Wanted: More Physicians to Serve in Community Health Centers

A recent article in "Modern Health Care" summed up the urgent problems of recruiting physicians for community health centers:

 "The limited supply of primary-care doctors and other clinical staff dedicated to the field has increased competition among healthcare providers to attract these key personnel. Federally qualified health centers often lose out in the scramble.

The larger health systems and hospitals have the wherewithal to offer lucrative signing bonuses and financial incentives to prospective employees. Community health centers do not.

“In any given market, whether it be small or large, there are at least 10 different delivery systems a family practitioner can practice in,” said Travis Singleton, senior vice president at physician search firm Merritt Hawkins. “That wasn't the world that we had 10 years ago.”

Many factors fuel the trend. One of the largest came with the implementation of the Affordable Care Act, as millions of newly insured Americans gained access to routine healthcare. Other causes include population growth, an increased elderly population and the likelihood that as many as one-third of the current physician workforce will retire over the next decade.

The confluence of factors has raised the possibility of a shortage of primary-care providers over the next decade. The Association of American Medical Colleges estimates the shortfall will reach between 14,900 and 35,600 physicians by 2025, according to a recent report.

A recent survey on physician recruiting by Merritt Hawkins showed family physicians are the most sought-after specialty for the 10th straight year. Urgent-care physicians, a growing alternative, have moved from 20th most requested in 2015 to ninth in 2016. Average starting salaries rose 13% to $225,000 in 2016 from a year earlier.

The nation's 1,200 community health centers are expected to be hit hardest by the shortage, experts say. The 10,000 primary-care physicians now at community health centers will need to be supplemented by an additional 15,000 providers over the next 10 years."

Here in San Francisco, recruitment is made more difficult because of the high cost of living and the fact that the scoring that is used to provide Federal Loan Repayment, traditionally a strong recruiting tool for doctors coming out of medical school with thousands of dollars in debt, disadvantages high cost, high density urban areas.

SFCCC is working with local, state and national partners on a series of initiatives to ameliorate this problem.  The California Primary Care Association (CPCA) has laid out the following priority recommendations and we will be adding local priorities and projects to address these issues.

CPCA Overarching Priority Recommendations

1. EDUCATE the public and key stakeholders about growing primary care access, quality, and cost challenges

2.  IMPROVE documentation and communication of emerging primary care workforce problems and consequences.

3. SECURE additional investment and partnerships to accelerate primary care transformation within CCHCs including pilot projects, training, technical assistance, and shared learning.

4.INCREASE the number of primary care residencies in California with a priority focus on residencies in community health centers and medically underserved regions.

5. EXPAND loan repayment funds and provisions to incentivize new and existing providers to practice in CCHCs.

6. ADVOCATE for funds to expand medical schools targeting candidates committed to primary care practice in underserved areas

7. DEVELOPformal ongoing relationships between CPCA and other key advocacy organizations and build an inclusive broad-based coalition to focus explicitly on primary care access and workforce-related policy solutions.

8. DEVELOP state level public-private entity with the necessary expertise, capacity, and relationships to advance collaborative primary care workforce solutions. Convene a process for development of a multi-year strategic plan for California to strengthen primary care capacity and access.

9. ACCELERATE and expand payment reform and pilot projects that align financial incentives and regulations with new team-based primary care models.