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Federal Program Aims to Boost Number of Primary Care Doctors

A new federal program will repay $9.1 million in student loans for 77 fourth-year medical students who, in turn, will serve a stint as primary care doctors in areas with a shortage of health care professionals.

The Students to Service Loan Repayment Program is a new pilot program offered by the National Health Service Corps and funded through the Affordable Care Act.

"These kinds of programs are really critical," said Dr. Virginia Hood, president of the American College of Physicians and a professor at the University of Vermont. "It's another way of getting people into areas that have been without health care professionals."

The National Health Service Corps has been around since 1972, but recent increases in funding have bolstered the agency's efforts to attract new doctors to areas in need, Hood said.

There were 3,600 primary care physicians enrolled in the National Health Service Corps in 2008, caring for 3.7 million people, she said. Last year, more than 10,000 agency-supported health care professionals looked after the medical needs of 10.5 million people.

U.S. Health and Human Services Secretary Kathleen Sebelius said during the official unveiling of the medical student awards in February that the "new program is an innovative approach to encouraging more medical students to work as primary care doctors."

Primary care physicians are considered central to health care reform efforts because they serve as the gatekeeper for an individual's medical treatment -- tracking prescriptions, coordinating with specialists and maintaining frequent contact with the patient.

To meet the federal target of one primary care doctor for every 2,000 Americans, 17,722 new physicians are needed in medically underserved areas in the United States, according to the Health Resources and Services Administration.

"We don't have enough primary care doctors in the country for everyone who needs a personal physician," Hood said.

Students in the new program will receive up to $30,000 a year for four years. They must either work full-time for three years in a medically underserved area or half-time for six years. Eligible doctors who stay longer eventually could pay off all their qualifying student loans, according to the agency.

Places in need of doctors are scattered throughout the country. The agency's website lists areas in all 50 states and several U.S. territories.

"It varies, and it doesn't always mean rural," Hood said. "Sometimes inner city urban areas are underserved because the people there don't have good health insurance because they're poor. There are lots of pockets throughout the country."

An ACP past president, Dr. Joe Stubbs, is also a National Health Service corps alumnus who got through medical school on agency scholarships and in 1982 set up a general practice in Albany, Ga., to carry out his service obligation.

"Thirty years later, I'm still here," said Stubbs, now 58. "I've helped raise three daughters here, and I've become a part of the community."

Stubbs said he enjoys working in a rural area partly because he gets to use the full range of his medical training and expertise because there's less opportunity to hand patients off to specialists.

"I was happy to have the opportunity in this setting to utilize all my skills and training more fully than I would have in a more metropolitan area," he said.

The true value of the Service Corps, Stubbs said, is in relieving medical students of the pressure they feel to pursue a high-paying specialty so they'll be able to pay off hundreds of thousands of dollars in student loans.

"A lot of medical students want to go into the field of medicine to do what I'm doing, but the financial burden of their medical training can force them to re-think their career options," he said.

Hood said she would like to see the National Health Service Corps receive even more funding, but Pres. Obama's proposed health care budget for 2013 does not add any extra discretionary dollars to the agency's $300 million budget. The agency also will not receive extra discretionary money this year.

"The American College of Physicians understands that cuts are going to be made, but they should be done with care," Hood said. "This is a program that really contributes to the quality of health care in this country, and it deserves better support."

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March 20, 2012
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