LANSING, Mich. (Michigan News Source) – Recent reporting by Michigan News Source has pointed out an emergency with a shortage of ambulance companies in Michigan and the rest of the country. In addition to that, rural hospitals have been closing all over the United States and more closings are on the way. In addition to those concerns, now we also have to worry about a shortage of primary care doctors and prescription medicines.

The Michigan Academy of Family Physicians and others are sounding the alarm about the shortage of primary care doctors. Dr. Glenn Dregansky, President of Michigan Academy of Family Physicians says, “Seeing your primary care specialist, like a family physician, leads to better health outcomes, yet there are still too many people without a primary care physician as their regular source of care. Alarming data shows that 20 percent of adults and 8 percent of children in our state do not visit a primary care physician for routine care like well-child appointments, annual exams, and immunizations. This means too many healthcare needs are unnecessarily being handled by urgent care centers and emergency rooms.”

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A new report from the Milbank Memorial Fund, a nonpartisan foundation that works on health policy, backs up his claim. The report is titled “The Health of U.S. Primary Care: A Baseline Scorecard Tracking Support for High-Quality Primary Care.”

The report states that they found a “chronic lack of adequate support for the implementation of high-quality primary care in the United States across all measures.” They outline five reasons for this:

Financing: The United States is systemically underinvesting in primary care.

Workforce: The primary care physician workforce is shrinking and gaps in access to care appear to be growing. Only about 1 in 8 medical students enter family medicine residencies every year.

Access: The percentage of adults reporting that they do not have a usual source of care is increasing.

Training: Too few physicians are being trained in community settings, where most primary care takes place.

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Research: There is almost no federal funding available for primary research care.

The report says, “Given declining life expectancy, racial and ethnic health disparities, the current epidemic of mental health needs, the ongoing COVID-19 pandemic, and other nationwide issues that primary care can help address, these findings represent an urgent call to policymakers and other stakeholders. It is time to accelerate adoption of policies that will demonstrably increase investment in high-quality primary care, create a robust primary care workforce, and enable analysis and learning around the impact of primary care.”

The Detroit Free Press also reports, “Without enough family medicine doctors, Michiganders aren’t getting the care they need to manage conditions like diabetes and high blood pressure or to prevent future illnesses with screenings and treatments that can reduce hospitalizations and emergency department visits.”

Dr. Julie Phillips, Chair of family medicine at Michigan State University’s College of Human Medicine, says, “We are 862 primary care physicians short in Michigan, and that’s just to maintain the status quo.” She says about three million Michigan residents are underserved in terms of access to primary care.

And living in a rural area makes things even worse. Phillips says, “In rural communities, the primary care shortage is compounded by the closure of rural hospitals and limited access to obstetric care, including labor and delivery care…Family doctors provide preventive care to adults but they also provide preventive care to children and obstetric care…In a lot of our rural communities, family physicians are the only physicians who are delivering babies.”

Another problem Michiganders and others in the country are facing is a drug shortage for everything from asthma to cancer. A new report from Michigan Senator Gary Peters finds that the United States is overly reliant on China, India and other countries for their supply of crucial pharmaceutical drugs. Peters chairs the Senate Committee on Homeland Security and Government Affairs and their recent report shows that those drug shortages rose 30% between 2021 and 2022 because of issues like supply chain problems and reliance on foreign sources for pharmaceuticals. Alarmingly, the report says that up to 95% of generic sterile injectable drugs used for critical acute care in the United States relies on materials that come from China and India.

Peters said in remarks during a Homeland Security meeting on Wednesday, “Taken together, these underlying causes not only present serious concerns about providing adequate care to patients, they also represent serious national security risks.” He said that at its peak, there were 295 drug shortages last year. A list from the FDA currently shows 130 drugs in shortage.

Andrew Shuman, an associate professor of Otolaryngology-Head and Neck Surgery and Chief of the Clinical Ethics Service Center for Bioethics and Social Sciences in Medicine at the University of Michigan Medical School, testified at the Homeland Security meeting and said, “When you’re baking, you have a list of ingredients and you need all the ingredients for that product to be exactly what it is. When you make a substitution, you don’t necessarily know how well that’s gonna work. But here you’re not going to end up with a dry cake, you’re going to end up with a child whose cancer has not been cured.”

The American Society of Health-System Pharmacists says that most drug shortages last about a year-and-a-half but that some drug shortages, like for hormonal drugs that slow the onset of cancer and other conditions, may last much longer. Local anesthetics are coming up short too as well as chemotherapy drug components and cardiology agents. 

With the multitude of health care problems plaguing the country, the shortage of ambulances, hospitals, doctors and drugs is more than concerning especially as the population ages and will be in need of additional care.