Or not enough primary care?
Programs to forgive medical school loans if newly-minted primary care doctors, geriatric specialists and palliative care docs agreed to practice in regions where physicians are needed (at last for a few years after graduation), this could go a long way toward redressing regional imbalances. Many would, no doubt, put down roots in their new communities, and wind up staying.
Many, in fact, won’t stay in underserved areas and will leave after their commitment is up. We need more primary care physicians everywhere, not just in remote, rural areas.
Forgive all loans to students who choose generalist careers without restriction on where they have the practice.
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{ 6 comments }
can someone enlighten me why they (comments section) think that img’s see uninsured patients and medicaid patients more than american grads? do the financial laws of the universe not apply to practices of img’s?
do they believe img’s willingly would take home less pay if they had an alternative to take home same pay? do they believe img’s somehow relate better to uninsured american patients? i am sure the majority of img’s that come over are from the upper middle class or upper class of the country they are from.
Loan forgiveness will do nothing to slow the exodus of current generalist physicians and will take three years to have any effect on numbers of new physicians in the field as medical students choosing generalist specialties will not join the workforce until completing a three year residency. To retain current physicians and current residents (who might otherwise go on to specialty felloships) better payment is needed.
I doubt anyone is willing to spend more money until this reaches a more obvious crisis level.
Regarding IMG’s, I have always found the belief that they will gladly work for peanuts for the privilege of serving those in need quite amusing. Why would someone leave their own people in dire need and underserved to go serve those already surfieted on medical care but for $$$$?
As a first-year medical student, I would like to point out that for all the lip-service given to the importance of turning out primary care physicians, there is still a deeply-ingrained notion that primary care is an undesirable specialty. My school talks big about the importance of primary care docs, but the notion of putting the PCP at the center of patient care is still not really addressed. IM, it seems, has a decent reputation, although I think they are still somewhat stigmatized as over-thinkers. Family Medicine seems to have just about zero status; many of my classmates still have the idea that FP is for folks who don’t want to work, despite the fact that FP docs work just as much as any other specialist, they just don’t get compensation for much of the work they do.
I absolutely agree that PCP’s need better compensation, and that will go a long way toward attracting students to the specialty; in fact, sadly, that’s probably the only thing that will. Or (gasp!) we could pay all physicians the same salaries (more or less, with some compensation for longer residencies, fellowships, etc); then folks might go into the specialty that they love or are good at instead of following the money…
Commence “commie” responses now.
IMG’s practice demographics mirror American grads. If a community is undesirable to a US citizen, it is undesirable to a Pakistani. Maybe even more so.
If you want doctors in these rural areas, you admit medical students who are FROM these areas. Preferably train the students in rural areas. Then pay them appropriately.
I am from those areas, and would love to live there again–may when I retire–but will not practice there. With the advent of the modern paved highway, they can get to the city to see their specialist as quickly as I can get across town for my daily commute. Faster in an emergency because they can drive 90mph with no traffic to get in the way.
If I practiced there, I during the day I would have a patient load top-heavy with the elderly who are too prefer to avoid the city traffic and like to visit with their cronies in the waiting room (medicare) and people who can’t afford the gas to get to town (medicaid and indigent).
At night I would be on call for all 10,000 because they would rather bother me than their nice doctor in town.
No way Hosea! I don’t need it, and frankly neither do they. “underserved community” is a myth in this country
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