Family practice physicians in short supply
|By Angela Hart, The Press Democrat, Santa Rosa, Calif.|
|McClatchy-Tribune Information Services|
What really struck her, however, was something simple: Her grandfather's deep relationship with his primary care doctor.
"He struggled so much in his life, so seeing the doctors really care about him and his health meant so much to me," she said. "They developed such a strong relationship that his doctor even came to his funeral when he passed away."
Now Rodriguez, 23, wants to join the ranks of local family doctors. This summer, she was one of six people selected for a fast-track joint medical program offered by the
The three-year program, shortened from the standard four-year medical education, is the first of its kind in
The dwindling supply of family practitioners, who handle patient needs including childbirth, preventive care, obstetrics and gynecology, is a not a new problem; but it is growing more pronounced as graduating physicians -- faced with hefty six-digit student loan debt -- instead choose fields where they can make more money or have more flexible schedules.
Among doctors and medical students, the rigors and sacrifices of primary care medicine are well known.
"Primary care is one of the most complex and demanding fields," said
Nearly four times as many primary care physicians are needed than are practicing in the county today, according to a recent study by the county's
The problem is mirrored throughout the state and across the nation. In
The problem is getting worse as millions of Americans become newly eligible for health coverage and seek care. The country is projected to be short 45,000 primary care doctors from what it will need in 2020, according to the
"Producing enough future primary care physicians is absolutely a challenge," said
Even as enrollment in medical schools nationwide is on the rise,
According to a county survey, 20 percent of primary care doctors plan to retire in the next five years, and an additional 9 percent said they had plans to move out of the county in the same period. About 54 percent of doctors in the county are in specialty care, according to the county survey. The remainder are in primary care.
The shortage comes at a time when the need for primary care doctors is rising faster than any time in recent history. Baby boomers are aging, and their health needs are growing more acute.
"The shortage is getting worse over time," said Maddux-Gonzalez, a former
Health care reform has expanded access to care for a population that has largely gone uncovered, many for their lifetimes. But having insurance has not necessarily helped alleviate problems for patients who have struggled to find a doctor and secure appointments.
Primary care shortages are leading to long wait times for doctor appointments, providers are overpacking their schedules, and patients are rationing doctor visits, according to county studies and local physicians.
"Not getting to the doctor in a timely way can lead to long-term negative consequences," Bindman said. "Someone who may have presented with an earlier stage of cancer could experience delays, and that could lead to spread of the cancer, for example; or someone with an infection that could have been treated with an antibiotic pill at home could have to now be hospitalized."
The shortage has hit low-income patients the hardest.
Less than 30 percent of primary care doctors are accepting new
"I'm busy," Sonander said. His practice sees about three dozen patients a day, and his medical work often is sidetracked by administrative chores.
"When I'm here we can maybe go up to 40 (patients)," he said.
The shortage presents a major stumbling block for health care reform, which has as one of its cornerstones expanded access to primary care. Already, roughly 1 in 4 people countywide receive their medical care in a clinic setting, and that figure is rising, according to Maddux-Gonzalez.
Local health care experts say
Still, local demand for family practice doctors continues to outstrip supply.
The new fast-track medical school seeks to help chip away at the problem, seeding graduates throughout
The new degree allows students to skip the fourth year of school and go right into a residency program either with
The program is backed by a
"Traditional medical schools don't give students a good sense of what that is," she said.
Rodriguez, whose grandfather was a patient at
"I've always known that I want to go into primary care," she said. "I would love to come back to
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