It's widely reported that the country is suffering from a shortage of primary care doctors. The problem is severe in Indiana. The federal government designated Indiana as one of the most under-served states in the U.S.
A number of factors are accelerating the problem, but this year's first graduating class from Marian University's medical school could help reverse the trend.
Marian University Graduates First Class Of Medical Students
Rachel Gahagen and Trenton Schmale are part of the first graduating class from Marian University's medical school.
"I've enjoyed all elements of medicine throughout medical school whether it be pediatrics, geriatrics, doing OBGYN sports medicine, emergency medicine," Schmale says.
The class of aspiring physicians includes 130 graduates, and of those, nearly half are focusing on primary care in Indiana.
"It's a great place to practice medicine," Gahagen says. "I think people here are genuine. I think they are caring."
Gahagen is doing her residency in pediatrics at Peyton Manning Children's Hospital. From there she hopes to stay in Indiana and continue practicing.
"There's a strong sense of community among Hoosiers and I don't think you find that everywhere," she says.
This is significant because a recent study from the national healthcare policy think tank Robert Graham Center found that to maintain the status quo, Indiana will need more than 800 additional primary care physicians by 2030.
"It just tends to get worse and worse every year," says Dr. Richard Feldman.
Feldman is a past president of the Indiana Academy of Family Physicians, and a family physician who is program director at the Franciscan Health Family Medicine Residency Program.
Indiana's population is aging as it grows. And more people are getting insurance through the Affordable Care Act and Indiana's expansion of Medicaid known as Hip 2.0.
"There's not an area of Indiana that doesn't have a shortage, not a city or town that doesn't have a shortage, and I'm talking about right here in Indianapolis," he says. "It doesn't matter where you are."
Nationally, Indiana ranks 38th in the ratio of physicians to patients. The statewide average is more than 1,500 to one.
But the problem is exacerbated in rural areas. Newtown County and Warren County have the highest primary care to patient ratios in the state. Each has only one primary care physician in the entire county.
Feldman says increasing training and the number of medical schools in Indiana goes hand and hand with more doctors practicing in the state.
Marian University Medical School Is A 'Game Changer'
There's a federal initiative led by the Association of American Medical Colleges to increase medical student graduation by 30 percent. Indiana University exceeded that goal, but the big story, Feldman says, is Marian University.
"And that's the game changer," he says. "It changes the whole dynamic in this state and now we're going to further our goals of getting enough physicians, particularly primary care to practice in Indiana."
"It changes the whole dynamic in this state and now we're going to further our goals of getting enough physicians."
Some states do offer incentives to medical students. They'll forgive their student debt, or offer dedicated funding for primary care residency programs.
Indiana does have a loan forgiveness program in state statue, but it doesn't receive any funding.
Schmale and Gahagen still say it makes sense for them and their careers to stay in Indiana. They've made valuable connections during their four years at Marian.
"I've worked in numerous hospitals in Indiana now, made some great connections through the Indiana State Medical Association and other family friends and doctors so that was a big reason for me staying," Schmale says.
"That's the biggest incentive for me is to continue to stay here and work with those physicians and learn from them and later go back and give back to the community that helped me to kind of have the success that I have had."
And for both Gahagen and Schmale, that could mean a long career practicing in Indianapolis or one of Indiana's rural communities.
Medical school enrollment is up across the country as universities expand their curriculum and more schools like Marian open their doors.
The next big hurdle is the lack of residency positions. Graduates can't go on to become practicing physicians until they complete their training in a residency program. But Congress hasn't increased funding for these positions in more than 20 years creating what Feldman calls a bottleneck of students with, in a sense, nowhere to go.
