My Solution for the Primary Care Shortage

In an attempt to alleviate the coming physician (particularly primary care) shortage, states are increasing the size of their medical school classes, and a few are even building new medical schools. As pointed out by the WSJ Health Blog, this will make little difference in the total number of licensed, practicing physicians since the number of practicing physicians is determined by the number of residency slots. The primary effect of increasing the number of US medical students will be to increase the proportion of US graduates to foreign medical graduates in residency programs, and ultimately the proportion of US grads to foreign grads in the ranks of practicing physicians.

Many states, including Mississippi, are foolishly increasing the size of their medical school classes in an attempt to increase the number of primary care doctors in their state. If the goal is to increase the number of primary care doctors within a particular state, a better way to accomplish this goal would be to increase the number of primary care residency slots in that state. Since CMS (Medicare) is not adding new subsidized residency slots (approximately 100,00 dollars per year), states should subsidize these slots themselves. If the goal is to increase primary care docs in a state, subsidizing primary care residency slots is a much better investment than increasing the number of medical students, many of whom will end up leaving the state or practicing a subspecialty. Since many internists go on to subspecialize, the best investment value would be to increase the number of family practice and pediatric slots.