What might a good solution be to the General Practitioner Shortage in the US?

[Starport Seven-Five]

Reduce cost of schooling, make health insurance companies obsolete, get rid of regional healthcare conglomerates, reform malpractice insurance, etc.

The American healthcare system has been a mess for a while and it seems to only be getting worse. I can see why less people are going that direction.

 

[VandVsmama]

In the US General Practitioners are the gateway to mental health care, many specialists and all sorts of other kinds of medical care. We have Urgent Care all over the place but since Urgent Care does not do followup of any kind they are't there to offer ongoing care for things like Depression etc or ongoing issues while a person waits to get into a specialist which can take months.

One of my adult children has been trying to get into a Primary Care - General Practitioner in Boston for over 2 years, yep, two years. I just spoke with someone in office staff who tole me there is a hold because so many retired during Covid and no new students want to go into the area. I just found an article saying the biggest system in the area was full back in 2023, https://www.nbcboston.com/news/loca...-accepting-new-primary-care-patients/3191270/ seems like nothing has changed which is scary still not taking patients. This is a big city with countless new residents, students and just just a massive a flux of humans so how can it be no-one is available to see people, not to mention some serious social issues with a substance abuse and homelessness in play

How can the US or struggling cities or states coax students into Primary Care? My best guess is to grant them student loan forgiveness if they commit for 5-10 years. Maybe another option is the laws change requiring Urgent Care to do follow-up? Maybe some states have made progress or brainstormed something because yikes, this needs to be remedied, the situation is terrible.

Some info & thoughts to consider:

• there's a federal program called the Public Service Loan Forgiveness program. Info available about it at https://students-residents.aamc.org/financial-aid-resources/public-service-loan-forgiveness-pslf. Requires an application.
• Some states have their own similar program. Arizona (where I live) has one and it applies to several types of healthcare jobs. Not only MD/DO's, but nurses, NPs, PAs, dentists, pharmacists, psychologists. https://www.azdhs.gov/documents/pre...ams/loan-repayment/arizona-loan-repayment.pdf
• Indian Health Service (IHS) also has a healthcare loan forgiveness program. https://www.ihs.gov/loanrepayment/
• Some COUNTIES might even have specific programs like this, too.
• Many healthcare systems are switching to use more NPs and PA's for primary care.
• The medical practice specialty of "General Practitioner" is kind of going away. You're more likely to find someone similar to this by going with an MD/DO whose specialty is Family Practice or Internal Medicine.
• Laws requiring an urgent care facility to do follow up isn't going to fix the problem. Urgent care is not meant to be used as ongoing care. What you'd end up doing is clogging up urgent care facilities so much that people with an ear infection will end up going to the ER instead and then ER wait times will go up more than they already are.

 

[LuvOrlando]

I'm not certain about MDs but I know for a fact Georgia has a similar program for dentists graduating from the state dental school in Augusta. Newly graduated dentists have been offered full tuition forgiveness if they move to a specified area and practice there for (I think) 8 years. My husband is a dentist and has gotten several student accepted to dental school in Augusta. A few of those students have been offered an amazing deal where a practice is set up for them, they are paid a very good salary (6 figures) and the state pays their outstanding college loans. My husband told each of those new dentists that they should accept that offer, work out the term, even if they work 3 or 4 days in the under served area and 1-2 days in the area of preference to establish themselves for when their contract is over. No one that he knows has taken the offer.

That's unfortunate, I wonder if this is largely due to the advanced age when a Dr will graduate. Once you are knee deep in medical school you already have a strategy and a plan to get to the other side that is keeping you going, might even have a significant other and made promises so another shift is very tough.

I imagine that this brilliant program would do much better if offered to younger students who don't have a plan yet so this becomes their plan. Float this around a bunch of new bachelors graduates worried about their loans and many might get wooed away from other disciplines.

 

[LuvOrlando]

Every type of doctor we have needed in more than 5 years is in short supply.

And everything already said in this thread is spot on.

One of our kids is in medical school. But has joined the US Navy so that the Navy will pay for school. Don't count on them treating civilians until after school, residency, and their obligation to the US military.

Their med school alone would be $60,000 per year.

There are states with programs for doctors to treat in rural areas and get some school paid for.

