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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