ST. LOUIS PARK, Minn. -- There is real concern among health officials there won't be nearly enough doctors in the future, let alone for rural Minnesota in the near term.
Dr. Edwin Bogonko, the President of the Minnesota Medical Association, estimates 30% of the state's physician workforce will either retire or change careers.
"One has to be worried because we're facing an unprecedented workforce shortage," Bokongo lamented to WCCO Investigates. "It's just a reality."
The projected shortage, moreover, is exacerbated by the population's health care needs, which Bokongo said is an additional 1,200 primary care doctors by 2040, a 28% increase of the working ranks now.
"We're behind the eight ball," he said.
Dr. Robert Karasov was a pediatrician at Park Nicolet for nearly 40 years. He retired in 2023, even though he said he had a few years in him left.
"The last several years I'd keep saying to them, 'You'll let me know if I stay too long,'" He quipped to WCCO Investigates. "They'd say, 'No we want you to stay.'"
That wasn't just pleasantries; pediatrics, family medicine and obstetrics are the most in-demand positions in the healthcare system.
According to the Minnesota Department of Employment and Economic Development, the vacancy rate for pediatricians in December 2024 was 32.4%. For family medicine, it was 8.5%, while OBGYN came in at 7.6%.
Karasov recalled a similar struggle many years ago to get more medical students interested in the field.
"In college I shadowed my pediatrician because I was thinking of medical school, and he told me, 'No matter what you do don't be a pediatrician.' I asked why, and he goes, 'Because the make the least money and you have to deal with all the crazy mothers,'" he said.
Karasov, though, was enamored with the idea of helping families.
"There's nothing like having a parent come back and tell you how much you helped them."
Still, both Karasov and Bokongo from the Minnesota Medical Association acknowledged the impact of money, especially with the exponential increase in medical school debt.
"A lot of our medical school graduates are looking at the debt and the time it will take to pay off those debts and they're opting to do more high paying specialties," Bokongo explained. "How we pay for services of our physicians is very heavy on how much technology is used, so for example people who have procedure-based specialties tend to get paid way, way more."
WCCO Investigates has spent months speaking with patients, providers and healthcare administrators about how several health systems in Minnesota have slashed or relocated services.
This includes pediatric units and labor and delivery.
"This is a symptom of a larger problem," Joe Schindler, the Minnesota Hospital Association's finance director told WCCO Investigates. "They're closing these services just to keep the doors open for the emergency room and other inpatient and outpatient care."
Rural communities have been the hardest hit, including labor and delivery closures in Cambridge, Fosston, Granite Falls, New Prague, Olivia and Regina.
Other hospitals, including Mercy Campus in Coon Rapids, closed its inpatient pediatric units.
"We need to have a better policy in place to support the very services that everybody needs in the community," Schinder said.
As for what specific policies can change, Schindler pointed to the reimbursement rates from Medicaid, a government-run health insurance program for lower-income individuals.
For Bogonko, he said he wants to see medical schools and health systems work together to think creatively on incentives for students choosing their specialties.
"It's about talking to our training institutions," he added. "Can they promote and sort of strengthen primary care directive residency training so they get into those programs and are guaranteed loan forgiveness in exchange to work in our local communities? Can we look at the crucial role of primary care doctors, OB docs, that not only keep people healthy, but also keep care local, and change how we reimburse those physicians," said Bogonko.