The primary care signing bonus

January 15, 2008

They are becoming more lucrative in light of the PCP shortage in Canada.

A simple way to relieve the shortages here. Forgive all student loans for those who choose primary care as a career.

Update:
Even the NY Times gets it. Nothing relieves physician shortages faster than cash:

New York’s governor, Eliot Spitzer, has announced plans to create a kind of Peace Corps for doctors called “Doctors Across New York.” The idea is to help lure physicians into practicing in areas where a quarter of the state’s population is officially underserved.

To make that happen, Mr. Spitzer wants to provide up to $150,000 in awards “” for a five-year employment commitment “” to help pay off medical school loans. Right now, the state offers a paltry $10,000 in loan forgiveness per year for two years served in one of these areas, barely a down payment on medical school debt that now averages up to $160,000.

Mr. Spitzer also wants to increase Medicaid reimbursement rates to doctors and clinics in these underserved areas. There could even be grants to specialists who can be persuaded to establish practices or clinics where they are most needed.



Related posts:

  1. Too many doctors?
  2. Primary care doctors struggle to survive, even in Beverly Hills
  3. My take: Dwindling primary care, spinal care, ratting out patients
  4. Massachusetts primary care
  5. Primary care in Massachusetts
  6. Will a 10 percent bonus for primary care be enough?
  7. MinuteClinics: Reflects "the sorry state of primary care in America"


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{ 5 comments }

1 Anonymous January 15, 2008 at 10:12 am

Student loan forgiveness is usually given via the local hospital and tied to accepting Medicaid and Medicare. This ties the new physician to those messes for years to come and limits the ability of small groups to recruit new physicians or drop Medicaid or Medicare.

2 Anonymous January 15, 2008 at 11:20 am

Much like the med-mal insurance premium relief in Oregon. It too a couple years for the Legislature to realize its power, but they now tie the premium subsidy to Medicare and Medicaid acceptance proportional to your county’s Medicare/Medicaid population. And, of course, without tort reform, you still face the risk of a bankrupting lawsuit.

3 Anonymous January 15, 2008 at 5:59 pm

I do not think these ideas are bad but how about some help for those of us already in these situations? I am 13 years out of medical school and would not mind a little debt relief or a raise in paltry medicaid reimbursement (New York pays around 30 dollars per visit). Come on Elliot, how about some relief for those of us already on the front lines?

Signed: an overworked, under-appreciated, under-compensated family practitioner in upstate New York

4 Anonymous January 15, 2008 at 11:17 pm

Yes! What about those of us in our 40’s, out of residency for 10 years, working on the front lines, who will be paying off loans in excess of $180K until we’re 70, while grossing $120K/year? There’s no retirement account. There’s no college fund. Just work, and work, and fear.

And diminishing empathy.

5 Anonymous January 20, 2008 at 8:01 pm

Anon 11:17p,

I feel your pain. I did primary care for 5 years and then went back to do hem/onc. Now in fellowship taking home $1200/two weeks.

I sympathize with you more than you know, probably more than your wife or family as I walked in your shoes and saw the future the way you see it. Now some tough words–you have two choices, 1) Find another way to make money for your family 2) Spend less money so that you can save for retirement and college

1) You are probably smarter than everyone you went to high school with and most in your college class. You have just lost the vision you had then. Expand your horizons. Can you start a second job at night? Can you hire a few transcriptionists to work from home and start a dictation business? Can you program? Start a web based database for doctors and sell it on a shoestring to everyone you know. You have to adapt. This is the galapagos my friend and you are a small beaked finch. You must change. You are smart enough and strong enough to do it now, even with a mortgage, car payment, two kids and a wife who wants to spend like a “doctor’s wife”.

2) Convince your partners, wife, kids, parents that you have to sell you house and cars. Stop dictating your notes and type. Fire the one office person you don’t really need. Cut your own grass. Change your own oil. Buy a book on home repair so you can switch out the faucet when you need to. You need to start saving 20-30% of your income if you want your retirement and kid’s education to turn out ok. You need to take the gloves off.

Doctors are horrible with money. If you don’t believe me, don’t pay some financial provider to review your situation, call your accountant, pay him $200 to talk to you for 30 minutes about your expenses and show him everything. It will be embarassing, but if you choose option 2), you have to make some drastic changes.

Hang in there. You are one of the good guys.
b

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