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The Primary Problem

The Primary Problem

The Problem: 

The health care system in the United States is currently in desperate need of Primary Care Physicians (PCPs). However, the allure of lucrative sub-specialties tends to sway medical school graduates away from careers in Primary Care. On average a PCP earns about half the salary of a specialist. Since most medical school graduates have very large debts to pay off, higher earning specialties are much more desirable career options. However, the problem lies in the growing and aging U.S population and the implementation of the Affordable Care Act. This will only increase the need for PCPs as healthcare is made more financially available.

The Solution

In an effort to increase the number of primary care physicians in the United States, many medical schools are actively implementing initiatives to encourage medical school graduates to pursue careers in primary care. One such initiative is the GME initiative, which recently made the following recommendations to congress:

  • Create a workforce that is at least 40% PCPs, holding teaching hospitals accountable and increasing the primary care residency position cap.
  • Provide direct GME (DME) payments of $100,000 per resident annually for programs that produce graduates who truly go into primary care.
  • Provide indirect GME (IME) payments to support primary care residency education, including education outside hospitals.
  • Allow states expanding Medicaid through the Affordable Care Act to increase PCP education capacity through Medicaid DME and/or IME Since more lucrative specialties generate more revenue for hospitals, these monetary incentives aim to encourage the expansion of Primary Care Residency Training Programs.

Other, more controversial, changes are being made to offset the shortage of PCPs, specifically in underserved rural areas. Recently, the State of Missouri passed a law allowing medical school graduates to work as “assistant physicians,” without going through a residency program. Instead, this new class of care-givers first must work with a certified physician for 30 days. After receiving approval from the Board of Healing Arts, they are then legally allowed to treat patients within a 50-mile radius of that same physician.