American College of Physicians: Internal Medicine — Doctors for Adults ®

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Regents offer solutions to primary care shortage

From the May ACP Internist, copyright © 2009 by the American College of Physicians

By Jessica Berthold

The Board of Regents approved at its spring meeting a policy monograph which offers several solutions to the impending shortage of primary care physicians. The document, Solutions tothe Challenges Facing Primary Care Medicine, recommends that the federal government:

  • Establish a permanent commission to develop a national healthcare workforce policy that would ensure enough health professionals—and particularly physicians—are being trained and educated to meet the nation’s primary care needs. As a preliminary target, the College recommends increasing the number of Medicare-funded graduate medical education positions by 3,000 primary care physicians each year for the next 15 years;
  • Create incentives for medical students to pursue primary care careers and to practice in areas of the greatest need. Specifically, the College recommends:
  1. Funding 1,000 awards annually for the next 15 years that would tie new loan repayment and medical school scholarship programs to primary care service at critical shortage facilities;
  2. Increasing funding for Title VII scholarships and loan repayment programs to allow for an extra 500 awards annually for the next 15 years;
  3. Increasing funding for National Health Service Corps scholarships and loan repayment programs for an extra 1,500 awards annually for the next 15 years for primary care; and
  4. Establishing new practice-entry bonuses for scholarship or loan repayment award recipients who stay in underserved communities after they finish their service obligations;
  • Enact legislation to let primary care residents defer their student loans throughout the duration of their residency;
  • Develop policies that support retention of senior primary care doctors, such as reducing the cost of medical liability insurance for those in part-time practice;
  • Increase Medicare fee-for-service payments for primary care doctors’ services.

The Regents also approved a second position paper supporting the need to develop new payment models which would pay physicians based on effective and efficient care, not on volume of services.

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