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Addressing the Shortage of Primary Care Physicians

Addressing the Shortage of Primary Care Physicians

According to The Boston Globe, a national shortage of primary care doctors is hitting Massachusetts especially hard.  The state's 2006 health insurance mandate has resulted in an additional 439,000 newly insured residents trying to seek care from an already over-stressed medical profession.  According to an annual survey by the Massachusetts Medical Society, wait times for new patients to see primary care doctors are running an average of 50 days, though some doctors report delays up to 100 days.

In order to increase the number of primary care doctors, the state legislature passed a number of financial incentives that focus on medical school debt forgiveness in order to attract more primary care doctors to the profession.  The incentives, part of a broad cost containment bill enacted this year, include:

  • $1.5 million to expand class size and increase enrollment at the University of Massachusetts Medical School,
  • Waiving tuition and fees for students who work as primary care doctors in the state for four years following medical school,
  • $1.7 million to repay school loans of doctors who work in community health centers, and
  • $500,000 to pay of debt for doctors who practice in under-served communities for at least two years.

As the Globe reports, a loan repayment program started last year with a $5 million grant from Bank of America plus $1.7 million in state funds has so far resulted in an additional 45 doctors and 19 nurse practitioners working in community health centers for two to three years.  The Massachusetts Medical Society is also urging action on payment reform and reducing the administrative burden on doctors.

A Nursing Shortage, Too: Elsewhere, as reported by Stateline.org, a nationwide nursing shortage has prompted more than two-thirds of states over the past five years to pass nursing education programs and increase funding for nursing scholarships and loan forgiveness programs.  According to the report, the US is projected to face a shortage of 1 million nurses by 2020.  Along with nurse retirements and a shortage of nursing teachers, another reason for the decline is workplace problems in hospitals, such as mandatory overtime and requiring nurses to care for too many patients, which put nurses and patients in jeopardy.

According to the report, to improve workplace conditions 14 states have acted to ban or limit mandatory overtime and 13 states require hospitals to establish committees to determine staffing needs.  In California, nurses are limited to caring for five patients at a time.

Solutions to Medical Debt and Shortages: The American Medical Student Association (AMSA), has 67,000 members and advocates before Congress advocating for solutions to the crippling debt, averaging $140,000, that greets students upon completing medical school, as well as other issues of concern to the medical community.  As AMSA explains, medical school debt is a particular barrier for physicians of color and for physicians choosing to work in under-served areas.  Yet recent federal legislation will drastically reduce the number of students eligible for debt assistance.

To make primary care more attractive to new physicians and to improve the diversity of the health care workforce, AMSA advocates for robust initiatives to help students manage or eliminate their medical school debt.  These include low interest loans, a cap on the rise of state medical school tuition, loan deferment programs, and full reauthorization of the National Health Services Corps, which is akin to AmeriCorps for the medical community and helps encourage students to enter the primary care field.

 

Resources

Addressing the Shortage of Primary Care Physicians

American Medical Student Association (AMSA) - Student Debt Fact Sheet 2008
AMSA - Creative Debt Solutions
AMSA - Charting a Course to Medical School: The AMSA Map for Success
Stateline.org - States Work to Avert Nurse Shortage