Economic Impact of a Primary Care Career: A Harsh Reality for Medical Students and the Nation

Palmeri, Martin; Pipas, Catherine Florio; Wadsworth, Eric; Zubkoff, Michael

doi:10.1097/acm.0b013e3181f5b754

Cited by 22 publications

(19 citation statements)

References 8 publications

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“…[16][17][18] Initially, it would appear that our survey findings could support that career choice is influenced by debt, with 42% of residents having no debt. In addition, residents ranked "the amount of loan debt to repay" as the third highest negative influence in choosing medical genetics.…”

Section: Program Directors' Surveymentioning

confidence: 95%

Opportunities to improve recruitment into medical genetics residency programs: survey results of program directors and medical genetics residents

Cichon

Feldman

2014

Genetics in Medicine

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Section: Program Directors' Surveymentioning

confidence: 95%

Opportunities to improve recruitment into medical genetics residency programs: survey results of program directors and medical genetics residents

Cichon

Feldman

2014

Genetics in Medicine

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“…15,16 These economic factors are also associated with reduction in GME training positions for primary care compared with the substantial expansion of nonprimary care training positions by teaching hospitals. 10,13,17 For example, between 1998 and 2008, family medicine lost 46 programs and 390 positions, and general internal medicine experienced a loss of nearly 900 general internal medicine positions, while 133 new internal medicine subspecialty programs were created.…”

Section: Economics Are Reshaping the Educational Landscapementioning

confidence: 99%

The Next Phase of Title VII Funding for Training Primary Care Physicians for America's Health Care Needs

Phillips¹,

Turner²

2012

The Annals of Family Medicine

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Health care reform will add millions of Americans to the ranks of the insured; however, their access to health care is threatened by a deep decline in the production of primary care physicians. Poorer access to primary care risks poorer health outcomes and higher costs. Meeting this increased demand requires a major investment in primary care training. Title VII, Section 747 of the Public Health Service Act previously supported the growth of the health care workforce but has been severely cut over the past 2 decades. New and expanded Title VII initiatives are required to increase the production of primary care physicians; establish high-functioning academic, community-based training practices; increase the supply of well-trained primary care faculty; foster innovation and rigorous evaluation of these programs; and ultimately to improve the responsiveness of teaching hospitals to community needs. To accomplish these goals, Congress should act on the Council on Graduate Medical Education's recommendation to increase funding for Title VII, Section 747 roughly 14-fold to $560 million annually. This amount represents a small investment in light of the billions that Medicare currently spends to support graduate medical education, and both should be held to account for meeting physician workforce needs. Expansion of Title VII, Section 747 with the goal of improving access to primary care would be an important part of a needed, broader effort to counter the decline of primary care. Failure to launch such a national primary care workforce revitalization program will put the health and economic viability of our nation at risk. Ann Fam Med 2012;10:163-168. doi:10.1370/afm.1367. INTRODUCTIONT he Patient Protection and Affordable Care Act (P.L.111-1148) (ACA) will provide health care coverage to nearly all Americans, but it did not go far enough to assure access to appropriate care. Despite providing for expansion of community health centers and the National Health Service Corps, the ACA did not do enough to reverse a serious decline in production of primary care workforce. Cautionary evidence to support this concern comes from the universal health care initiative in Massachusetts, where, despite having one of the nation's highest ratios of primary care physicians to the resident population, the newly insured were generally unable to access primary care physicians. 1The ACA contained some important provisions to shore up primary care, including primary care incentive payments, a preference for primary care if unfi lled residency positions are redistributed, authorization and funding for Teaching Health Centers, extension of Medicare Graduate Medical Education (GME) payments for training in nonhospital settings, and increase in Medicaid rates to 100% of Medicare for primary care physicians. 164 T I T L E V II FUNDING A ND PR IM A RY C A R Eexpand primary care physician positions.2,3 All these initiatives are useful, but health care reform demands a much larger and more focused policy effort to produce a greater numbe...

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“…18 Another study had more dire findings for new PCPs and how debt would alter their lifestyles. 36 However, their assumptions failed to allow for family support. Therefore, the validity of their conclusions is questionable.…”

Section: Discussion Of Analysis: Specialty Choicementioning

confidence: 99%

“…18,36 Non-PCPs could acquire educational debt up to $300,000 without procuring more debt while having a 10-year repayment plan and residing in any area. 18 Another study had more dire findings for new PCPs and how debt would alter their lifestyles.…”

Section: Discussion Of Analysis: Specialty Choicementioning

confidence: 99%

“…These factors decrease the likelihood of a physician becoming a PCP by 50%. 24,36 Further, between 1998 and 2008, teaching hospitals expanded graduate medical education (GME) to train residents in more lucrative specialties, and they reduced primary care residency positions as specialty care is more financially advantageous. 24 Additionally, physician salary has been shown to positively correlate with both structural and personal economic factors and with job satisfaction.…”

Section: Supply Of Primary Care Physiciansmentioning

confidence: 99%

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The association of medical student debt on choice of primary care specialty and rural practice location.

Ziegler

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Economic Impact of a Primary Care Career: A Harsh Reality for Medical Students and the Nation

Abstract: PC physicians, in the first three to five years following residency, will have expenses that exceed earnings. This reality greatly increases the financial disincentive for pursuing a career in PC compared with other fields of medicine.

Cited by 22 publications

References 8 publications

Opportunities to improve recruitment into medical genetics residency programs: survey results of program directors and medical genetics residents

Opportunities to improve recruitment into medical genetics residency programs: survey results of program directors and medical genetics residents

The Next Phase of Title VII Funding for Training Primary Care Physicians for America's Health Care Needs

The association of medical student debt on choice of primary care specialty and rural practice location.

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