Health officials: Defunding training reduces physicians

Karen Bouffard
The Detroit News

Lansing – — Gov. Rick Snyder's plan to eliminate state funding to train new doctors would reduce the number of physicians in Michigan, raise health care costs and diminish health care quality in the state, according to testimony Tuesday before a House committee.

Faculty and physicians-in-training from some of Michigan's 57 teaching hospitals told the House Health Policy Committee about the role graduate medical education programs play in recruiting and retaining physicians in Michigan, saying about 60 percent of doctors remain in the community where they complete their residency training.

Dr. James Bicknell IV, president of the physician group practice at Midland-based MidMichigan Health, said graduate medical education programs are a pipeline for new doctors to serve Michigan's under-served rural communities. Affiliated with the University of Michigan Health System, MidMichigan Health has six resident physicians providing emergency room staffing at local hospitals within a 40-mile radius.

"We have a graduate of our program working within 30 miles of her graduation site at the tribal clinic in Mount Pleasant," Bicknell said. "These are all examples of practice locations that would struggle to recruit and retain physicians if we were not training them locally."

The Snyder administration defends its proposed budget cut.

"We needed to make some strategic decisions given the budget situation and opted to change the way this program is financed," said Dave Murray, a spokesman for Snyder. "Michigan is still strongly supporting graduate medical education, but we're proposing to do it through the hospital's Quality Assurance Assessment Programs financing. Even after these changes, Michigan remains in the top 10 nationally when it comes to funding Medicaid GME (graduate medical education)."

Dr. Suzanne White, chief medical officer and chief academic officer at the Detroit Medical Center, said resident physicians at the DMC's urban clinics serve hundreds of uninsured and low-income Medicaid patients in Detroit's neighborhoods. Many don't seek medical care until their illnesses are advanced and difficult to treat.

"To replace every resident at the DMC (with a non-resident doctor) would cost four times as much," White said.

Dr. Toronto Robinson, a DMC resident who grew up in Detroit, said he plans to stay in the community after he finishes his residency at a neighborhood clinic.

"Last year I saw a 55-year-old female who had never had a mammogram," Robinson said, adding as a result of coming into the clinic the woman discovered she had advanced breast cancer.

Graduate medical education programs provide residents who are crucial to the quality and quantity of care provided by hospitals, said Laura Wotruba, spokeswoman for the Michigan Health and Hospital Association. If residency programs were reduced, hospitals would struggle to make up for the loss.

"There's currently 7,200 medical residents in hospitals, and they are providing care to people," Wotruba said. "A lot of these residents, because of the nature of a teaching hospital, they're dealing with the sickest of the sick."