As medical schools and teaching hospitals proliferate in the various states, state government officials, academics, and healthcare executives ponder how to retain this physician talent (see: How states are keeping doctors from moving out). A recent article provided details about some of the answers. Below is an excerpt from it:
Widespread concerns about physician shortages have many states working to keep doctors trained in medical schools and residency programs there from crossing state lines to practice medicine....On average, only 39% of U.S. physicians practice in the same state where they went to medical school. Forty-eight percent practice in the state where they completed graduate medical education, said [a] report...by the AAMC Center for Workforce Studies. As a result, medical schools, hospitals, medical societies and state legislatures increasingly are taking a practical approach to retain the physicians and doctors-in-training they already have........Many states have responded [to physician shortages] by opening new medical schools or expanding existing ones. Several offer incentives such as bonuses, scholarships or loan repayment programs to keep physicians from leaving. Communities also are developing new residency programs in hopes that physicians will develop long-term professional and personal relationships during GME training that will tie them to the area....Recruitment and retention often go hand in hand. For example, many medical schools recruit students from the states in which they are located, with the idea that students are more likely to practice in their home state. But such efforts can be thwarted if there aren't enough GME positions for those students after graduation....
Ever wonder why there is a continuing stream of new medical schools being opening up across the country as well as an an expansion of GME residency and fellow slots in the state teaching hospitals? It's all about ensuring an adequate number of physicians for the state in future years with particular emphasis on physicians in specialty practice. As noted above, "forty-eight percent [of speciality trainees] practice in the state where they completed graduate medical education."
There is one other facet of this issue of physician recruitment not alluded to in the article. The majority of newly minted speciality physicians take jobs as hospitalists. These are hospital-based, hospital physicians as opposed to those who select private practice in the community. This trend is expected to continue unabated. It was described in a previous note (see: Hospitals Use Their Medical Schools, Residencies for Later Physician Recruitment). Here is a quote from this previous note:
I asked the dean of a major medical school recently about how the school and its teaching hospital were accommodating to this trend. He said that they were well positioned to recruit the most talented hospitalists in the future because they could observe their medical students and house officers over time and select the best of them for subsequent job offers. He added that this explains, in part, the impetus for hospitals across the country to launch medical schools and increase their numbers of post-graduate trainees: they are seeking the means to ensure an adequate supply of well-trained physicians in the future.
The hospital executives will increasingly be in the driver's seat regarding the future direction of healthcare in concert with governmental officials and health insurance executives. As hospitals expand their services, they want a dependable supply of highly qualified physicians to hire as hospitalists. The best way to guarantee this supply is through tight links to local and regional medical schools and post-graduate speciality training programs.
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