Rochester, N.Y.— For Sarada Abraham, a second year medical student at the University of Rochester, it isn’t a difficult decision. She knows she wants to be a primary care physician.
Before medical school, Abraham was teacher in inner-city Chicago and she saw the need for good primary care doctors.
“For something as simple as pink eye, you would see kids going to the emergency room,” she says. “There are no standard physicians and there is no one that can get to know them.”
However, the path Abraham is choosing is not one many medical students take.
According to the American Academy of Family Physicians, the number of primary care doctors has dropped 51.8 percent since 1997.
The University of Rochester says there is a critical nationwide shortage of primary care physicians. The need is also great in the Rochester community.
“Fewer and fewer medical students have been choosing primary care as a career,” says Dr. Marc Berliant, the division chief of General Medicine at URMC. “Combine that with the fact that there are, at least in our communities and many communities, a number of primary care physicians that are in their fifties and sixties and they are considering retirement.”
Berliant says the problem is only set to get worse. With the Supreme Court’s decision to uphold the Affordable Care Act, URMC is expecting more people who are newly insured to take advantage of primary care practices instead of using urgent care or visiting emergency rooms.
“With the Supreme Court saying that the Affordable Care Act is legal, potentially 30 million more people will need health insurance. Combine that with the silver tsunami of 80 million Americans who are entering the baby boomer age,” Berliant says.
The reasons for the shortage are plenty. For one, primary care doctors earn less than specialists.
According to Health Affairs, primary care doctors’ annual salaries can be, on average, $100,000 less than specialists’.
Also, there is a negative perception about a heavy workload.
“The medical student’s perception, some of which was inaccurate, is that primary care physicians aren’t enjoying their career and that it's not much of an enjoyable career.”
The U of R Medical School is trying to change the perception.
“Medical students are placed into primary care, into other offices in the community from day one of their med school curriculum,” says Berliant. “They will see more satisfied physicians who will encourage them to get into primary care.”
The medical school is also looking to increase the interest of medical students in primary care by giving them additional experiences as they move through their training.
Excellus BlueCross BlueShield is one of several companies and agencies nationwide which offer loan forgiveness programs for medical students entering the primary care field.
“Medical students have a large degree of debt,” says Berliant. “It’s another reason they haven’t chosen primary care because it takes longer to pay off that debt.”
Abraham says she’s excited to get started in her field. She takes pride in knowing that she’ll be working in a field where the need so great.
“If you have a primary care doctor, they know you, they have continuity of care with you and they can treat you accordingly. That's something invaluable when it comes to your personal care and I think everyone has the right to have that type of care.”