Every year, medical schools in Arkansas graduate about 430 physicians. However, there are only about 375 entry-level physician residency positions available each year. Now, contrast that with the fact that more than 1 million Arkansans live in federally designated health professional shortage areas, so there is a need for more of those new doctors without residencies to stay in the state.
This is all included in a new report, "Growing the Physician Workforce in Arkansas: A Statewide GME Strategy." The report coincides with the institute's launch of a new Graduate Medical Education Technical Assistance Center to help narrow those medical gaps.
Angela Lappin, vice president, chief of value-based initiatives at Heartland Whole Health Institute, says this ratio of new physicians to available residencies is definitely worth exploring.
Lappin: And that's important because Arkansas is facing a provider shortage. We currently have a third of our Arkansans living in health care professional shortage areas, and that means that they don't have a single provider, even a primary care provider, in their county that they can access for health care. This is a real problem, especially in our rural areas, and we want to try to solve that by retaining more physicians in our state. And we don't have an education problem. We actually train and graduate about 430 physicians annually. The problem is in the bottleneck that occurs after they graduate and they try to get an entry-level residency position, because we only have 375 of those across the state. So this forces many of our Arkansas-trained physicians to leave the state for their residency programs. And it has a trickle-down effect, because we know from national data that physicians usually end up living and working within 100 miles of where they attend their residency programs. So this is going to be one piece of solving the provider shortage that Arkansas currently faces.
Kellams: That bottleneck you were talking about, about 430 physicians annually ready to practice, we just don't have enough entry-level residency positions. I mean, that it's a difference of like 55 or so.
Lappin: Yeah, it's a huge delta. And we see it in several critical specialties in our state, including general surgery, obstetrics, gynecology and urology.
Kellams: Yeah, with those, if you take Arkansas and the surrounding states, we rank seventh out of seven in availability. So that is a problem.
Lappin: It is. And we've got a lot of opportunity there. This is going to become even more of a bottleneck in 2029, when the Alice Walton School of Medicine starts to add 48 more trained physicians every year to the workforce.
Kellams: Yeah, so then you're talking about 100 or slightly more than 100 that would be Arkansas-trained but, as it stands now, would not have a place to go in Arkansas. This report, "Growing the Physician Workforce in Arkansas: A Statewide GME Strategy," mentions that more than one-third of Arkansans live in federally designated health professional shortage areas. And that's even kind of more acute of a problem, because when you think about the rural areas, they cover so much more of the land than Northwest Arkansas and Central Arkansas and Jonesboro.
Lappin: Yeah, it is not uncommon in our state for Arkansans to have to drive over 50 miles to access any type of health care. And you can see the impact of that in our chronic disease outcomes. We are usually at the bottom when compared to national rankings for most chronic conditions, especially obesity, diabetes and hypertension.
Kellams: So how will the Graduate Medical Education Technical Assistance Center help relieve this bottleneck and help relieve some of these medical gaps?
Lappin: The Technical Assistance Center is going to provide our health care partners, hospital partners, community partners who want to set up additional residency programs the ability to tap into a free resource statewide that will walk them through how to operationalize a residency program and how to get funding for those residency programs.
Kellams: And as you mentioned before, it isn't a problem trying to convince those who are Arkansas-trained to stay here. More than half who have the opportunity do stay.
Lappin: Absolutely. The great news is physicians who do get a residency here stay at a higher rate than most other states. This is a very solvable problem for us. And our report shows that we have the ability to expand to an additional 500 residency positions across the state, which would generate approximately $705 million in economic activity. It's a significant return on investment for the state.
Kellams: And also, just if you've got a 9-to-5 job in children and you've got to drive 50 miles or more to see just your primary care physician, I'm imagining the idea is it will also raise the collective health of Arkansans.
Lappin: I think the most important thing that we want to make sure folks realize is that this Technical Assistance Center is designed to endure. This approach emphasizes neutrality, statewide coordination and shared workforce insight to support long-term decision-making. This is the first step in a really important strategy to retain physicians here in the state of Arkansas. And it's live today and can be accessed through gme@hwhi.org. And our report is available through the Heartland Whole Health Institute website.
Kellams: Angela, thank you so much for your time.
Lappin: Yeah, you too. Have a wonderful day.
Angela Lappin is vice president, chief of value-based initiatives at Heartland Whole Health Institute. You can find out more about the Graduate Medical Education Technical Assistance Center and the report "Growing the Physician Workforce in Arkansas: A Statewide GME Strategy" at heartlandwholehealth.org.
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