Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The National Health Service Corps impact on primary care doctors

Kohar Jones, MD
Physician
March 17, 2011
336 Shares
Share
Tweet
Share

Before I had even begun medical school, I already knew that I would enter primary care when I finished.  I had successfully applied for and received a scholarship from the National Health Service Corps Scholars program.  By the time I graduated, I knew that after my three years of residency training, I would practice in an underserved area for at least four years, one year of service to America for each year Americans, through their taxes, had paid for me to go to medical school.

By committing to primary care early, and getting paid for that commitment with a monthly salary and medical school fees, and being threatened with paying back $200,000+ worth of loans in that amount, times 3, with interest, I had an even stronger commitment to primary care as I finished medical school.  I didn’t want to be a million dollars in debt before I even began my working life.  And so rather than running away to join the circus, or write a book, or become a surgeon, I entered family medicine.  Now I get to be part of the solution to our country’s health care crisis.

An important part of health reform is to strengthen primary care, and get more people to see their doctors to stay healthy.  But more primary care to keep people healthy requires more primary care doctors.  And right now we’re experiencing a national shortage. It’s a tough sell convincing medical students to enter primary care.

The students I work with on the family medicine clerkship look at the doctors and see us working hard to cover lots of complex issues in fifteen minute visits, while living at the bottom of the medical totem pole.

As one student wrote in a reflective writing piece for the clerkship: If it weren’t for the system of reimbursements that we are mired in, it seems obvious that the smartest people in this profession should be on the front lines.  Is that it, then?  Have we found our clarion call for reforming our broken health care system: better reimbursements for primary care so that doctors can spend more time with patients and so that the smartest minds will provide intelligent triage and preventative care?

Well, improved reimbursements for primary care are one goal of health reform, with 10% higher payments to primary care (still far short of narrowing the 2:1 pay differential between specialists and primary care physicians). That may nudge some students to choose a lifepath into primary care.

But at the same time America needs more primary care doctors, it also needs to distribute those docs around the country to work where they are most needed.

The National Health Service Corps was established in 1972 as a way for the government to direct the most needed physicians to the neediest Health Professional Shortage Areas (HPSA). Physician NHSC Scholars go through school and graduate knowing they will become a primary care physician—a family physician, an internist, a pediatrician, a psychiatrist or an ob/gyn.  Then there are loan repayors, who first find themselves a job in a clinic with a sufficiently high HPSA score to qualify, then apply for additional support from NHSC to pay off their loans.

With the ACA, the NHSC loan repayment program just got a lot bigger and a lot more generous.  Instead of paying off $40,000 worth of loans in the first two years, it’s jumped to $60,000, with up to $170,000 in repayments for a five-year service commitment, with the possibility for complete repayment of loans with six or more years of service. They’ve also sweetened the deal—and made sure that the most passionate physicians are able to teach the next generation—by arranging for eight or twenty hours out of a 40 hour work week that may be dedicated to teaching. There is also a half-as-much-time for twice-as-long option.  These applied to the loan repayors, and coming up soon (perhaps as soon as this week) will start to be applied to Scholars also.

I love the combination of clinic work and teaching.   I applaud the NHSC for creating what I think of as the “clinic plus” positions, allowing dedicated physicians to serve the underserved while grooming the next generation of primary care physicians to look after the nation’s health.

Kohar Jones is a family physician who blogs at Progress Notes.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

Label the interaction as difficult, not the patient

March 17, 2011 Kevin 6
…
Next

Match Day 2011: Family medicine grows, but enough to save primary care?

March 17, 2011 Kevin 11
…

Tagged as: Primary Care, Public Health & Policy

Post navigation

< Previous Post
Label the interaction as difficult, not the patient
Next Post >
Match Day 2011: Family medicine grows, but enough to save primary care?

More by Kohar Jones, MD

  • a desk with keyboard and ipad with the kevinmd logo

    A positive view of health reform, no thanks to the HITECH Act

    Kohar Jones, MD
  • a desk with keyboard and ipad with the kevinmd logo

    The gun violence epidemic is a traumatic injury epidemic

    Kohar Jones, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Blessed to be alive after a gunshot wound

    Kohar Jones, MD

More in Physician

  • Tom Brady’s legacy and the importance of personal integrity in end-of-life choices

    Kevin Haselhorst, MD
  • The hidden truths of hospital life: What doctors wish you knew

    Emily Stanford, DO
  • The heart of a Desi doctor: Balancing emotions and resources in oncology

    Dr. Damane Zehra
  • The Iranian diaspora’s fight for liberty: Overcoming challenges in the largest women’s rights movement of our century

    Montreh Tavakkoli, MD
  • The harmful effects of shaming patients for self-education

    Maryanna Barrett, MD
  • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

    Wendy Schofer, MD
  • Most Popular

  • Past Week

    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • Breaking free from a toxic relationship with medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Revolutionizing COPD management with virtual care solutions [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Breaking free from a toxic relationship with medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Tom Brady’s legacy and the importance of personal integrity in end-of-life choices

      Kevin Haselhorst, MD | Physician
    • The hidden truths of hospital life: What doctors wish you knew

      Emily Stanford, DO | Physician
    • 10 commandments of ethical affiliate marketing for physicians

      Aaron Morgenstein, MD & Amy Bissada, DO | Finance
    • The heart of a Desi doctor: Balancing emotions and resources in oncology

      Dr. Damane Zehra | Physician
    • Safe sex for seniors: Dispelling myths and embracing safe practices [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 3 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Journal Shows Its Commitment to Exploring AI in Medicine
  • Do Away With 'Lockout' Period in iPLEDGE, FDA Advisors Urge
  • Cluster Headache, Migraine Linked to Circadian System
  • Smaller Liver Transplant Candidates Wait Longer, Less Likely to Receive Organ
  • A 'Double Whammy' for Gastric Cancer Risk

Meeting Coverage

  • Oral Roflumilast Effective in the Treatment of Plaque Psoriasis
  • Phase III Trials 'Hit a Home Run' in Advanced Endometrial Cancer
  • Cannabis Use Common in Post-Surgery Patients on Opioid Tapering
  • Less Abuse With Extended-Release Oxycodone, Poison Center Data Suggest
  • Novel Strategies Show Winning Potential in Ovarian Cancer
  • Most Popular

  • Past Week

    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • The psychoanalytic hammer: lessons in listening and patient-centered care

      Greg Smith, MD | Conditions
    • Breaking free from a toxic relationship with medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Revolutionizing COPD management with virtual care solutions [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Breaking free from a toxic relationship with medicine [PODCAST]

      The Podcast by KevinMD | Podcast
    • Tom Brady’s legacy and the importance of personal integrity in end-of-life choices

      Kevin Haselhorst, MD | Physician
    • The hidden truths of hospital life: What doctors wish you knew

      Emily Stanford, DO | Physician
    • 10 commandments of ethical affiliate marketing for physicians

      Aaron Morgenstein, MD & Amy Bissada, DO | Finance
    • The heart of a Desi doctor: Balancing emotions and resources in oncology

      Dr. Damane Zehra | Physician
    • Safe sex for seniors: Dispelling myths and embracing safe practices [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The National Health Service Corps impact on primary care doctors
3 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...