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Wanted: Physicians to Treat the Poor, Uninsured: Experts Say More Docs Are Needed for Health Centers

Posted on: Sunday, 19 March 2006, 15:00 CST

By Melissa McGrath, The Idaho Statesman, Boise

Mar. 19--President Bush has touted community health centers as one of the most effective government programs in the nation, and he plans to increase funding this year and next to build more than 400 health centers.

Officials at community health centers in Idaho and other states are grateful for the extra funding, but they are questioning how they will staff those clinics if the government doesn't put more money into training.

Recruiting family doctors to work in the state's 10 community health centers, which serve the poor and uninsured populations, has been a task and is going to become a bigger problem in the next few years, officials said.

Family doctors make up 90 percent of the doctors working at community health centers, but, on average, about 13 percent of the full-time positions for these doctors were vacant at health centers in the United States, according to a recent survey conducted by the Rural Health Research Centers at the University of Washington and University of South Carolina.

Vacancy rates were not available for health centers in Idaho, but the Idaho Primary Care Association, a non-profit group that supports community health centers, said Idaho clinics currently have seven positions open for family physicians. Clinics from around the state have been trying to fill some of those for months, said Katrina Hoff, recruitment director at the Primary Care Association.

The problem likely will get worse in the coming years because more medical school graduates are choosing to specialize rather than practice family medicine. According to the survey, the number of family medicine graduates has declined by about 51 percent between 1997 to 2005.

"I would say there needs to be more money put into the Family Medicine Residency with the hope that more people choose that particular specialty," said Erwin Teuber, executive director of Terry Reilly Health Services in Nampa.

The Family Medicine Residency of Idaho trains family physicians during their residency, the three years medical graduates are required to serve after graduation. The program's residents work at community health centers in the state during their three years of training, and some graduates go on to work at community health centers, said Ted Epperly, chairman and program director of the residency.

At least two of his recent graduates plan to work at community health centers.

"I think the Hispanic population is growing steadily (in Idaho), and I think I can reach out as a family doctor. The best way to go is community health centers," said Rosalia Richardson, who went to medical school in Mexico and completed the residency program in Boise. Richardson is starting work at Terry Reilly clinics in May.

Gary Vaughn is moving to New Mexico after he graduates this year to work at a Native American clinic in Gallup. Vaughn joined the Indian Health Services program while he was in medical school. The program paid for some of his school as long as he agreed to work at a clinic for a few years after he graduated.

"It was a no-brainer in school. They are going to pay my way through school, and then let me work where I want to work anyways," Vaughn said. He said he expects to work at a community health center for most of his life.

"I wanted to continue to work with patients that are challenged economically as well as in access to care," he said.

Scholarship programs like the one Vaughn is enrolled in and loan repayment programs convince many doctors to serve in the community health centers for at least a few years, said Bill Foxcroft, executive director of the Idaho Primary Care Association.

The government should help Idaho and other states provide financial incentives, like loan repayment programs, for doctors who work in health centers, Foxcroft and others say.

Researchers at the Rural Health Research Centers came to the same conclusion after conducting the survey of health centers across the nation.

Some officials said health centers probably still will face problems recruiting medical professionals even if the government creates more financial incentives because most centers are located in rural areas and the patients tend to have more complicated health problems.

"Patients in those populations sometimes are complex patients. They have not been getting the regular preventive health care they need. I think that scares some people off," Vaughn said.

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Copyright (c) 2006, The Idaho Statesman, Boise

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Source: The Idaho Statesman, Boise

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