AAFP to President-Elect Obama: ‘Reinvest in Primary Care Medical Education’

LEAWOOD, Kan. – President-elect Barack Obama can significantly improve Americans’ access to health care by making “a robust investment” in federal programs that support medical education and primary care physician training, according to Jim King, M.D., chair of the American Academy of Family Physicians’ Board of Directors.

In a Dec. 24 letter to Obama, King commended Obama for “making a strong health care workforce a key component of your legislative agenda.” He urged the president-elect to invest $215 million in Title VII, Section 747, grant program to medical schools and residency training programs and $150 million in the National Health Services Corps. Both programs should be a part of Obama’s economic stimulus package, King wrote.

Title VII is part of the Public Health Services Act, and Section 747 provides grants to medical schools to support primary care education and training, including academic and faculty development in primary care. Despite the growing shortage of primary care physicians, federal funding for Section 747 has plummeted from $92.4 million in fiscal 2003 to $48 million in 2008.

The NHSC provides scholarships and loan repayment awards to primary care physicians, nurse practitioners, dentists, mental health professionals and others who provide health care services to Americans in medically underserved areas.

“Including that level of funding for primary care training in the stimulus bill would reinvigorate medical education, residency programs, as well as academic and faculty development in primary care to prepare physicians to support the patient-centered medical home medical practice model,” King wrote.

In addition, the Obama administration can improve medical school graduates’ ability to choose primary care careers by reinstating a student loan deferment mechanism known as the 20/220 pathway. Eliminated in 2008, the 20/220 pathway enables medical students to invoke economic hardship in requesting loan deferment while they complete their medical residency training.

Noting the average first-year stipend for medical residents is less than $45,000 a year, King wrote “High medical student debt, averaging $140,000 in 2007, is a significant hardship throughout the loan repayment period, particularly during the years of training in medical residency programs. The high debt burden that many medical graduates face may influence their career choices, deterring some from practicing in underserved areas, starting a career in medical education or research, or entering primary care medicine.”