ROTC-type primary care scholarships proposed
■ Medical students would practice medicine in underserved areas in return for education funding under a new House bill.
Washington A bill introduced by Rep. Jim McDermott, MD (D, Wash.) seeks to add thousands of new primary care doctors to the work force by establishing a program that would pay for a student’s medical school education in return for several years of service as a primary care doctor in a medically underserved area.
Dr. McDermott said his RDOCS program, or the Restoring the Doctors of Our Country through Scholarships Act of 2012, follows the model of ROTC programs, which pay college expenses for students who commit to be trained as reserve officers in the U.S. military. Most of the funding for the new program would come from the federal government, but states would administer it for participating medical students attending state medical schools. In exchange for scholarship funds, students would conduct their residencies in primary care and serve as primary care physicians in underserved areas of their respective states for five years.
The nation is facing a projected shortage of 45,000 doctors by 2020, a problem that will increase in severity when major coverage provisions of the Affordable Care Act take effect in 2014, Dr. McDermott said in a statement. He noted that a lack of primary care can lead to mismanagement of patients and costlier emergency care down the road. “We do not have enough primary care doctors to meet the demand, and the problem will continue to worsen without a major initiative to produce new doctors,” he said.
The goal of the legislation is to graduate 4,000 new physicians through the program in 2020 and 20,000 physicians by 2024. Priority would be given to students in six-year accelerated family medicine programs, as well as to those participating in programs that emphasize clinical training in underserved areas.
Existing programs designed to boost the primary care work force have gaps, according to a fact sheet on the legislation. The National Health Service Corps, for instance, is a federal program that uses scholarships and loan repayment to place more physicians in underserved areas, and there is a state loan repayment program for medical professionals that’s financed by the federal government. What’s been missing is a federally funded, state-level scholarship program, Dr. McDermott said.
Perry Pugno, MD, MPH, a family physician and vice president for education with the American Academy of Family Physicians, said the legislation would provide additional resources to help replenish the primary care work force. The AAFP continues to support the NHSC’s efforts, as well as the Title VII program, which provides funding for primary care education and training programs, Dr. Pugno said. But both of those programs need more robust funding, and the RDOCS program will complement those efforts, he said.
“The thing that is good about this is it’s focused more locally, so it appears to be designed to impact work force shortages in the specific areas where shortages exist,” Dr. Pugno said.
The legislation, which was referred to the House Energy and Commerce Committee, would authorize $200 million for fiscal years 2013 through 2016 to fund the program.