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The Michigan Primary Care Consortium
March 2010
Declining Primary Care Workforce
2
National MD Experience
Number of Residents 2000 to 2005
*Combined Primary Care/Specialty Residents, e.g. FM/ER, are Counted as a .5 FTE, all FM & IM Emphasis and Track Interns are Included in these Numbers as well as MDs who participate in SCS programs. Traditional interns are not included.
2000 2001 2002 2003 2004 20050
200
400
600
800
Primary Care
Non-Primary Care
Primary Care 367.5 318.5 281.5 289.5 261.5 276
Non-Primary Care 499.5 493.5 530.5 593.5 629.5 703
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Michigan DO Experience
Ideal: 50% Primary Care Physicians (Pew Commission Report on Health Care Workforce)
Michigan: 34% Primary Care Physicians, of which 38% will retire within ten years(MDCH Survey of Physicians 2005)
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Michigan’s Primary Care Status
• $150,000 - $200,000 Debt
• Three Years GME @ $40-45,000/Year
Take Your Choice!
Starting Salaries:
Family Practice $120,000 - $150, 000
Internal Medicine $120,000 - $175,000
Pediatrics $110,000 - $125,000
Orthopedic Surgery $250,000 - $400,000
Cardiology $250,000 - $400,00
(Medical Opportunities in Michigan 2006 Data) 5
Medical School Perspective
Year Inflation Medicaid Medicare
BCBSM
2005 3.39 -2% (-4% for 6 months)
1.5% 2%
2004 2.68 0 1.5% 2%
2003 2.27 0 1.4% 2%
2002 1.59 11%* -4.8% 2%
2001 2.83 0 5.0% 2%
2000 3.38 0 5.5% 1.5%
1999 2.19 0 2.3% 1.6% (2% for 8 months)
1998 1.55 0 2.3% .8%
1997 2.34 0 .6% 2.4%
1996 2.93 0 .8% 2%
Totals 25.1% 9% 16.1% 18.3%*Medicaid HMOs received an 11% increase for physician services. The amount that flowed to physicians is unknown.
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How does Michigan’s reimbursement compare to inflation?
FIN
Per Capita Health Care Expenditures
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Primary Care Score vs. Health Care Expenditures,
1997
More Primary Care Physicians / 100,000
•Lower Cost
•Higher Quality
(2003 Medicare Data on “General Practitioners”)
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Primary Care is the Foundation of the Health
Care System
Contributors to Health
9
