VALPARAISO — The United States, state of Indiana and the Region are all facing a shortage of physicians.
State and local officials say they have a remedy: medical residencies, the post-graduate training doctors must do before they can become licensed to practice. Currently, much of Indiana lacks slots for medical residents, causing doctors to leave the state for training.
"Northwest Indiana does not have a residency program," said Beth Wrobel, CEO of Valparaiso-based HealthLinc and member of the state Graduate Medical Education Board.
That board met this week at HealthLinc to discuss efforts to increase medical residencies in the state and Region. Representatives of Northwest Indiana hospitals and community health centers were on hand.
In Northwest Indiana, East Chicago, Gary and North Township already have shortages of primary care providers, per the U.S. Department of Health and Human Services, while Gary and the low-income population of north Lake County lack mental health professionals.
In response, a group of Region hospitals and community health centers have formed a consortium to host medical residents. The partnership could support as many as 165 residents in such specialties as OB-GYN, psychiatry, general surgery and family, internal and emergency medicine, starting as soon as 2019.
The group received a $75,000 grant from the state to study the feasibility of the program. The state still has $7 million in funding available for residency programs.
Residents boost economies
The state of Indiana will need an additional 817 primary care physicians by the year 2030 to meet the demand created by population growth, the aging population and the increase in the insured rate under the Affordable Care Act, according to a report from the Robert Graham Center.
Indiana currently ranks 38th in the nation in active physicians, the Association of American Medical Colleges found. Nationally, the shortage of primary care doctors could reach 43,100 by 2030, according to the association, while the dearth of specialists could exceed that number.
The state Graduate Medical Education Board was formed in 2015 to address this issue. The group provides funding for residency programs, program expansion and residents who aren't federally funded, as well as technical support for new residency programs.
Angie Vincent, a project director for Tripp Umbach, a health care consultancy firm that assists the board, said these programs can benefit the health and economy of a given area.
"You are having students and residents living in your community. You have to provide housing to them. They may live here, start a family here," she said.
She noted that each physician who establishes a practice in a state generates $2.2 million in economic impact, including $300,000 in regional tax revenue, and creates an average of 14 jobs. A resident who opens a practice in an underserved area creates $3.6 million in health care utilization savings, she said, as patients who regularly visit their primary care doctor avoid costly emergency room visits.
Physicians are likely to stay and practice in the area where they did their residencies, Vincent said.
"You want to get someone from here, who goes to K-12, undergraduate and medical school here. Then they end up doing a residency here," she said. "You have a 70 percent chance they're likely to practice here. They're connected here. They have families."
'It's important to grow our own'
Vincent said hospitals often spend tens to hundreds of thousands of dollars recruiting doctors from out of state, only to see them leave for new jobs after a few years.
"It's important to grow our own," Wrobel said.
Vincent said hospitals that host residents are considered teaching hospitals, giving them increased cachet among the public. She said residents also improve health care overall at a facility by engaging the doctors who train them.
She and Wrobel noted that the least healthy parts of the state, according to the County Health Rankings, are the ones without residency programs. Northwest Indiana is among them.
The catch with all this is that residency slots require federal funding.
"We're in an environment where the federal government is broke," said state Rep. Tim Brown, R-Crawfordsville, who authored the bill to expand residencies in Indiana. He also noted that medical residents don't help reduce health care costs.
"There is a downside to graduate medical education: It is expensive. Residents order more tests, work slower, don't see as many patients," he said.
The funding issue is why, the board members say, health care entities must garner the backing of the public and legislators.
"The federal government won't fund all of these," Vicent said. "It's going to take community support to keep these programs going."