The D.C. Board of Doctors announced last week only 453 out of 8,000 physicians licensed to work in Washington, D.C., are actively practicing primary care doctors, resulting in a doctor shortage for District patients.
This marks a decrease from 2010, when it was reported that 918 physicians were actively practicing. The survey measured the number of physicians that spent more than 20 hours caring for patients per week.
According to American Association of Medical Colleges Director of Federal Relations Christiane Mitchell, this doctor shortage will be exacerbated by the implementation of the Affordable Care Act and its effects on the District’s 42,000 uninsured residents. This will be seen most clearly in Wards 4, 7 and 8, which contain the most uninsured D.C. residents and the fewest practicing physicians.
Executive Director Jacqueline Watson claimed the D.C. Board of Medicine is acutely aware of the problem, particularly because it corresponds with a nation-wide trend.
In 2006, AAMC predicted a shortage of 45,000 primary care physicians by 2020, which it attributed to the aging of the baby boomer generation — a further incentive for many medical students to turn to specialized fields rather than primary care.
“The amount of primary care physicians does concern the board,” Watson said. “We believe that many of the licensees that did not respond to the survey are likely those that live outside of the metropolitan area and just maintain a license here.”
Some of these doctors may work part-time in D.C., Maryland or Virginia, while others become involved in academic or educational applications of medicine or administrative medicine. In addition, Georgetown Assistant Vice President for Student Health James Welsh said that many medical school graduates turn to other fields of medicine rather than primary care because of a perceived lack of prestige and lower earning potential.
“The main reasons that medical students are not choosing careers in primary care are income differentials — on average, a primary care doctor earns on half of that of a specialist — rising medical student debt, medical student training that is largely done in tertiary hospital settings and an inadequate number of training programs for residency,” Welsh said.
To solve this problem on a national scale, AAMC proposed increasing the number of students entering medical school by 30 percent in 2007 — a goal it is on track to meet by 2017. But federal support for medical training has been frozen since 1997, preventing an increase in the number of available residency positions, which students must hold before practicing, according to Welsh.
Several initiatives, however, are attempting to attract medical students to primary care. Mitchell said that the majority of medical schools are now offering incentives to medical students who choose primary care, such as curriculum changes, increased extracurricular opportunities, expanded faculty resources, tuition decreases and increased availability of loans.
For example, the Georgetown University School of Medicine has made an effort to increase medical students’ exposure to primary care specialties and issues through changes in its curriculum and extracurricular offerings. In addition, the School of Medicine has been working to reduce its graduates’ student debt.
“There was not federal support for this, but rather, medical schools felt obligated to do it to meet the needs of the American population,” Mitchell said. “The AAMC has taken steps to solve the problem, and the federal government needs to step up and meet us.”