As simple as that?

Bank of America has decided to donate $5 million for medical school loan forgiveness for primary care doctors who agree to work a couple of years in Community Health Centers. It’s a shrewd move for BoA, which will be seen as helping increase the supply of primary care physicians to treat the thousands of MA residents who will be newly insured as a result of the health reform law.

The $5 million is being funneled through Partners HealthCare, which will hive off $500,000 to study how to make primary care more attractive to medical students. The other $4.5 million will be used for loan forgiveness for physicians in 23 Community Health Centers that are affiliated with Partners. In other words, if all goes according to plan, the subsidized physicians will soon be increasing referrals of insured patients to Partners! (It’s fun to be Partners.)

From the Boston Globe (Bank to aid health centers)

Dr. James Mongan, president of Partners HealthCare, which will oversee the program, said yesterday that the shortage of primary care doctors results from fewer medical students choosing internal medicine, pediatrics, and other primary care specialties; 20 percent of US medical students went into internal medicine in 2005, compared to 55 percent in 1998.

As a result, he said, the average wait for a new patient to get an appointment with a primary care doctor in Massachusetts is nearly five weeks.

Let’s give Dr. Mongan the  benefit of the doubt and assume he has a more sophisticated view of the situation than that. Specialist waits are worse yet. In fact Boston, with its high concentration of specialists, has the worst waits in the country! Is that because so many med students have opted to specialize?

Bigger drivers for poor access are the many would-be clinicians involved in research (like this new $500,000 study) instead of seeing patients, low reimbursement and respect relative to specialists, and antiquated approaches to scheduling and workflow.

March 12, 2007

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