94

-238

OtorhinolaryngologyMedicine/PediatricsObstetrics & GynecologyEmergency MedicineSurgeryOrthopedicsUrologyOphthalmologyNeurosurgeryDermatologyOral SurgeryPediatricsSurgery-VascularPhysical Medicine & RehabChild NeurologySurgery-Vascular Surgery-ResidencyPathologyRadiologyFamily MedicineNeurologyPlastic SurgeryChild PsychiatryAnesthesiologyPsychiatryMedicine

1. Data Includes Physicians in OFFICE BASED PRACTICE & PHYSICIAN STAFF (Current Trainees are excluded). Data includes Primary practicing Specialty ONLY

2. Data includes physicians with office address as Louisiana and in case the office address was missing, the state from the preferred mailing address was used.

Source: LA AMA Physician Masterfile, 2003-2014.

3. Data Source for US : 2015 AMA Physician Characteristics & Distribution in the US.

Number of Physicians Needed to Catch up with US Average ( Red Bars)

& Physicians More than US Average ( Blue Bar) (OFFICE BASED + PHYSICIAN STAFF)

1. Data Includes Physicians in OFFICE BASED PRACTICE & PHYSICIAN STAFF (Current Trainees are excluded). Data includes Primary practicing Specialty ONLY

2. Data includes physicians with office address as Louisiana and in case the office address was missing, the state from the preferred mailing address was used.

Source: LA AMA Physician Masterfile, 2003-2014.

3. Data Source for US : 2015 AMA Physician Characteristics & Distribution in the US.

2020

18999

86

54444

333

2222111111

00

-1.0-1.0-1.0

-2.0-2.0-2.0

-3.0-4.0-4.0-4.0

-6.0-7.0-7.0

-8.0-9.0

-10.0-10.0

-12.0-27.0

Medicine Card InterventionalMedicine-CardiologyMedicine NephrologyPathology CytopathologyAnesthesiology- Adult CardiothoracicPsychiatry ForensicSurgery Colon & Rectal SurgeryInternal Md/Emergency MdMedicine Pulmonary/Critical CarePMR- Pain MedicinePediatrics-NeonatologyMedicine GastroenterologyEM- HyperbaricsMedicine RheumatologyOrthopedics Sports MedicineOrthopaedics-PediatricAnesthesiology- ObstetricsMedicine-DermatologyPediatrics-Allergy & immunologyUrology-Female Pelvic Reconstruction FellowshipPain MxSurgery-Trauma CriticalPathology DermatopathologyPediatrics-CardiologyPlastic Surgery- IntegratedMedicine Allergy & ImmunologyPathology- Pediatric FellowshipPsychosomatic MedicineOtorhinolaryngology- NeurotologyPediatrics-GastroenterologyPediatrics-NephrologyPediatrics-EndocrinolgyPediatrics- Infectious DiseasesMedicine OncologyMedicine Sleep MedicinePathology HematopathologyAnesthesiology Pain ManagementMedicine ElectrophysiologyMedicine Infectious DiseasesMedicine Critical CareFamily Medicine- GeriatricsPediatrics-Hematology/OncologyFamily Medicine- Sports MedicinePediatrics- Emergency MedicineMedicine EndocrineMedicine Hematology/OncologyMedicine- Geriatrics

INCREASING DEMAND FOR HEALTHCARE SERVICES

Population increases & increases in life expectancy

Baby Boomers aging:

Number of people turning 65 is expected to double by

2030

Demand for primary and specialty healthcare services

doubles for Medicare patients

Also affects the supply of healthcare professionals

Increases in the number of individuals with health

coverage

Technological advances and treatment options

1. Physicians in Direct Patient Care are those with self- designated primary type of practice as Direct Patient Care. ( Residents are excluded).

2. Data includes physicians with office address as Louisiana and in case the office address was missing, the state from the preferred mailing address was used.

Source: LA AMA Physician Masterfile, 2003-2014.

