The report, online in Academic Medicine, suggests that not only are we facing a primary care shortage, but also that the problem is not likely to be solved soon. In addition to finding that just 4.8 percent of the medical education system's graduates practiced in rural areas, 198 institutions (26 percent) produced no rural physicians and 283 institutions (37 percent) produced no Federally Qualified Health Center or Rural Health Clinic physicians, which were created to enhance the provision of primary care services in under-served communities.
“If residency programs do not ramp up the training of these physicians the shortage in primary care, especially in remote areas, will get worse,” said Dr. Candice Chen, lead author of the study. “The study’s findings raise questions about whether federally funded graduate medical education institutions are meeting the nation’s need for more primary care physicians.”
The U.S. is producing primary care physicians at rates that are “abysmally low” and unless changes are made to the system, the nation will have an even greater shortfall of primary care doctors just as the Affordable Care Act ramps up demand for these services, Chen said in a news release. In some states, the additional need for primary care doctors as a result of Medicaid expansion exacerbates the problem.
The study's authors said policymakers should take a hard look at the skewed incentives and other factors that have led to the current primary care crisis and develop a more accountable graduate medical education system. It is critical to find a better balance in medical specialties and more primary care physicians to build an effective, affordable health system.