The shortage of physicians in the U.S. is not new but lately we’ve been hearing more and more on the topic due to health system changes as Affordable Care Act implementation moves forward. The Health Resources and Services Administration (HRSA) has designated 5,900 primary care shortage areas. These are areas where there are 3,500 or more people for every primary care physician. Highlighting the issue is also a report from U.S. Sen. Bernie Sanders (I-VT), Primary Care Access 30 Million New Patients and 11 Months to Go: Who Will Provide Their Care? According to the report:
- One in five Americans live in areas where there is no adequate access to primary care, and it is more prevalent in rural an low-income urban areas;
- One in five sick people visit the emergency room for care they could have received from a primary care physician;
- To address the current shortage we need 16,000 primary care practitioners and 52,000 primary care physicians will be needed to meet the needs by 2025;
- 45,000 people die each year because they don’t have health insurance and don’t get to the doctor on time.
The shortage of primary care providers is an issue very familar to Community Health Centers. Health centers serve more than 22 million patients a year, of whom 72 percent are below the federal poverty level, in rural and urban communities which have always struggled with access to care. Health centers are a model for providing quality, affordable care and will expand their reach as millions of newly insured people gain access to coverage under the ACA and will need a primary care provider. Here are a few programs that aim to fill the primary care provider shortage gap:
Teaching Health Center Graduate Medical Education– The ACA created program is a five-year initiative to increase the number of primary care residents and dentists trained in community based settings. According to HRSA “physicians trained in health centers are more than 3 times as likely to work in a health center and more than twice as likely to work in an underserved area than those not trained at health centers.” The program is expected to create 600 new primary care physicians by moving training out of academic teaching hospitals and into community based settings.
Community HealthCorps– Founded in 1995 by NACHC, it’s the largest health-focused, national AmeriCorps program that promotes health care in underserved areas and develops the health care workforce. A 2009 evaluation of the program found over 110,000 individuals per year benefited from heath education provided by Community HealthCorps members and 120,000 individuals received assistance in improving care utilization.
National Health Service Corps– The NHSC connects primary health care providers to areas of the U.S. with limited access to care. Currently, 10,000 NHSC members are providing care at more than 14,000 sites across the country. The ACA awarded NHSC more than $10 million for loan repayments for medical students in exchange for their service in underserved communities.
Wright Center-A.T. Still University National Family-Medicine Residency Program– You may have seen my earlier blog on this innovative program. This is a multi-state, collaborative effort to place 87 graduates over a span of three years in Community Health Centers. The program will serve a pipeline of doctors who are trained to provide care to underserved populations in rural and urban communities.
The University of California Riverside School of Medicine– The new school of medicine will not enroll its first class until August of this year with the goals of expanding the diversity of California’s physician workforce and developing health care delivery programs to improve the health of underserved populations. Read more here.
The Quinnipiac University Frank H. Netter School of Medicine– Another new medical school, Quinnipiac is offering a Primary Care Fellowship program. The fellowship will offer full tuition and a fee waiver for four years if the fellow practices primary care for four years. Read more here.
UCLA International Medical Graduate Program– This program seeks to address the shortage of Hispanic doctors in California, where 36 percent of the population is Hispanic and only 5.2 percent of physicians are Hispanic. The program allows physicians from Latin American countries to become certified to practice in California. Through the program these physicians receive the tools and resources they need to off-set costs and take the medical licensing examinations in exchange for committing to working in underserved communities. You can read more about this effort here.
These are just a few programs that have some across my computer screen in the last month or so. Do you know of any others? Is there something you’re doing in your community to address this problem? Let us know.