Beaumont's success fuels medical brain drain

You can’t swing a stethoscope at Beaumont Health System without hitting a resident.

More than 400 young doctors -- 429, to be exact -- are working as residents and fellows at hospitals in Royal Oak, Troy and Grosse Pointe, making Beaumont, until recently, the largest training hospital in the country without its own medical school, according to Jeffrey Devries, director of graduate medical education at the Southeast Michigan medical system.

Beaumont's status changed, though, when 50 fresh-faced medical students walked through the doors of the shiny new Oakland University William Beaumont School of Medicine last fall. Eventually, the school plans to graduate 125 doctors per year.

But despite co-founding a medical school, Beaumont isn’t likely to have any additional residents in its hallways.

The reason: money.

Beaumont is emblematic of the bottleneck stifling efforts to boost the number of physicians practicing in the Michigan. Sure, new medical schools are opening around the state, but residencies -- the post-school training required to practice medicine -- are not.

Residencies are funded by federal and state dollars, as part of the Medicaid and Medicare programs. But the federal cap on them hasn’t been raised since 1996, so many hospital systems such as Beaumont tap their own budgets to bring in additional residents above the number funded by the government.

“That came about because of the hospital’s commitment to being a premiere training institution, and a good way to staff our clinics and take care of patients we might otherwise not be able to take care of,” says Devries.

Budgets are tight at Michigan hospitals, though, thereby limiting the ability to self-fund more residencies. “At Beaumont, the number of Medicaid patients we’ve cared for in the past five years has doubled,” explains Devries. “That reimbursement is lower. Eventually, there will be hospitals that will not be able to expand or will actually reduce (their residencies).”

For now, there are enough residencies. But when Michigan’s new medical schools at Oakland, Central Michigan University and Western Michigan University are all operating at capacity, Michigan likely will be producing more medical school graduates than it has the room to train.

“We’re doing what we need to do in terms of increasing the physician supply at the beginning (of the education process), but if they don’t have residency positions here, they’ll go on to other states,” warns Devries.

What makes the residency location issue so salient for doctor access is what happens after the training is complete.

About 60 percent of doctors set up practice close to where they complete their residencies.

“We have a beautiful opportunity to capture another physician and we are losing that opportunity,” Devries said. “If someone graduates from here and they leave (because of a shortage of Michigan residencies), it represents a brain drain.”

Senior Writer Ron French joined Bridge in 2011 after having won more than 40 national and state journalism awards since he joined the Detroit News in 1995. French has a long track record of uncovering emerging issues and changing the public policy debate through his work. In 2006, he foretold the coming crisis in the auto industry in a special report detailing how worker health-care costs threatened to bankrupt General Motors.

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Wed, 06/13/2012 - 10:54am
I'm glad to read that medical schools are expanding instead of continuing the previous practice of just importing doctors from other countries for Michigan residencies. Many immigrant doctors' J-1 visa status requires them to serve in low-income areas for a required number of years. Are the shortages in residencies in part due to our import policy? It's always cheaper to hire doctors trained by another country than to train Americans.