0

500

1,000

1,500

2,000

2,500

3,000

34 Years and Younger 35 to 44 Years 45 to 54 Years 55 to 64 Years 65 Years and Older

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

+10%

+2%

-9%

+47%

+43%

+12%

+19%

+11%

+14%

+3%

+53%

34 Years andYounger

35 to 44 Years 45 to 54 Years 55 to 64 Years 65 Years andOlder

Urban Rural PCP Non PCP Male Female

AGE GROUP PRACTICELOCATION

PRACTICETYPE

GENDER

% Change between 2003 & 2014 in Louisiana Direct Patient Care Physicians

1. Physicians in Direct Patient Care are those with self- designated primary type of practice as Direct Patient Care. ( Residents are excluded).

2. Data includes physicians with office address as Louisiana and in case the office address was missing, the state from the preferred mailing address was used.

3. . Primary Care = Self- Designated Primary Practicing Specialty as Family Medicine, General Practice, Internal Medicine, Pediatrics & Med Peds ( Sub Specialties are excluded)

Source: LA AMA Physician Masterfile, 2003-2014.

“The highest growth

occupation will be the

medical field. The aging of

the baby boom generation

will necessitate more

people working to care for

this segment of the

population. This is

supported by noting that

three of the top four

growth occupations are

expected to be from the

health care industry.”

2011-2012 Louisiana Workforce

Information Review

Louisiana Workforce Commission

16

0 20,000 40,000 60,000

Mining

Construction

Wholesale Trade

Transportation and Warehousing

Finance and Insurance

Professional, Scientific, and…

Administrative and Waste Services

Health Care and Social Assistance

Accommodation and Food Services

Government

2020 Louisiana Industry Projections

8 out of 10 of the highest paid occupations in the

state are in the Healthcare Industry.

Healthcare employment is less sensitive to

economic downturns to other industry sectors

like manufacturing and construction.

The average annual impact of an office based

physician is $2.2 million.

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In-State Matriculation to Medical School 2012-2013

19

Of all LA students

gaining admission

to Medical Schools

across the country,

LA ranks 1st with

91% of students

choosing to remain

in Louisiana for

Medical School

LA Rank: 1st

LA = 91%

State Median= 69.2%

Physicians Retained from PUBLIC

Undergraduate Medical Education 2014

LA = 54.1%

LA Rank: 5th

State Median: 43.8%

Match 2016

HSC-NO consistently leads the state

in both the number and percent of

Medical Graduates that remain in

state for residency training

100% of the 207 positions matched

Matched in State: 51%

• LSUHSC-NO Program 71%

Matched in Primary Care 57%

21

Historical Match Data

22

Source: Annual Report of the Medical Education Commission ( MEC) Reports

1,574 1,594 1,589 1,616 1,603 1,600 1,604 1,598 1,624

1,434 1,453

1,6611,740

1,7861,862 1,827

1,900

216 219 215 249 249 245 254 264 282226 236

284 305 336 358 338 347

1,790 1,813 1,8041,865 1,852 1,845 1,858 1,861

1,906

1,660 1,689

1,946

2,0442,107

2,196 2,1652,246

670720 729 761 750 730 726 726 713 680 689

799 821868

908 878930

1997 1998 1999 2000 2001 2002 2003 2004 2005 2007 2008 2009 2010 2011 2012 2013 2014

Residents Fellows Total Residents & Fellows Primary Care

24

EFFORTS TO MITIGATE PRIMARY CARE SHORTAGES

Rural Track Program

Rural Residency Program

Increased class size of

Nurse Practitioner program

to over 100 students

Nurse Practitioner run clinic

Physician Assistant Program

Multidisciplinary Primary Care

Dental and Medical Clinic

73%

Percentage of Rural Track Graduates Practicing in a Rural Area

Medical School & Resident

Enrollments have

increased

Programs targeting

Primary Care have

increased

Public Medical School

Retention of Medical

Students and Residents is

amongst the top in the

Country

Shortages exist in Primary

and Specialty Care

Projections indicate

increased demand for

Primary Care

Continued support for

Medical Schools is critical

if we are to have the

requisite number of

healthcare providers to

care for our citizens 26

Summary