Pediatrician Numbers Outpace Family Physicians

Marcia Frellick

October 23, 2013

Although the number of primary care physicians, including family physicians, internists, and pediatricians, has grown faster than the overall population in the last 3 decades, growth has been uneven for those 3 categories.

The growth in general pediatrics has far outpaced that of family medicine and general internal medicine, which have grown only incrementally, according to a policy brief article published in the October 1 issue of American Family Physician.

Laura A. Makaroff, DO, from the Robert Graham Center: Policy Studies in Family Medicine and Primary Care, Washington, DC, and colleagues found that the smallest growth has been among family physicians, which is the medical specialty most likely to practice in underserved areas.

Insurance under the Affordable Care Act will cover several million more children, but it will also cover millions more adults, most of whom will be located in underserved areas and will enter the system with complex care demands. The authors stress that simply increasing the number of residency training positions does not solve patient access issues and that efforts to build the physician workforce should focus on the needs of the underserved.

However, encouraging medical students to choose the family physician path comes with its own set of challenges, said Tannaz Rasouli, director, government relations, Association of American Medical Colleges, Washington, DC.

Rasouli says some programs have been very effective in offering loan repayment options and scholarship support, such as the National Health Service Corps, which offers financial incentives for students pursuing primary care in underserved areas.

"When you look at the factors that are driving student choices, a lot of them tend to be factors that are outside an educational environment and are related to things like clinical reimbursement.... Schools can't change the day-to-day content of a specialty or the type of lifestyle they're going to have once they've chosen their specialty," Rasouli told Medscape Medical News.

She added that a number of schools have been expanding their primary care faculty and resources and enhancing extracurricular opportunities in underserved areas. To the extent that schools can guide students toward family medicine, they are doing that, she said, but much is out of schools' control.

"It's easy to forget that physicians aren't products that a medical school produces. They are people who make choices about their careers based on their passions, their interests, and the lives they want to lead.... That's where I think federal policies can be effective in providing incentives."

Am Fam Physician. 2013;88(7). Full text

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