PSLF advocacy centers student debt relief, community service

Additionally, AAFP President Jen Brull, MD, FAAFP, participated in a May 1 Department of Education hearing, testifying about the importance of the PSLF program. She urged policymakers to maintain eligibility for family physicians.

“The Public Service Loan Forgiveness program has been especially important for family physicians,” she said. “Without it, many would have been forced to leave public service for the private sector, leaving critical health needs unmet.”

Brull added: “While the cost of medical education is the same whether a doctor enters a primary care or a non–primary care specialty, primary care specialists, including family physicians, typically earn far less.”

Her testimony echoes what scores of fellow members said in their survey responses. The overwhelming majority said they had relied on PSLF or other federal debt-relief programs; for many, the knowledge that such assistance would be available sometimes drove the choice to practice family medicine.

Given that about 80% of all physicians carry student debt, minimizing this burden on current and future family physicians has long been a pillar of our efforts to strengthen the family physician workforce. The PSLF program in particular has done much to ensure that

• more physicians practice in safety-net hospitals,

• more physicians find it financially viable to specialize in primary care,

• more pathways are laid out for students from low-income backgrounds to become physicians,

• the health care workforce is diversified and

• underserved communities have greater access to health care and improved health equity.

As the commenter we quoted above adds: “I have nearly $300,000 remaining in medical school debt. I work at a federally qualified health center, serving mostly Medicaid patients, and get paid less than most nurses I work with in other settings.

“I love our clinic and know that each and every visit is of value to our patients. However, without the promise of loan forgiveness, it makes even less financial sense to stay. Without the PSLF program, we will continue to have a brain drain from preventive care fields, especially in high-need areas, which will lead to higher health care costs due to progression of preventable conditions.”

Almost half of the family physicians who responded to our survey offered similarly compelling testimony about their experiences. That passion for community service is central to why, in a letter we sent the administration this month, the AAFP asked to be part of the rulemaking process.

“The AAFP strongly urges the Department of Education to include a family physician in the negotiated rulemaking process, and we look forward to participating in the related nomination process when it begins,” we said. “We believe a family physician being involved in the process will help support the department’s goals and advance policies that would provide meaningful debt relief for physicians across the nation.”

As this process unfolds, we will keep you updated and keep quoting you as we work to secure favorable policy. Please use the link above to let your lawmakers know why this is so important.