Report seeks action on shortage of primary care doctors in Pa.
“The inability of people to get care in the time frame they need? It is making them look for it in other places.”
With a new report detailing the ongoing shortage of primary care doctors, Rep. Paul Schemel said a failure to fix the problem in Pennsylvania means “we are going to increasingly find we are not going to see a doctor” when desired.
The “Medical School Impact on the Primary Care Physician Shortage” report calls for better collection of data, more incentives at medical schools for studying primary care, and investing in a “pipeline” of primary care doctors.
Schemel, a Franklin County Republican, was prime sponsor of the 2019 resolution that led to the report from the Joint State Government Commission.
The Pennsylvania Academy of Family Physicians pushed for it. Academy President Tiffany Leonard said she hoped lawmakers would realize the difficulties the shortage is causing.
People frequently go to emergency rooms with sore throats, ear pain or headaches when they should be seeing primary care doctors, according to Leonard.
Mary Stock Keister, an Allentown physician, said, “The inability of people to get care in the time frame they need? It is making them look for it in other places.”
The report drew data from many sources. It said the U.S. could be short between 37,800 and 124,000 physicians by 2034, including a shortage of 17,800 to 48,000 primary care physicians.
One projection indicated Pennsylvania would be short 1,039 primary care physicians by 2030. Another estimated the shortfall at 1,000 by 2025.
Other data and observations in the report included:
The U.S. in 2020 spent 5% to 7% of health care dollars on primary care services, while the same spending in a group of other countries averaged 14%. In a study of 29 states, Pennsylvania had the second or fourth lowest primary care spending percentage from 2011 to 2016, depending on how primary care was defined.
In 2021, the average annual salary of a primary care physician ranged from $221,000 to $248,000, while specialists in fields like cardiology made more than double that amount.
The overall process of education and training for a doctor, beyond high school, can take more than 10 years. The average debt of medical graduates from some of Pennsylvania’s medical schools in 2021 were Drexel University School of Medicine, $233,943; Lewis Katz School of Medicine at Temple, $218,632; Lake Erie College of Osteopathic Medicine, $209,643; Sidney Kimmel School of Medicine at Thomas Jefferson University, $208,110; University of Pittsburgh, $190,964; and Perelman School of Medicine at University of Pennsylvania $130,583.
Burnout among health care physicians is a growing problem, and especially among primary care doctors. The report said “burnout” is “generally defined as a ‘syndrome of emotional exhaustion, depersonalization, and a sense of low personal accomplishment that results in decreased effectiveness at work.’”
The report identified the implementation of electronic health records as a leading source of doctor burnout.
“Many physicians claim they spend more time ‘connected to [our] computer screens than connected directly to our patients,’” the report said.
Keister, the Allentown doctor, said public and private insurance organizations reimburse primary care doctors at a lower level than specialists.
That, she said, means primary care doctors cannot create office budgets for “the kind of staff that would allow our patients to be healthier and for us to offer a greater variety of services.”
Among its recommendations, the report said the state’s nine medical schools have little reason to prioritize primary care physicians. And, it said Pennsylvania’s loan forgiveness program for primary care physicians isn’t as attractive as those in other states or one run by the federal government.
Schemel, a member of the House Health Committee, said the shortage is more acute in rural areas than urban.
A former board member at a Franklin County-based health system, Schemel said he learned doctors often choose to settle close to where they went to medical school — and most medical schools are in or near cities.
And, he said, doctors tend to marry other professionals who have job opportunities that are more plentiful in urban areas than in rural ones.
Schemel said the next step for the Legislature would be to seek input from medical organizations and medical schools on how to attack the problem.