Our state has a doctor shortage. A third of our people live in a federally designated primary care shortage area. More than 2 million Louisianians lack the access to specialist physicians enjoyed by people who live in wealthier states.
Louisiana’s physician shortage is probably going to get worse. More of our doctors (28 percent) are 60 or older than are under 40 (19 percent). Our three medical schools — LSU New Orleans, LSU Shreveport and Tulane — graduate about 450 doctors a year, but not all of them stay in Louisiana. (In 2012, 108 out of 171 graduates of LSU Medical School in New Orleans remained in Louisiana; for Tulane’s Class of 2012, it was 35 out of 177.)
Like the rest of America, our population is aging. By 2030, 20 percent of all Louisianians will be 65 or older, and most of them will need a doctor. The federal Affordable Care Act (Obamacare), which will insure many previously uninsured Americans, will push demand even higher. No wonder the Association of American Medical Colleges predicts our country will need 63,000 more physicians by 2015 (140,000 by 2025) than we are likely to have to serve America’s medical needs.
Other states are addressing their physician shortages. Twenty-nine new medical schools have opened in the last 20 years, including a major expansion in 2013 of the University of Mississippi College of Medicine. Louisiana still has time to catch up, but only if we act immediately by establishing a fourth medical school in our state.
Our politicians can fight over the turf later, but an appropriate location for that new medical school is Lafayette. Metropolitan Lafayette is one of the fastest-growing regions of our state, with a thriving, diversified economy, superb quality of life and an accomplished community of health care providers.
Lafayette General Medical Center, which is now a teaching hospital after taking over the state’s charity hospital (the University Medical Center), is the largest full-service, acute care medical center in Acadiana. Lafayette General could easily and efficiently support the new medical school, perhaps in conjunction with the new Our Lady of Lourdes Regional Medical Center, the Regional Medical Center of Acadiana and Women’s and Children’s Hospital.
There will, of course, be hurdles. For one thing, money is tight. The new medical school at Quinnipiac University in Connecticut, which opened in 2013, cost $100 million. I believe Louisiana could do it cheaper. Louisiana could save money on its new medical school’s physical plant needs by using some of the existing infrastructure in our charity system. Besides, once our new medical school is operational, a class of 100 students would generate $8.4 million a year in tuition for all classes in the four-year program.
A second hurdle will be obtaining new medical residencies. A medical school graduate cannot practice medicine in the U.S. until he has received on-the-job training as a resident under the supervision of a senior, fully licensed physician for three to five years, depending on the branch of medicine the resident chooses. There is a looming shortage of medical residencies. By 2020 the number of U.S. medical school graduates will exceed the number of residencies.
The good news is there are solutions. Bipartisan legislation is pending in Congress to create 15,000 new residencies over the next five years. Obamacare creates 600 new primary care residencies. Teaching hospitals currently pay for 10,000 residencies a year; Louisiana could ask its new private hospital partners to contribute. Commercial insurance companies, which will benefit handsomely from Obamacare, can be asked to help. States can also use Medicaid monies to fund residencies. It’s important to address the need for more medical residencies in Louisiana teaching hospitals, because 60 percent of physicians end up practicing within 100 miles of where they did their residency.
Louisiana needs more doctors, and we’re going to have to grow our own. In 2013, Louisiana’s three medical schools had 14,116 applicants for 493 spots. A new medical school in Lafayette is needed, and makes financial sense. If you want somebody to take care of you in 20 years, the training must start now.
John Kennedy is the state treasurer for Louisiana.