Report: Nurse staffing improving throughout Minnesota, but physician shortages remain

CATHY WURZER: Data out today about Minnesota's medical workforce shows that the nurse staffing levels are improving, but it's getting tough to find doctors. The report from the Minnesota Hospital Association finds the vacancy rate for physician jobs increased from nearly 12% to almost 15% this past year. There are some explanations for the problem, including the ripple effects of the pandemic. Here to help explain the issue and potential solutions is Dr. Laurel Ries, president of the Minnesota Medical Association. Dr. Ries, welcome.

LAUREL RIES: Hi, Cathy. Thank you so much for having me. And also thanks for discussing this really important issue that affects all minnesotans.

CATHY WURZER: Thanks for bringing that up in terms of affecting all of Minnesota, because, gosh, it seems as though we've been hearing about a physician shortage in rural areas for quite some time. This feels like it's across the board, urban and rural.

LAUREL RIES: We're expecting about 1 in 5 Minnesota physicians to retire in the next five years, or just leave practice. But a really significant loss of physicians over the next five years. And the reason is multifactorial, but a big factor driving it is the aging physician population in Minnesota. Many of our physicians are just going to be retiring and it comes at a time when our Minnesota population is also aging and our baby boomers are going to be hitting some of the most health care intensive years of their life.

CATHY WURZER: How did the pandemic fit into all this? Obviously, this was a time that led to a lot of burnout, people exiting the profession. Did physicians look at this and say, well, I'm pretty close to retirement, I'm getting out now?

LAUREL RIES: I think that the pandemic definitely played a part. It changed the culture of medicine. It made it so that it was less rewarding to practice medicine instead of being able to keep people healthy and treat disease. We're doing a lot of conversations about evidence-based care and what really is the best way to treat conditions and prevent conditions now. So that's driven part of it, but a lot of it is also just due to the age of our workforce.

And a physician takes a long time to train. And so we're looking at needing about over 1,000 new physicians by 2030, which is a 28% increase compared to our current workforce. So a really big need that we're not going to be able to meet. So we're going to be looking at a pretty big gap in the amount of available physicians in Minnesota.

CATHY WURZER: And when you talk to young people, what's your pitch for them to become physicians? When they look at the current landscape of our health care system, and we're looking at shortages, a lot of work. It's expensive to become a physician. What's your pitch to these young folks?

LAUREL RIES: Well, I can speak from my own personal experience. I'm a farm kid from rural Wisconsin, and my family doctor told me that I would never be bored if I became a physician. And she was absolutely right. It is the most delightful job that you can have. It's rewarding in so many different ways. It's hard work, but it's good work.

You are entrusted with people's health and you get the privilege of being able to walk with them through good times and bad times and really help them be their best selves. So I would definitely 100% do it again if I had to do it all over just because of how wonderful of a career it's been for me despite the many challenges that physicians encounter.

CATHY WURZER: There's a loan forgiveness program on the state level that makes it more affordable for students to get in-- to get into nursing. Are there similar supports for prospective physicians?

LAUREL RIES: There are a variety of different loan forgiveness programs available, but the more that we can do in terms of making medical school more affordable, the better. Right now the cost for a medical school education are really tremendous and a big barrier to people wanting to practice, especially for people wanting to go into primary care fields, which are ones that have smaller salaries compared to some of the specialty fields.

CATHY WURZER: I'm wondering, as you were talking about the shortage, and it's getting worse as more physicians are retiring, and it's, as you say, it takes a while to get new doctors into the pipeline because it just takes so long in terms of the education part of this. As we see this decrease in working medical doctors, will we see an increase then with nurse practitioners, physicians assistants, those sorts of individuals in the health care system who can step in?

LAUREL RIES: I think it's a combination of things. I think that the ideal is a team-based approach with physicians leading and then using a whole team to the peak of their abilities to be able to provide best care for patients with what we have available. There have been studies that have shown that APPs, without having that team perspective, can be more costly and lead to decreased quality of care compared to physician-based care. So we really recommend that you use a team approach with a physician on the team and then APPs.

But what we've noticed is that they don't fill gaps in shortage areas because they also want to practice in the same areas as physicians. So we really especially need to put our efforts into our primary care shortage areas. And in Minnesota, that's our rural communities where we're expecting 1 in 3 physicians to leave practice within the next five years. So even more significant than our other areas.

CATHY WURZER: How helpful, then, is it with the new medical school that will be launched with Centracare in Saint Cloud and the University of Minnesota?

LAUREL RIES: I think it's going to be a really good improvement. So every physician counts as we get more people to build our workforce. And one of the things that we know is that one of the best ways to get physicians into rural communities is to grow our own. If people come from rural communities, they have connections in those communities. They know what it means to live in a rural community.

I'm a farm kid personally and I love rural communities. I think that they are an amazing place to live and work. And so knowing that and having that perspective makes a great difference in where you're going to practice. So that Saint Cloud campus is really exciting for us in Minnesota, as is our Duluth campus, which helps us to get more physicians into our rural communities.

CATHY WURZER: So final question here, Dr. Ries. As we see this widening gap as more physicians are retiring, but as the attempts are made to get more new physicians into the pipeline, what's a patient to do when you hear this news? What does a patient to make of all of this?

LAUREL RIES: Yeah, so our access to care is going to be different than it has been in the past. And what I've talked to my own family members about is trying to really be proactive with health care. So if you think you have a problem that's going to need to get addressed, know that it's going to take longer to get an appointment, for example.

So schedule an appointment as soon as you think you need it. If you don't need that appointment later on, cancel it so somebody else can get that appointment. But as much as possible, really emphasizing that proactive, trying to get things done earlier rather than later, so that the problems are smaller, easier to take care of, and also so that you can get the access that you need.

CATHY WURZER: All right. Dr. Ries, I appreciate your time. I know you're busy. Thank you so much.

LAUREL RIES: Thank you so much, Cathy. Have a great day.

CATHY WURZER: You too. Dr. Laurel Ries is the president of the Minnesota Medical Association.