At least the government realizes that there aren’t enough primary care physicians in Massachusetts to handle the influx of newly insured.
In response, they recently passed a law to remedy this:
In response, the law directs the University of Massachusetts Medical School in Worcester to increase class size so that it can graduate more primary care doctors, Bigby said. In addition, the law calls for better training of primary care doctors and aids some of them in repaying medical school loans.
Increasing the medical class size will not help. The incentives are so strong favoring specialty care, more medical students will simply mean more specialists.
“Better training” won’t help either. Again, it doesn’t address the financial incentives stacked against primary care.
Addressing medical school debt is the only proposal that makes sense. The effectiveness will solely depend on how much debt will be alleviated if a medical student chooses primary care.
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Increasing class size at UMass won’t help. Although the purpose of the school was to churn out more primary care doctors to practice in the state, and there are some financial incentives in terms of loans for students to enter primary care, less than 10% of my class from UMass is actually working in primary care. As you state, it will only create more specialists.
The financial incentive at Umass for primary care is some tuition abatement; however, the amount I saved on tuition is less than $30,000, which would be easily paid off in a few months as a specialist.
How in the world are they going to enforce their dictum that UMass produce more students going into primary care?
This is absolutely ridiculous and shows how out of touch the political world is with the reality of healthcare.
The solution is simple: there will be more doctors going into primary care when the salaries of primary care doctors improve. Until then, any other suggestion, be it P4P (a gimmick), loan forgivenss (not enough) or “cost neutral” adjustments (improving pay for primary care by taking it from other deserving fields like surgery) are doomed to fail.
Addressing medical school debt will only help years from now, if at all, when current students enter the physician workforce. The only effective measure now that would both retain current physicians and attract new ones to generalist medicine would be to substantially increase generalist pay from the payers controlled by the state.
Until they do that, they’re not serious about fixing the primary care physician shortage.