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A New View of the Complexion of the California Physician Workforce: Preliminary Data From the CA Medical Board Survey

A New View of the Complexion of the California Physician Workforce: Preliminary Data From the CA Medical Board Survey. Kevin Grumbach, MD UCSF Department of Family and Community Medicine, California Ethnic Physician Leadership Summit, 2006. Overview of Presentation.

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A New View of the Complexion of the California Physician Workforce: Preliminary Data From the CA Medical Board Survey

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  1. A New View of the Complexion of the California Physician Workforce: Preliminary Data From the CA Medical Board Survey Kevin Grumbach, MD UCSF Department of Family and Community Medicine, California Ethnic Physician Leadership Summit, 2006

  2. Overview of Presentation • CA Medical Board Relicensure Survey • New source of data on CA physicians • Policy context for Med Board Survey • AB 1586 • Value of Med Board Survey data for understanding physician diversity • Results of preliminary analyses on race-ethnicity • Case study of South Asian physicians • Policy Implications

  3. Policy Context 2001 • Controversy about number of physicians in CA • Dueling reports: • UCSF: “Profile of the Physician Workforce” • CMA: “And Then There Were None” • Controversy over validity of AMA Physician Masterfile Data • Number of active physicians • Physician race-ethnicity

  4. California Physicians and Population by Race/Ethnicity (2000) Sources: AMA Masterfile, California Dept. of Finance.

  5. A Constructive Solution: AB 1586 (McLeod) • CMA Sponsored • Enacted October 2001 • Required CA Medical Board to implement a physician survey linked to relicensure • “…training and practice characteristics for each physician licensed in California”

  6. Survey Items • “Required” items • Weekly hours in patient care, research, etc • Practice zip code (if in patient care) • Training status • Self-designated specialties • Board certification

  7. Survey Items • “Not-So-Required” items • Ethnic background • 28 ethnic options • Can select >1 • Foreign language (“fluent”) • 34 options

  8. Active CA license, CA mail address 92,062 Survey respondents with entered data 48,840 Active patient care, zip in CA, not in training 39,843 Initial Survey Data Base Represents 75,013 CA patient care physicians

  9. Respondent Ethnicity

  10. Ethnicity Summary* * Total adds to >100% due to physicians with more than 1 ethnicity checked

  11. Selected Asian Ethnicities, as % Overall CA Physicians:US Medical Grads & International Medical Grads

  12. Selected Latino Ethnicities, as % Overall CA Physicians:US Medical Grads & International Medical Grads

  13. Case Study of South Asian Physicians in CA • Context: • IMGs are known to be more likely than USMGs to work in underserved communities • Many IMGs are South Asians • US South Asians are growing proportion of US medical students • Study Question: • Does the likelihood of practicing in an underserved community depend on whether a South Asian physician in CA is an IMG or USMG?

  14. Study Design • Study sample • Self reported ethnicity Indian or Pakistani • Not currently in training • Active in patient care in California • 315 South Asian USMGs, 1,223 South Asian IMGs • Data on practice communities • Based on reported zip code of practice • Linked to state data base from OSHPD on HPSAs, MUAs, rural status, census characteristics

  15. Percentages of South Asian Physicians in CA Working in Underserved Communities,According to Whether Physician is a USMG or IMG

  16. Study Conclusion • Country of medical school education, rather than ethnicity per se, is the key predictor of practice in an underserved community among South Asian physicians

  17. The Broader Context of Physician Diversity

  18. Underrepresented Minorities: U.S. Population and U.S. Medical School Entrants Population Percentage Medical School Entrants Phase 1 Phase 2 Phase 3 Phase 4

  19. URMs as % matriculants: US vs CA, TX

  20. Number of Medical Students per Capita: State Comparisons

  21. UC PRIMEPrograms • NewUC initiative • Programs in Medical Education (PRIME) • First expansion of medical school enrollment at UC in 30 years • Short term: 15% increase at existing schools • Long term: 1-2 new UC medical schools • New student tracks to address unmet health needs in California • Attract students with life experiences preparing them for leadership and service to disadvantaged populations

  22. Ominous Federal Trends in Support for Workforce Diversity HCOP COE

  23. Take Home Points • Unprecedented ability to understand the ethnic profile of CA physicians using Med Board survey data • More accurate measurement of overall patterns and trends by major ethnic groups • Ability to discern variation within major ethnic groups (e.g., Asian, Latino) • Importance of physicians completing surveys and reporting ethnicity, language information!!!!!! • Need for funding and infrastructure to track and analyze CA physician workforce data

  24. Take Home Points: Policy Trends • The Good: • UC Prime Programs • The Bad and the Ugly: • Elimination of federal diversity programs • Need for federal and state political action

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