It’s called the "primary care crunch" in some circles: The looming problem of a health care provider shortage as an aging population needs more care at the same time a staggering number of primary care physicians are preparing to retire.
Pair those issues with an approximately 48 million uninsured Americans who are now gaining access to health care for the first time as a result of the Affordable Care Act, and it’s no wonder primary care physicians are in hot demand.
The Association of American Medical Colleges estimates a current shortage of 20,000 primary care physicians, with that statistic expected to rise in the next decade because 50 percent of the country’s presently employed physicians are over the age of 50.
In Utah the problem is even more acute, as The Salt Lake Tribune highlighted in its recent Feb. 10 story, "Lawmakers debate fixes for doc shortage." Our state ranks last in the U.S. for the number of active primary care physicians per 100,000 people. Utah’s statistic in that category is 58.4, significantly less than the national average of 79.4, according to the Utah Medical Education Council’s 2012 report on Utah’s physician workforce.
The University of Utah School of Medicine wants to help solve this dilemma by training future physicians to help Utah be fully prepared for primary care needs in the future. Right now, we’re working hard to battle the "what ifs" of tomorrow’s U.S. physician shortage by proactively focusing on recruiting and training students who want to go into primary care in a number of ways.
Our selection process favors students who are committed to serving our communities and, from the first year of medical school, we spend significant time encouraging medical students to consider primary care.
With the new medical school curriculum implemented five years ago, we make sure the very first clinical exposure our students have is with family medicine, pediatrics, internal medicine and other primary care providers. By the time they are in their third year, all of our students have two years of primary care experience.
The data suggest we have done well in our efforts. The Journal of the American Medical Association in a recent study noted that only one in five graduating medical students chooses primary care over another specialty field, a reality sometimes driven by differing pay for positions in the medical field. Statistics from the School of Medicine show that between 2003 and 2012, about 45 percent of our graduates chose a primary care residency. An additional 40 percent of our physician assistant students also chose primary care as their career route.
An important consideration for many students is the financial implications of choosing primary care over specialty fields. The School of Medicine, with the support of our active Alumni Association, is working on funding for a new loan forgiveness program, the University of Utah Cares About Primary Care Program (UCAP), which gives students loans that can be forgiven when they practice primary care in a medically underserved area in Utah for at least two continuous years.
Serving the rural population in Utah is critically important. The Department of Family and Preventive Medicine’s Utah Rural Outreach Program (UROP), which is operated by medical students, is designed to address the issue of disproportionately low numbers of health care providers, especially primary care providers, in rural Utah. Medical students participating in UROP visit high schools in rural communities to increase awareness and interest in health careers and education. They also work to recruit rural physicians to act as mentors for prospective students in their communities.
The School of Medicine and University of Utah Health Care see primary care as a critical component of community health. Many patients seeking health care don’t need a specialist, but a trusted health care provider who can help with preventative medicine and common ailments. I’m proud to say primary care is among our top priorities as an institution and is an area we will continue to focus on as the health care landscape continues to change ahead.
Vivian S. Lee, M.D., Ph.D, MBA, is senior vice president for Health Sciences at the University of Utah, dean of the University’s School of Medicine and CEO of University of Utah Health Care.
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