South Dakota Faces Doctor Exodus as Governor Proposes Cuts to Medical Residency Funding
PIERRE — South Dakota’s health care system is at a crossroads as Gov. Kristi Noem’s proposed funding cuts to the state’s medical residency program spark fears of a worsening physician shortage. Health care organizations warn that the move could leave the state struggling to retain and attract doctors, exacerbating an already critical issue.
The proposal comes amid a nationwide crisis, with the Association of American Medical Colleges projecting a shortage of 86,000 physicians by 2036. South Dakota, which ranks 35th in the nation for its patient-to-physician ratio,already faces meaningful challenges. With 763 residents for every primary care doctor, 51 of the state’s 66 counties are designated as health professional shortage areas.
Jacob Parsons, director of advocacy and reimbursement for the South Dakota Association of Healthcare Organizations, voiced his concerns during a recent meeting of the Legislature’s Joint Appropriations Committee. “I think the message we’d be sending to our potential residents is that, ‘Why not go to Iowa?’” Parsons said, referencing Iowa Gov. Kim Reynolds’ plan to create 460 new medical residency slots over the next four years.
The contrast between the two states’ approaches highlights the growing competition for medical professionals. While Iowa invests in expanding its residency programs, South Dakota’s proposed cuts could drive aspiring doctors to seek opportunities elsewhere.
Key Data on South Dakota’s Physician Shortage
Table of Contents
| Metric | South Dakota | National Context |
|———————————|—————————|————————————|
| Patient-to-Physician Ratio | 763:1 | Varies by state |
| Health Professional Shortage areas | 51 of 66 counties | Nationwide shortage projected |
| Projected National Shortage by 2036 | N/A | 86,000 physicians |
The stakes are high. Without adequate residency programs, South Dakota risks losing its ability to train and retain the next generation of doctors. This could have a ripple effect, leaving rural communities especially vulnerable.
As the debate over funding continues,health care advocates urge lawmakers to consider the long-term implications. “This isn’t just about budgets,” Parsons emphasized.“It’s about ensuring South Dakotans have access to the care they need.”
The question remains: Will South Dakota invest in its future, or will it lose its doctors to states like Iowa? The answer could shape the state’s health care landscape for decades to come.
south Dakota Faces critical Decision on Residency Program Funding
South Dakota’s medical residency programs, which serve as a vital pipeline for training the next generation of doctors, are at a crossroads. Governor Kristi Noem’s proposed budget cuts to the state’s general medical education funding have sparked a heated debate among lawmakers, health care leaders, and residents. The proposal would eliminate $1.7 million in state general funds and an additional $1.86 million in federal Medicaid matching funds,raising concerns about the future of medical training and health care access in the state.
What’s at Stake?
A residency, or graduate medical education, is an intensive, on-the-job training period for doctors after completing medical school. These programs are funded by health systems, Medicare, and state funds tied to Medicaid. In South Dakota, 78 residency programs across Sanford, Avera, and monument health systems rely on this funding. Currently, 154 residents are participating in these programs, which range from pediatrics to family medicine and internal medicine. notably, the state does not offer an obstetrics-gynecology residency.
Jason Simmons, Chief Financial Officer of the South Dakota Department of Social Services, explained that state funding is based on the number of Medicaid patients served by residencies. “The state funding is based on the number of Medicaid patients served by residencies,” Simmons said during a presentation to the Joint Committee on Appropriations.
Though,Governor Noem’s proposal would eliminate this funding,leaving lawmakers to decide whether to retain it in the final budget. Since the program receives general funds and there are no laws mandating its continuation, the decision rests entirely with the Appropriations Committee.
Rural residency Program Gets a Boost
While the general medical education funding faces cuts, Noem has proposed increasing funding for the rural residency program by $70,821. This program is separate from the general medical education funding and is designed to address the shortage of doctors in rural areas.
Kim Malsam-Rysdon, Vice President of Public Policy at Avera Health and former state Department of Health secretary, expressed gratitude for the rural residency program’s continued funding. However, she warned that cutting general residency funding could have dire consequences. “if South Dakota doesn’t have the same capacity for residencies as other states, we’ll lose doctors to other states where they’re being trained,” Malsam-rysdon said.
She added that without state Medicaid funding, some residency slots could be cut altogether. “If those funds aren’t continuously appropriated, we’ll have some hard questions to answer about the ability to continue to support medical students who are training in our space.”
The Impact on South Dakota’s Health Care System
More then 80% of residents who complete their training in South Dakota stay and practice in the state, according to Matt althoff, Secretary of the Department of Social Services. This statistic underscores the importance of residency programs in addressing the state’s physician shortage.
The potential loss of funding could disrupt this pipeline, forcing medical students to seek training opportunities elsewhere. “We’ll lose doctors to other states where they’re being trained,” Malsam-Rysdon emphasized.
Key Points at a Glance
| Aspect | Details |
|———————————|—————————————————————————–|
| Total Residency Programs | 78 programs across Sanford, Avera, and Monument health systems |
| Current Residents | 154 |
| State Funding at Risk | $1.7 million in general funds and $1.86 million in federal Medicaid funds |
| Rural Residency Funding | Proposed increase of $70,821 |
| Residency Retention Rate | Over 80% of residents stay and practice in South Dakota |
What’s Next?
The Joint Committee on Appropriations will play a pivotal role in determining the fate of South Dakota’s residency programs.As lawmakers weigh the economic implications of the proposed cuts, health care leaders are urging them to consider the long-term impact on the state’s health care system.
“They’re going to put funding forward there,” said Parsons, highlighting the critical need for continued investment in medical education.
For now, the future of South Dakota’s residency programs hangs in the balance. the decision made by lawmakers will not only shape the careers of aspiring doctors but also determine the state’s ability to provide quality health care to its residents.
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