State grapples with physician shortage

With Florida’s population growing and an anticipated shortfall of nearly 18,000 physicians by 2035, a research arm of the Legislature is suggesting ways that lawmakers could increase retention of new doctors.

“Florida’s physician workforce is inadequate to meet projected demand,” according to a presentation given Monday by the Legislature’s Office of Program Policy Analysis and Government Accountability to members of the House Select Committee on Health Innovation.

Lawmakers heard that the issue could affect Floridians’ access to health care if current trends persist, as the supply of physicians could meet only 77% of the projected demand by 2035.

The office, known in state-government circles as OPPAGA, spent more than a year collecting data related to the state’s Graduate Medical Education program. The program involves health-care facilities that have agreements with “sponsoring institutions,” such as universities, to train residents after graduation from medical school.

The Graduate Medical Education program receives a mix of federal and state money. In the 2021-2022 fiscal year, 49% of the program’s $1.5 billion in funding came through the federal Medicare program and 51% came through the Medicaid program, which uses a combination of state and federal money.

But Florida has lagged in comparison to some other states in retaining doctors after they complete residency programs. Data presented to the House committee showed that in 2020, Florida ranked fifth among states by retaining 79%, or 6,211, of its graduates who completed both medical school and graduate medical education in the state.

Using the same criteria, OPPAGA found that California retained 82% of 26,902 graduates and Texas kept 81% of 22,286 graduates.

“They’re obviously holding and attracting a lot more students than Florida is, at the moment, to be able to have that many graduates,” Rep Ryan Chamberlin, R-Belleview, said of the other states during Monday’s meeting.

Wendy Scott, staff director for health and human services at OPPAGA, pointed to better retention rates for students who graduated from Florida medical schools and took part in residency programs in the state compared to students who went to out-of-state medical schools.

The data showed that between 2008 and 2015, 75% of Florida medical-school graduates who completed residency programs in the state elected to stay as physicians, compared to 42% of students who had come from medical schools outside of Florida.

Scott said health-care facilities reported multiple reasons for doctors leaving Florida after their residencies. Wanting to be closer to family, pursuing additional training outside Florida and simply wanting to live in other places were among the reasons.

Senate President Kathleen Passidomo, R-Naples, has made boosting the supply of doctors in Florida a priority for the 2024 legislative session, which will begin in January. Passidomo in a Nov. 9 memo to senators pointed to population estimates that project the state will grow by 300,000 residents a year over the next five years.

“The fact is, we will need more maternity rooms to welcome new Floridians to the family. We will need more services for our elders to live out their golden years safely and with dignity. We will need more primary care providers who play a vital role as the main point of contact in the health care system for families and seniors,” the Senate president wrote.

OPPAGA offered some recommendations, including incentivizing Florida medical schools to give priority to in-state students when matching graduates to healthcare facilities. In the meantime, Scott said more research is needed to identify why doctors leave the state after completing residencies.

“This could be an opportunity for Florida, but we need to know more about the reasons that they’re leaving. Is it because we don’t have what they want? Or because they’re seeking additional training just preferred in another state?” Scott said.

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