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Monday Apr 01, 2013

Primary Care Physician Shortage Requires Bold Action

If we build it, they will come.

For the first time in more than 100 years, a new medical school will open this summer in Indiana. Marian University's College of Osteopathic Medicine(www2.marian.edu) has a decided focus on primary care. The dean, the associate dean and two of the trustees -- including  me -- are family physicians. We have taken a deliberate approach to screening, looking for students who not only have an interest in primary care but who also are interested in staying in the Hoosier State to practice medicine. We hope the new school will produce more than 90 primary care physicians per year, starting in 2017.

Student interest in the school has been encouraging. For the 150 spots available in Marian's first class, we received more than 3,200 applications.

This effort is an important step in addressing a glaring need. Indiana University's School of Medicine, the state's only med school (until now), boasts the nation's second-largest student body, but the school has not produced enough primary care doctors to meet demand.

That demand is going to increase dramatically in the near future as veteran physicians retire, the Patient Protection and Affordable Care Act expands access to health care and an aging baby boomer population becomes eligible for Medicare. By 2020, the state is expected to face a shortage of 2,000 primary care physicians.

Health care leaders in my state are well aware of the need, and opening a new med school is one strategy to address it.

Indiana isn't alone. The United States is facing a shortage of 45,000 primary care physicians by the year 2020. Marian is one of three osteopathic med schools (www.aacom.org)opening this year, and more than a dozen new allopathic medical schools(www.lcme.org) are in various stages of development.

Of course, it won't do much good to churn out more medical school graduates if we don't also increase the number of residency slots available. Although there are bills under consideration in Congress that would increase the number of Medicare-funded residency positions, there is no guarantee that such legislation will produce more family physicians.

Here in Indiana, we're taking steps to do just that.

Marian -- a small Catholic school in Indianapolis -- won't offer a residency program, but the new medical school has partnered with two hospital systems that do. St. Vincent Health is a network of 20 hospitals, and Community Health Network has eight. (I am the chief medical officer of the latter.)

Community Health Network has two family medicine residencies -- one allopathic and one osteopathic. We recently expanded our allopathic residency from seven slots per class to eight per class.

We also successfully applied and received CMS funding for 22 additional residency positions. We now must decide whether to expand our existing programs or develop a new residency program. Whichever way we decide to go, we need to act quickly before Marian's first class graduates in 2017.

It's becoming increasingly clear that it will take bold action and creative thinking to address the looming physician shortage. What is happening in your state?

Clif Knight, M.D.is a member of the AAFP Board of Directors.

Posted at 01:50PM Apr 01, 2013 by H. Clifton Knight, M.D.

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