Written by Liz Carey
A new study from the Robert Graham Center of the American Academy of Family Physicians (AAFP), co-funded by the Milbank Memorial Fund and the Physicians Foundation, finds that communities across the country are struggling to meet the demand for primary care physicians. found. It’s also important to keep those doctors in the community. Dr Yalda Jabbarpour, lead researcher on the study, said it was difficult overall, but even more so in rural areas.
“Ten years ago, we knew we had a problem with primary care physician density,” Jabarpour said in an interview with The Daily Yonder. “Today, even though people are older, sicker, the population is growing, and demand is increasing, there are actually fewer doctors to meet that need.”
Rural areas are more likely to rely on primary care clinicians, especially family physicians, Jabbarpour said.
In 2021, 37% of all physicians in training (residents) began primary care training, but only 15% of physicians are practicing primary care three to five years after residency. Research has shown that there was no.
Research shows that more than half of residents who would enter primary care become subspecialists or become hospitalists instead. And only 15% of primary care residents spend most of their time training in outpatient settings, where the majority of the U.S. population receives care, compared to rural and other underserved settings. Researchers found that less than 5% of primary care residents spent time training in underserved communities.
The AAFP study also found that primary care provider densities are slightly higher in rural and underserved areas. This study focuses on social health factors such as housing, transportation, income, and education and how they affect population health, and focuses on social health factors such as housing, transportation, income, and education, and how they affect population health status, as well as those with more social disadvantage (lack of adequate housing). For example, people in areas with higher rates of chronic disease and worse health outcomes were found to have higher rates of chronic disease and worse health outcomes.
In 2021, the overall primary care density in areas with more social disadvantage was 111.7 people per 100,000 people, compared to the primary care density in areas with less social disadvantage was 99.5 people per 100,000 people. . However, the researchers said that while these measures are promising, they are still insufficient.
“This finding may be due, in part, to the success of the community health center movement, which aimed to place clinicians in areas where societal need was greatest,” the researchers said. Ta. “Yet, given that people living in high-need areas tend to have higher levels of health care needs, even with such a high density of primary care clinicians, patient demands This promising finding needs to be tempered by the reality that this may not be possible.
“Rural areas are much better at training and retaining their primary care workforce, but at the same time they are still not doing enough to meet growing demand,” Jabarpour said.
Family medicine, like other medical specialties, is distributed similarly to the U.S. population, she said. According to the US Census Bureau, 19.88% of the total US population lives in rural areas across the country. Jabarpour said a correlated proportion of primary care physicians will be in rural areas. But the needs in rural communities are greater because they tend to be statistically older and sicker.
One way to solve this problem is to increase investment in primary care, the study found. Changing the percentage of overall health spending for primary care by the Centers for Medicare and Medicaid (CMS) would encourage federal investments in primary care, similar to new rural investments by the U.S. Department of Health and Human Services (HHS). It will be. According to the report, clinics, health centers and Indian Health Service (IHS) facilities in shortage areas.
“The United States is underinvesting in primary care, largely due to Medicare’s fee schedules that list fees for services,” the report said. “Undervalue primary care services compared to specialty services and pay per visit, which prevents care from non-visit services such as email and phone calls and other members of the primary care team. Masu.”
Jabarpour said another key to increasing the number of primary care physicians in rural areas is for universities to recruit from rural areas.
“People tend to go home to practice, so medical schools should recruit from those areas,” she says.
Attracting doctors to rural areas also means helping doctors’ spouses find jobs.
“Some doctors want to go into rural areas, but if their partner is not also in medicine, they don’t have the opportunity to work in rural areas,” she says.
The biggest way to bring primary care physicians to rural areas is to expose them to rural environments, she said. The study found that physicians who train in academic health centers or rural training tracks are more likely to practice in those areas.
“We know that not all rural areas are the same. Some rural areas are probably areas where doctors would want to live and raise their families if they knew this,” she said. Told. “We know it’s difficult because hospital systems are really trying to recruit aggressively, set up local training courses, and reach out to medical schools across the country to send their students here. ‘Cause we need to say, ‘Please, we’ll provide housing for them, and they can get into college.’ If they touch this beautiful piece of heaven that we have, they’ll be here. They’ll want to come. ”