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MMA Meets with State Health Care Workforce Commission

[MMA News Now, July 24, 2014] Jeremy Springer, M.D., chair of the MMA’s Primary Care Physician Workforce Expansion Advisory Task Force, appeared before the newly formed Legislative Health Care Workforce Commission on July 22 in St. Paul to discuss the looming primary care physician workforce shortage.

Springer presented an overview of the state’s primary care physician workforce shortage. He also included background on the MMA task force’s work and discussed its recommendations (scroll to the bottom of page for link to  PDF) for expanding Minnesota’s primary care physician workforce.  

This was the first meeting of the commission, whose members are charged with:
•    identifying current and anticipated health care workforce shortages by both provider type and geography
•    evaluating current and potential incentives currently available to develop, attract, and retain a highly skilled and diverse health care workforce
•    Identifying current causes and potential solutions to barriers related to the primary care workforce, including, but not limited to: training and residency shortages; disparities in income between primary care and other providers; and negative perceptions of primary care among students.

For more information on the group, visit their website

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2 comments on article "MMA Meets with State Health Care Workforce Commission"

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Jackson Thatcher MD

7/25/2014 6:35 AM

This is a great idea. Dr. Springer truly understands medical education from a 'front-line' position.

I expect he also knows its not just a numbers game. Providers are not just placeholders, they are caregivers who come to the table with varying levels of training and education. Indeed only 10% are AOA graduates, while 50% graduated in the bottom half of their class. Yet the system needs all of them, whether MD, DO, R-NP, PA-C, or pharmacist, even MOA, Clerk, and supply and housekeeping attendants, to get the job done.

The education process of physicians under the now not so new hours-restrictions continues hamper the duty of postgraduate medical education to release not only fully-trained, but also adequately-experienced young physicians into practice. Once in practice they may be on their own, or the number of patients who must be seen makes mentoring young physicians and learning the ropes of a new practice beyond what occurred in OP clinics or Rounds during Residency all the more difficult. This is further compounded by problems of an aging patient population, non-English speaking patients and providers for whom English is not their best language. The conundrum of meds, side effects, dangerous interactions and relative risks are daunting as is balancing what the patient wants from what they need e.g.giving them a pill and sending them out the door instead of having adequate time, first and taking the time, second, to insist they exercise more. Then running late during the next visit they may have to decide and educate the patient, spouse, and family, as to whether dad is most likely to succumb to a stroke if they don't give him a drug or if they do, will he have a fall on his own, or provoked by another meds' side effect, and/or be given other meds by other providers from a different EMR or who being too busy didn't re-ask whether he were taking contraindicated OTCs, which then results in life-threatening or fatal hemorrhage.

My 90 you father just went through that without me or his RN daughter at his side. My mother, a former RN, completely understood the issues and all agreed he should be put on apixiban 2.5 MG BID. I was contacted by my mother ands spoke to the excellent Cardiologist in Florida who made the recommendation and had taken my parents through the entire CHA2S2-VASc CVA AND HAS-BLED Fatal/Hemorrhage discussion. Dad, who doesn't fall, had just been found to have new, asymptomatic PAF lasting 2-4 hours on his pacemaker telemetry, but since they failed to bring his medication list, which my sister, unable to attend a pacemaker check visit, had prepared, and given them a copy and emailed to me the day prior, the specialist missed that he was taking aspirin

81 mg QD and diclofinac 75 mg BID. It IS just that easy to KILL an elderly patient. Fortunately, as soon as I mentioned the contraindication of aspirin and NSAIDS' with apixiban, my mother immediately got it, and said he would have to stop both those medications. Will his provider think to have him try 1000 MG acetaminophen BID if he complains of aches and pains? Will he tell me or my sister? Will his provider, or a covering colleague working from a small screen on a smart phone, put him on tramadol instead resulting in delerium, increased imbalance and a fall? Or might my 90 yo father and 82 yo mother simply forget and he start taking Aleve or Advil instead? Our patients [and parents] face those risks every day, but do we provide them all of the education and written guidance we can,? Do our nurses ask EVERY PATIENT who is taking an antithrombin about ASA and NSAIDs EVERY visit and insist on an accurate list or all the bottle brought from home and follow up to complete med rec if not?

It's not just having an workforce, but enough experienced physicians,to help all those mid levels and lesser experienced providers being used as surrogates know what they are to do when they are acting as our surrogate. It takes a lot of time to teach andlearn that and while you are swamped with an inexperienced nurse or PA, though interruptions you can make plenty of mistakes of your own . Surrogates without sufficient oversight because of the workload is a recipe for disaster. Counting on your surrogate to have cleared up the ASA NSAID issue doesn't work if they don't know you are about to prescribe an antithrombin. Busy providers have a lot of responsibility, yet they are only paid and barely given documentation time for the RVUs they generate and none for mentoring or oversight of others work. Most providers will tell you it is a lack of time and not pay that really drives their decisions to stay, move retire, or worse: just give up and push paper, numbed by the shear magnitude of the job. Fortunately most physicians don't choose that route, but unfortunately they suffer none the less and along with them their relationships and loved ones suffer to from a parent or spouse who has nothing left when they get home from the office.

Here's to better EMRs and especially the watchdog-processes to make sure human error does not harm our patients. And as always, the responsibility is left to the physician, who has increasingly less authority and less time to ensure his or hear patients' health

I wish Jeremy great success in this endeavor. We all need to learn more about and support this project. Our very profession depends on it.

Fondly, a lifelong mentor and student of the medical arts and sciences


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elena polukhin

7/27/2014 12:55 AM

Dr. Springer, are you going to address the FMG to enter MN practice and to get the license? If yes, I will be more than happy to help. I was working in Canada with Royal College of Physicians and Surgeons and we developed the special program for FMG to get the license with 1-2 years externship after passing licensing exams. This program is in force till now and helped Canada to resolve critical situation with primary care doctors, especially in immigrant communities and in rural areas. Similar program is developing in CA. I will be happy to help.

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