Can Florida increase its physician workforce by giving advantages to Florida-educated physicians?

Physicians educated in Florida-based medical schools and graduate medical programs are more likely to stay in state to practice than those who graduated from out-of-state colleges and completed their graduate medical education (GME) in state residency programs, a new report shows.

On average between 2008 and 2015, 42% of physicians who graduated from out-of-state medical schools and came to Florida and started residencies ultimately stayed in the state to practice medicine, according to the report from the Office of Program Policy Analysis and Government Accountability (OPPAGA).

By contrast, 75% of physicians who graduated from one of the 10 Florida-based medical schools and completed their residencies in state chose to remain in the state and launch their practices.

A national report ranked Florida fifth best in the nation for retaining state educated and trained physicians. The national analysis ranks Hawaii No. 1, with that state retaining 87% of its state-educated and trained medical school graduates. California ranked No. 2, retaining 82% of its state-educated and trained physicians. Texas ranked third with an 81% retention rate.

The OPPAGA report was released as lawmakers look at ways in the 2024 Legislative Session to beef up the state’s health care workforce, which includes a broad array of providers ranging from physicians and nurses to home health aides and certified nurse aides.

Senate President Kathleen Passidomo has made girding the state against a future health care workforce shortage a top priority in the upcoming 2024 Session that begins Jan. 9.

To that end, the report recommends that lawmakers consider giving priority in match residency rankings, which the state helps to fund, to physicians who graduated from Florida-based medical schools.

Florida in 2022 was ranked 25th in the nation for active physicians per capita. Demand will increase due to population growth and an increase in elderly residents.

By 2035, a shortfall of 17,924 physicians is projected and physician supply is estimated to meet 77% of the projected demand.

In 2020, Florida had 273.9 active physicians per 100,000 population. In Fiscal Year 2021-22, Florida had only 1% more physicians per 100,000 population than the state had 11 years ago.

In addition to giving preferential state medical graduates preferential treatment for residency programs lawmakers also could direct the Florida Department of Health to find ways to increase recruitment for residencies and ways to retain those graduate residents.

The OPPAGA report also suggests that lawmakers can require health care facilities that receive state funds for their GME programs to report information about GME revenues and expenditures to the Agency for Health Care Administration.

The OPPAGA report was presented to members of the House Select Committee on Health Innovation on Monday. According to the analysis, which was directed by the Legislature, physicians leave Florida for a number of reasons following completion of their residency programs.

For instance, the facilities reported that 84% of the physicians chose not to stay in Florida following their residencies because they wanted to be closer to their families. Facilities also report that a lot of physicians (69%) want to continue their medical education outside of the state.

GME programs are an important component of training physicians to practice medicine. GME programs involve multiple entities and are administered by hospitals and federally qualified health centers and behavioral health centers.

In Fiscal Year 2021-22, approximately half of Florida’s GME was funded by Medicare dollars, which is federal funds only, and the other half by Medicaid, a combination of state and federal dollars.