study by researchers at the George Washington University School of
Public Health and Health Services (SPHHS).
The report, which was just released in the “Published Ahead-of-Print” section in Academic Medicine, suggests that not only are we facing a primary care shortage, but also that the problem is not likely to be solved soon. There’s been a lot of talk about the need to get primary care doctors to practice in Kentucky, specifically in the state’s rural areas, without mention of the underlying issue that the study makes clear: there are not even close to enough doctors being trained as primary care physicians in the first place.
In addition to finding that just 4.8 percent of the graduate medical education system practiced in rural areas, 198 institutions (26 percent) produced no rural
physicians and 283 institutions (37 percent) produced no Federally Qualified Health
Center or Rural Health Clinic physicians, which were created to enhance the provision of primary care services in underserved communities.
“If residency programs do not ramp up the training of these physicians
the shortage in primary care, especially in remote areas, will get
worse,” said lead study author Dr. Candice Chen, a professor at SPHHS. “The study’s findings
raise questions about whether federally funded graduate medical
education institutions are meeting the nation’s need for more primary
Currently, the U.S. is producing primary care physicians at rates that
are “abysmally low” and unless changes are made to the system, the nation will have an
even greater shortfall of primary care doctors just as the Affordable
Care Act ramps up demand for these services, said Chen in a Newswise release. And in Kentucky, the additional need for primary care doctors as a result Medicaid expansion is piled onto the heap of issues.
The study’s authors said policymakers should take a hard look at the skewed incentives and other
factors that have led to the current primary care crisis and develop a
more accountable graduate medical education system. It is critical to find a better balance in medical specialties and more primary care physicians to build an effective, affordable health system.