1. The Michigan Primary Care Consortium March 2010 Declining Primary Care Workforce

2. 2 National MD Experience

3. Number of Residents 2000 to 2005 * Combined Primary Care/Specialty Residents, e.g. FM/ER, are Counted as a.5 FTE, all FM & IM Emphasis and Track Interns are Included in these Numbers as well as MDs who participate in SCS programs. Traditional interns are not included. 200020012002200320042005 0 200 400 600 800 Primary Care Non-Primary Care Primary Care367.5318.5281.5289.5261.5276 Non-Primary Care499.5493.5530.5593.5629.5703 3 Michigan DO Experience

4. Ideal: 50% Primary Care Physicians (Pew Commission Report on Health Care Workforce) Michigan: 34% Primary Care Physicians, of which 38% will retire within ten years (MDCH Survey of Physicians 2005) 4 Michigan’s Primary Care Status

5. $150,000 - $200,000 Debt Three Years GME @ $40-45,000/Year Take Your Choice! Starting Salaries: Family Practice$120,000 - $150, 000 Internal Medicine$120,000 - $175,000 Pediatrics$110,000 - $125,000 Orthopedic Surgery $250,000 - $400,000 Cardiology$250,000 - $400,00 (Medical Opportunities in Michigan 2006 Data) 5 Medical School Perspective

6. YearInflationMedicaidMedicareBCBSM 20053.39-2% (-4% for 6 months) 1.5%2% 20042.6801.5%2% 20032.2701.4%2% 20021.5911%*-4.8%2% 20012.8305.0%2% 20003.3805.5%1.5% 19992.1902.3%1.6% (2% for 8 months) 19981.5502.3%.8% 19972.340.6%2.4% 19962.930.8%2% Totals25.1%9%16.1%18.3% *Medicaid HMOs received an 11% increase for physician services. The amount that flowed to physicians is unknown. 6 How does Michigan’s reimbursement compare to inflation?

7. FIN Per Capita Health Care Expenditures Primary Care Score 7 Primary Care Score vs. Health Care Expenditures, 1997

8. More Primary Care Physicians / 100,000 Lower Cost Higher Quality (2003 Medicare Data on “General Practitioners”) 8 Primary Care is the Foundation of the Health Care System

9. Contributors to Health 9