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How To Fix The Primary Care Physician Shortage

By G. Richard Olds, M.D.
physiciansThe U.S. healthcare system is at a crossroads. The number of primary care physicians is expected to grow modestly over the next ten years. But demand for them is skyrocketing.

As a result, America is expected to be short anywhere between 12,500 and 31,100 primary care physicians by 2025, according to the Association of American Medical Colleges.

Medical schools must change their ways to stem this shortage. They can start by reducing their students’ debt load, changing the way they recruit applicants, and providing their students more exposure to primary care.

For the U.S. health system to thrive, at least half of all medical graduates need to go into primary care — family and general practice, general internal medicine, general pediatrics, and geriatric medicine.  According to a recent study, though, only 2 percent of medical school graduates surveyed expressed interest in pursuing primary care.

Their reluctance is understandable. On average, primary care physicians earn about $150,000 per year — but have to pay off around $200,000 in medical school debt. Specialty doctors make over $250,000 a year.  They can pay off their debt in a couple years — while primary care physicians may be saddled with theirs for decades.

Medical schools must find creative ways to limit student debt. If students don’t have hundreds of thousands of dollars in loans hanging over their heads, they’ll be more likely to pursue less lucrative callings.

St. George’s University, the school I lead, provides several students with CityDoctors scholarships to offset the costs of their medical education. In exchange, they commit to practicing in New York City’s public hospital system. Many choose to go into primary care.

Medical schools should also revise the criteria they use to admit students. Rather than just picking those who excel academically, they should look for students who have demonstrated a commitment to their communities.

Several schools already look for service-based activities on applicants’ resumes — like a stint in the Peace Corps, for instance — that could make them excellent candidates for primary care. They can also recruit students from underrepresented groups, older students, and students with other healthcare training, such as registered nurses and physician’s assistants.

Finally, medical schools can do a better job of exposing students to primary care. For example, by partnering with community hospitals, St. George’s gives its students the opportunity to work in primary care and have a direct impact on a community. What’s more, many of St. George’s faculty members are primary care physicians who can share their experience and passion directly with their students.

Thanks to these efforts, over 75 percent of St. George’s graduates go into primary care — in contrast to about one-third of U.S. medical school graduates.

America’s primary care prognosis isn’t good. But with the right strategies, medical schools can ensure that the United States has a strong pipeline of primary care physicians for years to come.

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Dr. G. Richard Olds is president of St. George’s University. Prior to joining SGU, he was the Vice Chancellor for Health Affairs and Founding Dean of the School of Medicine at the University of California, Riverside. Dr. Olds is a graduate of Case Western Reserve University School of Medicine and trained in internal medicine at the Massachusetts General Hospital in Boston. (Photo by Day Donaldson via Flickr)

One comment

  1. The cost to practice medicine, the increasing wasteful nonsense in medical records- specifically EHR demands, meaningful use, and PQRS, are making medicine unpleasant to practice

    The government, as usual , has forced doctors to expend a great deal more energy away from patient care and towards their computer punching in meaningless data
    Until that ends, top tier students will keep being told to stay away from the medical field because frankly, with decreased pay and increase costs, and the aforementioned….its sadly no longer the great profession it once was

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