1. University of Arizona Health Sciences
Higher Education & Workforce Development Preparing Healthcare Practitioners
Michael Dake, MD
Senior Vice President
University of Arizona Health Sciences
August 22, 2019

2. Arizona’s Health Professional Shortage
UAHS is committed to partnering with the State to tackle Arizona’s health professional shortage.
Arizona faces alarming primary care physician and nurse practitioner shortage, especially in its rural areas
Areas in every Arizona county are federally designated as primary care Health Professional Shortage Areas (HPSAs)
Arizona needs 563 Primary Care Physicians (PCPs) to address the current shortage
Workforce projections by the Robert Graham Center indicate that Arizona will need an additional 1,941 PCPs by 2030
HPSAs are based on the following factors 1) Ratio of population residing in the area to the primary care physicians practicing in the area, 2) High poverty level, 3) Infant mortality rate, 4)Travel time to nearest care point
Sources
(Health Resources and Services Administration) (2018). Designated Health Professional Shortage Area Statistics As of December 31, 2018
Robert Graham Center. Arizona: Projecting Primary Care Physician Workforce.

3. Primary Care Physician Shortage Map
4.17
--- 16
1.14
--- 13
16.16
--- 18
2.81
--- 13
9.42
--- 17
4.57
--- 17
20-25
15-19
10-14
5-9
0-4
LEGEND
2.54
--- 14
214.07
--- 18
# of PCPs
Short
---
Highest
HPSA Score
0.65
--- 13
45.14
--- 18
63.99
--- 17
2.03
--- 18
108.17
--- 21
10.95
--- 21
Areas with higher HPSA scores experience a severe shortage
Source: Health Resources and Services Administration
6.11
--- 12

4. Arizona PCP Shortage Factors
Arizona’s PCPs are aging & retiring, especially those practicing in rural and underserved areas
25% of rural AZ PCPs plan to retire within five years 
Arizona’s population is growing rapidly
PCPs earn half what specialist physicians do
Yet, PCPs graduate with the same debt burden

5. Primary Care HPSA Scoring
HPSAs are a geographic area, population, or facility with a shortage of primary care, dental, or mental health providers and services. HPSAs are based on factors illustrated below.
Population-to-Provider Ratio
[10 points max]
% Population below 100% Federal Poverty Level (FPL)
[5 points max)
Infant Health Index (Infant Mortality Rate or Low Birth Weight)
[5 points max]
HPSA Score
0-25
Travel time to Nearest Source of Care (NSC)

6. AZ Primary Care Physician Shortage
Arizona
Meets just 42% of PCP need
Ranks 44th PCP 77.9 (US 91.7) per 100,000 population
Ranks #4 in pop growth
Dan Derksen, MD

7. Effects of the PCP Shortage
Areas with lower PCP-to-population ratios have:
Worse health outcomes at higher costs
More visits to emergency departments
Higher rates of preventable hospitalizations
Longer waits for routine appointments
Expectant mothers are more likely to face complications and increased maternal morbidity and mortality
Example: Without ready access to primary care, expectant mothers are more likely to face complications, maternal morbidity and mortality

8. Helping UAHS Address the PCP Shortage
SB 1364 (Appropriations; Medical School; Primary Care)
Covers education costs for medical students who commit to practicing primary care in an underserved rural community for up to three years
Recruits top Arizona students to our programs, trains them in areas of need, prioritizes them for AZ PCP residencies, supports PCPs in Arizona’s underserved areas
Fuels economic growth: one rural PCP generates 15 jobs
Grows Arizona’s rural field faculty that can mentor, precept, train and partner with other needed health providers who are crucial to the primary care workforce. (Nurse practitioners (NP), certified nurse midwives (CNM), and physician assistants (PA))
Thank bill Sponsors Sen. Carter, Sen. Leach, Sen. Brophy McGee  
We are excited and ready to work with the legislature to help design an impactful program. One that will make real strides to solve the shortage and can be used as a model throughout the nation.
Additional components to included in the program.
- Complete an approved state and/or federal certification program to effectively predict, diagnose and address substance abuse and addiction.
- Prioritize these medical student graduates for residency training programs with rotations and experiences in Arizona Medical Underserved Areas.
- Provide business training and assistance through a partnership with the Eller College of Management for the first three years of practice after residency.
Provide the waiver to second year students