Joint State Government Commission Recommends Boosing Primary Care

(December 21) -- A report released this week by the Joint State Government Commission looks at the training needed to become a primary care doctor and efforts by the medical schools to promote primary care as a career choice. It examines a host of issues that contribute to the PCP shortage, including student debt burden, doctor burnout and low public investment in primary care.

PA-ACP had requested the House resolution that led to the study and provided information to the Commission during its efforts. The report recommends increasing state funding for programs to train, recruit and retain primary care physicians, noting that would pay dividends in health care costs, the report concluded.

“If more federal and state funds are invested in primary care (through increased subsidizing of education and training and reimbursement of primary care physicians) the population will be healthier and less of its money will be spent by individuals on down-the-road health care and treatment costs,” the report said.

The report tackles a situation where there is a shortage of primary care doctors who usually treat patients of every age, focus on internal medicine for adults and pediatrics for patients under age 21 both nationwide and in Pennsylvania.

Exacerbating the shortage is a national population increasing in size and age. The impending retirements of doctors reaching age 65 or higher only adds to the problem.  “It is predicted that the growing prevalence of burnout among primary care physicians will increase with the on-going COVID-19 pandemic, leading many physicians to accelerate their retirement, rather than delay it,” the report says.

In Pennsylvania, the report cites estimates of a shortage of 1,039 primary care doctors by 2030.  The Commonwealth has designated 143 primary care health professional shortage areas with more than a half million residents, many in rural areas.

Pennsylvania has responded to this problem in recent years by creating low-interest loan programs to help with the costs of student medical education, a program first proposed by the state’s internists.

The actions to graduate primary care doctors by Drexel University College of Medicine, Geisinger Commonwealth School of Medicine, Lewis Katz School of Medicine at Temple University, Lake Erie College of Osteopathic Medicine, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania State University College of Medicine, Philadelphia College of Osteopathic Medicine, University of Pittsburgh School of Medicine and the Sidney Kimmel College at Thomas Jefferson University are detailed in the report.

The report makes five recommendations to policymakers:

• Provide state and federal incentives for medical schools to recruit and mentor primary care doctors likely to practice in Pennsylvania and keep track of students outcomes in primary care.
• Increase state funding and eligibility for Pennsylvania’s program to help primary care doctors repay student loans.
• Increase state funding for the non-profit Pennsylvania’s Primary Care Career Center which connects doctors to available positions. This could bring more health care physicians to rural areas where the need is acute.
• Increase state funding for primary care pipeline programs to boost the number of doctors practicing in Pennsylvania and in rural areas.
• Improve the data on primary care doctors practicing in Pennsylvania.

To combat burnout which primary care doctors are reportedly experiencing at a higher level than other health care professionals, the report suggests several solutions, including:

• making the Electronic Health Record system more usable for doctors,
• developing more proactive support programs for mental health treatment for doctors experiencing burnout and increasing the number and training of support staff.

This report builds on earlier commission reports in 2015 and 2019 on health care workforce needs.