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"The Medical College of Wisconsin has moved to lessen one of the state's most severe physician shortages: the lack of psychiatrists in northern Wisconsin.
The medical school announced last week that it had received initial accreditation for residency programs in northeastern and north-central Wisconsin for seven psychiatrists.
The two programs eventually could reduce the shortage, because physicians often remain in the area where they do their residencies.
Psychiatrists are in short supply throughout the nation, but the shortage in northern Wisconsin is considered severe.
"It's hard to get in to a see a psychiatrist in the Milwaukee area, and up north it's almost impossible," said Jon Lehrmann, chairman of psychiatry and behavioral medicine at the Medical College.
Wisconsin ranks second-last in the nation, behind only South Dakota, for meeting the behavioral health needs of its population, according to an analysis by the Kaiser Family Foundation. Based on the ratio of psychiatrists to the overall population, Wisconsin meets 20% of its population's need for mental health care.
The two residency programs, scheduled to start July 1, 2017, would increase the number of psychiatrists who do their training in Wisconsin by 41%.
If only one or two of the seven physicians remain in the area each year after completing their training, the new programs would make a significant difference in the shortage of psychiatrists in northern Wisconsin over the next decade, said Robert Gouthro, a psychiatrist in Green Bay who will oversee the program for northeast Wisconsin.
The new residency programs will train three psychiatrists in north-central Wisconsin and four in northeastern Wisconsin. The programs will be based in Green Bay and Wausau.
Physicians who specialize in psychiatry and behavioral medicine must complete a four-year residency after medical school.
The Medical College now has eight residency slots for psychiatrists and the University of Wisconsin School of Medicine and Public Health has nine.
Rural areas typically struggle to recruit physicians, and the problem is particularly pronounced for specialties in strong demand such as psychiatry.
"We called it the silent shortage," said Travis Singleton, a senior vice president for Merritt Hawkins, a unit of AMN Healthcare that recruits physicians.
Merritt Hawkins has seen a sharp increase in requests to recruit psychiatrists in recent years.
"Just on its face, it is one of the most underserved areas of health care," Singleton said. "It's not even debatable. When you get into rural areas, it's just downright frightening."
Recruiting a psychiatrist to Green Bay, for instance, can take several years, Gouthro said.
The two residency programs will cost an estimated $3.5 million a year when fully staffed with 28 residents — seven physicians for each of the four years.
Residents are paid about $60,000 to $65,000 a year, plus benefits. They see patients, under supervision, during the residency.
The residency programs will be paid for by the state, the Milwaukee VA Medical Center, Medicare and the health care clinics and systems participating in the program.
The Medical College began initial discussions on starting the residency programs about three years ago, said Carlyle Chan, a professor of psychiatry who helped put together the program.
That included spending about 18 months traveling through northeastern and north-central Wisconsin meeting with the health systems, clinics and other organizations where the residents will train.
Chan credited Gary Bezucha, who recently retired as chief executive of North Central Health Care, based in Wausau, for his help in developing the program for north-central Wisconsin.
The sites where the residents will train include the VA outpatient clinics in Wausau, Wisconsin Rapids and Green Bay; Bellin Psychiatric Center in Green Bay; and Ministry Health Care's hospitals in Stevens Point and Rhinelander.
Other sites include Winnebago Mental Health Institute, Wood County Human Services and Portage County Health and Human Services.
"This required great collaboration across the sites," said Lehrmann of the Medical College.
Filling the residency slots should not be a problem.
Medical schools have increased enrollment in recent years, Chan said, and the number of graduates interested in specializing in psychiatry is increasing.
Preference may be given to physicians who want to live in smaller cities and rural areas, such as those who enjoy hiking, cross-country skiing, hunting and fishing and value easy access to the outdoors.
But the hope is that others in the residency programs also will come to appreciate the advantages of living in a rural area or small city — and decide to remain in northern Wisconsin. And there's a good chance that could happen.
"This really is going to have an impact on health care in northern Wisconsin," Chan said."