But medical schools have limited number of seats for medical students and have a cap on the number of incoming students they can accept. That's part of the reason medical school is hard to get into. There are just not enough openings for everyone.

It does make sense to open up many more schools to keep up with population growth, good point.

 

[China Expat]

Medicaid cuts are coming in 2026...this will make access to medical care even more difficult.

 

[tony67]

So just to say it yeah the whole system with PCP is a big problem, but its not just in the US.
It can also vary by state - the closest PCP I could get for about 10 years was 60 miles away in another state.
There was a PCP in my town, but he was about 80 and not very competent IMO.
BTW - I live in a town with a major hospital for the entire county - still no PCP.
Then when you finally get a PCP it takes 9 months for an initial visit and they wont do much for you until that visit.

All that said other countries have the same issues with GPs - its not just a US problem regardless of what some want you to think.
So even in countries where education is basically free many of the slots go to foreigners who pay.
So for example an American who could not get into med school but has money can pay and get in elsewhere taking a slot that would have been used by a local.

Then on top of that the folks that do graduate have countries like Australia recruiting GPs from other countries as well, so even though a country is qualifying GPs they are going to Australia where they have better weather, better pay, better opportunities.
Its very tempting for most. I personally know multiple GPs (and nurses) who have done this.

 

[LoveDaisy]

Change in the cost of higher education, changes for malpractice insurance, salary, and changes within the government to support science.

 

[Bad Pink Tink 2.0]

Then on top of that the folks that do graduate have countries like Australia recruiting GPs from other countries as well, so even though a country is qualifying GPs they are going to Australia where they have better weather, better pay, better opportunities.
Its very tempting for most. I personally know multiple GPs (and nurses) who have done this.

I was just about to say this. Other countries who have medical personnel shortages have recruitment programs in various countries. Australia is just the high profile one right now. Since the late 1990's Ireland has been recruiting Filipino nurses. This is the Irish Governments Recruitment page for international medical personnel. https://www.hse.ie/eng/staff/jobs/overseas-candidates/

Some things that the Irish Government offers as part of the recruitment package.

• The relocation package provides an allowance towards flight and accommodation costs up to the value of €4,160 for EU/UK candidates and €4,710 for Non-EU candidates
• Payment of Registration fees to Regulatory Bodies
• Payment Visa Fees
• Payment of Royal College of Surgeon (RCSI) Ireland Aptitude Test Fees/ other required registration fees
• Payment of Philippine Overseas Employment Administration (POEA) Language Testing and Examinations for the purpose of registration
• Payment of Recognition Fee / Validation of Qualification fee
• Payment of Atypical Working Scheme (ATWS) fee

Being mindful of Dis rules, and trying to be careful with my words. The Irish Government welcomes international medical personnel and makes it easy for them to come here as well as helping with the costs of relocation. This gives an immediate boost in numbers of qualified medical personnel which then supplements the Irish medical personnel who graduate each year. This is how you fill a deficit in an industry.

 

[SueInBoston]

In the US General Practitioners are the gateway to mental health care, many specialists and all sorts of other kinds of medical care. We have Urgent Care all over the place but since Urgent Care does not do followup of any kind they are't there to offer ongoing care for things like Depression etc or ongoing issues while a person waits to get into a specialist which can take months.

One of my adult children has been trying to get into a Primary Care - General Practitioner in Boston for over 2 years, yep, two years. I just spoke with someone in office staff who tole me there is a hold because so many retired during Covid and no new students want to go into the area. I just found an article saying the biggest system in the area was full back in 2023, https://www.nbcboston.com/news/loca...-accepting-new-primary-care-patients/3191270/ seems like nothing has changed which is scary still not taking patients. This is a big city with countless new residents, students and just just a massive a flux of humans so how can it be no-one is available to see people, not to mention some serious social issues with a substance abuse and homelessness in play

How can the US or struggling cities or states coax students into Primary Care? My best guess is to grant them student loan forgiveness if they commit for 5-10 years. Maybe another option is the laws change requiring Urgent Care to do follow-up? Maybe some states have made progress or brainstormed something because yikes, this needs to be remedied, the situation is terrible.

I've been trying for over 3 years for myself and my 78 year old aunt. I just finally got an appt for my aunt (we had the same PCP who left St Elizabeth) with a Geriatric practice. They seem to have availability each year.
Yes, I am just praying that I stay healthy.