A 14-point plan released Tuesday by the Michigan State Medical Society<\/a>, calls for vastly expanding pay and reimbursements. Overall, 5% of total medical expenditures go to primary care. The society wants to boost that to 12%.\u00a0<\/p>\n \u201cMichigan has made an underinvestment in primary care,\u201d said Dr. Tom George, an anesthesiologist and chief executive officer at the society.<\/p>\n Michigan is short at least 464 primary care providers, federal estimates show, fueled in part by a pay gap: They average $287,000 per year nationally, compared to $404,000 for specialists, according to one report<\/a> last year.<\/p>\n Michigan\u2019s population is aging faster than most states, with 1.9 million residents<\/a> \u2014 nearly 1 in 5 \u2014 already 65 or older.\u00a0<\/p>\n The health conditions that come with age further stress the health care system. George said his group wants to focus on primary care expenses as other expenditures grow.<\/p>\n Related:<\/p>\n \u201cThis is not \u2018Let\u2019s just pay the neurosurgeons less than we\u2019ll pay primary care,\u2019\u201d George said. \u201cWe\u2019re talking about the big pie of health care spending\u201d as it grows.<\/p>\n The report, which calls primary care doctors \u201cthe foundation of a robust, effective, and efficient system,\u201d stops short of dictating specific steps to spend more money on primary care.<\/p>\n But it highlights efforts elsewhere.<\/p>\n Oregon requires that 12% of the state\u2019s Medicaid dollars be spent on primary care, while Rhode Island mandates commercial insurers invest at least 10% on primary care.<\/p>\n The report comes as more than 1 in 4 Michiganders, about 2.7 million, live in Health Professional Shortage Areas<\/a>, a federal designation<\/a> based on the number of providers, the portion of residents under the federal poverty level, and travel time to the nearest providers outside the designated area.<\/p>\n Legislators have considered solutions<\/a> such as giving broader responsibilities to nurse practitioners \u2014 a step that some have argued<\/a> could help expand access. The doctors\u2019 group has fought that, saying that those clinicians don\u2019t have adequate training and should not work on their own, but rather as part of a physician-led team.<\/p>\n Michigan is also weighing temporary licenses to doctors who earned their degrees outside the US or Canada and continued participation in an interstate compact<\/a> that lets providers licensed in other states practice here.<\/p>\n Building teams<\/p>\n Raising insurance reimbursements to primary care doctors would have a ripple effect, said Dr. Dennis Ramus from his office this week in New Baltimore, north of Detroit.<\/p>\n The increased funds would allow them to add, at a minimum, a nurse case manager and an advanced practice clinician, such as a nurse practitioner or physician assistant, to their practices, he said. Ultimately those teams also could include pharmacists, social workers, psychologists and others, he added.<\/p>\n While some health problems require specialists, \u201cI can generally take care of 65% of what you need done if you call me first,\u201d said Ramus,\u00a0the report\u2019s lead author.<\/p>\n Moreover, Michigan retains less than half of the primary care physicians it trains, according to the report.<\/p>\n The Michigan State Medical Society report also recommended:\u00a0<\/p>\n All Medicaid and commercial payers abandon fee-for-service payments in primary care<\/p>\n Michigan establish a hub to provide practices with services such as accounting, billing and electronic health records<\/p>\n The state establish pre-medical apprenticeship programs to recruit medical students from \u201ccommunities of need.\u201d<\/p>\n Michigan boost funds to allow medical students to pay off student loans<\/p>\n Michigan expand incentives for new doctors to practice in underserved areas<\/p>\n \u2018Foundational\u2019 care<\/p>\n The new report echoes findings from the New York-based Milbank Memorial Fund, a nonprofit research organization that focuses on health equity and produces a dashboard<\/a> that tracks primary care spending by state.<\/p>\n Milbank and the Michigan doctors group say boosting payments for primary care allows doctors to expand their practice, thereby offering better care to more patients.\u00a0<\/p>\n The key is to have those team members on-site as familiar faces on the care team, Ramus said.<\/p>\n While many offices purport to have health care \u201cteams,\u201d members are often available only remotely, or they are a single staff assigned by a large health system to support many physicians, Ramus said.<\/p>\n \u201cThere\u2019s this illusion of a team,\u201d Ramus said.<\/p>\n While the reports\u2019 focus is on primary care, the Michigan State Medical Society represents physicians of all specialties.<\/p>\n \u201cSpecialists recognize the value of a foundational primary care that serves as the triage, sending appropriate patients to them,\u201d said George, the executive director.<\/p>\n Dr. Brad Uren, an emergency medicine doctor in Ann Arbor, said he often sees patients in the emergency room who need follow-up care but lack a primary care doctor for a myriad of reasons.<\/p>\n \u201cIt\u2019s easy for me to say, \u2018Well, you\u2019re not having a heart attack, but you need to follow up with your doctor because your blood pressure was high, and your sugar was high, and we know your cholesterol is not under good control,\u201d he said.<\/p>\n But without a primary care home, that patient is likely not going to get critical follow-up care, resulting in a revolving door of emergency room visits, said Uren, who also is vice chair of the Michigan State Medical Society board of directors.<\/p>\n As a specialist or an emergency room doctor, Uren said, \u201cyou really need somebody to quarterback that care.\u201d<\/p>\n \n\tRelated\n<\/p>\n Thank you to our Michigan Health Watch Sponsors<\/p>\n Bridge Michigan Health Watch is made possible by generous financial support from our sponsors. Sponsorship supports our independent journalism mission but does not constitute sponsor endorsement of individual articles or editorial content. Bridge Michigan journalism remains fact- and data-driven and independent at all times.<\/p>\n Please visit the\u00a0About<\/a>\u00a0page for more information and to\u00a0subscribe<\/a>\u00a0to Health Watch. Interested in becoming a sponsor?\u00a0Contact Emma Carr<\/a>.<\/p>\n Republish This Story<\/p>\n![\"doctor](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/03\/03162026_Dr.-Dennis_Ramus_BG-2.jpg\")
Dr. Dennis Ramus examines patient Danny Stevens, 56, during a routine checkup. Ramus is the lead author of a new report by the Michigan State Medical Society. (Brayan Gutierrez for Bridge Michigan)<\/p>\n![\"Dr.](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2026\/03\/brad-uren-right.jpg\")
A larger primary care workforce alleviates pressure in emergency rooms as well as specialty clinics, said Dr. Brad Uren, an emergency medicine doctor in Ann Arbor and vice chair of the Michigan State Medical Society board of directors. (Brayan Gutierrez for Bridge Michigan)<\/p>\n
![\"Creative](\"https:\/\/www.newsbeep.com\/us\/wp-content\/uploads\/2025\/08\/1754973788_72_cc-by-nd-4.0.png\"\/)
<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"Michigan faces severe shortages in the health care workforce across many fields, including both primary care doctors and…\n","protected":false},"author":2,"featured_media":531409,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[97,252,253,208268,220419],"class_list":["post-531408","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-health","tag-health-care","tag-healthcare","tag-michigan-worker-vacancies","tag-top-of-homepage"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/531408","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=531408"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/531408\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/531409"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=531408"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=531408"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=531408"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}