Leading Change

Seeking collaborations and solutions at a conference on workforce issues.

By Allison Campbell Jensen

“Every day, we see the taillights going to somewhere else to get care that we could provide here,” said Dave Nelson, University Extension educator from Morris. Marketing local hospital and clinic services to residents is essential for Minnesota’s small towns, where health care typically ranks near the top of local economic contributors.

Health care and economic experts, realities, and implications came together during the Leading Change conference held in St. Paul April 14-15, 2005. Nearly 200 people from 20 communities across Minnesota joined state officials and University faculty and staff, including President Robert Bruininks, to discuss building a vital health professions workforce. The conference was organized by the Academic Health Center’s Office of Education, whose staff analyzes health workforce issues, goes on fact-finding missions around the state, and manages the Minnesota Area Health Education Center.

Conference attendees discussed trends that, if unchecked, would decrease the future health professional workforce and access to health care for people around the state, particularly in Greater Minnesota. “These factors include the educational pipeline and the need for academic excellence, so that K-12 students better prepare for health professions,” says AHC Assistant Vice President for Education Barbara Brandt. Those future health professionals—and those who would hire them—also must recognize how the large and growing debt burden of health professional education affects career choices.

Demographic shifts, as the state’s population grows older and more diverse, also foreshadow trouble. At the same time as the population is aging, noted state demographer Thomas Gillaspy, the labor force is not growing fast enough to meet demand for care. Minnesota Commissioner of Health Dianne Mandernach told the conference that “rural areas are losing young people to the metropolitan area just at the time we need them most.” In addition, in parts of Minnesota, nearly a third of the health care workforce is over 55 and considering retirement. Minnesota’s population also is becoming increasingly racially and ethnically diverse but that has yet to be mirrored in the health care workforce.

Frank Cerra, senior vice president for health sciences, encouraged the attendees to reflect and discuss. “Engaged dialogue creates a community-based culture of cooperation and shared leadership,” he said. “When it comes to educating the next generation of health professionals for you and your family, the University of Minnesota cannot do it all and cannot do it alone.” Communities and regions were encouraged to be active participants in their future, seeking the involvement of many sectors in their communities and around the state, seeking collaborations wherever possible, and raising the awareness of community leaders.

Communities in Greater Minnesota can play an important role in recruiting health care professionals, said Kim Raub. The only 2003 graduate of the School of Dentistry who decided to set up a solo practice, Raub and her husband grew up outside the Twin Cities metropolitan area and sought opportunities in smaller cities. Most chambers of commerce they contacted sent a real-estate guide and information about utilities. But the business community in Alexandria made an extra effort, including a local dentist who spent time with Raub introducing her to the city and its opportunities. She set up her practice there.

Debt is another area of growing concern. Conference participants learned about the increasingly heavy educational debt burdens faced by physicians, veterinarians, and other health professionals from Deborah Powell, dean of the Medical School, who led a national task force on the issue. Innovative strategies such as community loan repayment and scholarship options were encouraged as ways to draw new health professionals to communities.

Conference participants were given many encouraging words. “We are people who have accepted change…,” said Lois Quam, C.E.O. of Ovations. “My grandparents spoke Norwegian and came here, as so many did, because they wanted to create something better.” Today, facing the challenge of the health workforce, she said, those concerned need to stop blaming, to understand their strengths, and to decide they’re really going to make progress in transforming this complex system.