Talking to a group of doctors about health care sucks, but I’ve been known to tread in areas I probably shouldn’t. The North Carolina Academy of Family Physicians is made up of deeply respected and dedicated people. They are the gateway to healthcare.
Primary care physicians choose this specialty as essential to their patients’ health, but not necessarily to themselves. Less than 1 in her 4 new doctors are on this path. Those who do value the personal relationship they have with their patients and truly believe that this is the best approach to improving their overall health.
I started my remarks by calling the common attention that healthcare costs are too high. With only 4% of the world’s population, the country is responsible for nearly half of the $8 trillion in global health care costs. In 1970, the United States spent her 6% of its Gross Domestic Product on health care. According to the Centers for Medicare & Medicaid Services (CMS), this is currently 19.7%, equivalent to 20 cents of every dollar of economic output. Health care costs per capita are estimated at $11,945, more than double her average in the developed world. About 64% of those surveyed also said they avoided or delayed medical care because of the cost.
Many people who do not have health insurance are heavily indebted. North Carolina Treasury Secretary Dale Folwell touted a bill on New He Byrne forums that would help working families avoid financial ruin just because they got sick. The problem is particularly acute in Eastern Carolina, which has the highest concentration of medical debt in the state.
The Robert Graham Center in Washington reports that North Carolina has about 6,000 primary care physicians (2010 figures), or about 1 family physician for every 1,633 people, compared to the national average of 1 to 1,463. far superior. Our state has set a goal of getting closer to the national average, but due to population growth and our state’s aging population, this is not growing. The Graham Center also predicts that by 2030, the state will need an additional 1,885 primary care physicians (up 31%).
Of the 25% of new physicians who choose family medicine, even more choose to start or attend practice in rural areas of states where people are poorer, less healthy, and more dependent on Medicaid and Medicare. Fewer. Often there are higher patient numbers, fewer support services (such as pharmacies) available, and fewer employment opportunities for physician spouses. Adding family physicians to rural communities does more than reduce health care costs and improve health outcomes. It is a morale boost that can attract new businesses and residents.
UNC’s Sheps Center for Healthcare Services Research reports that between 1990 and 2020, 334 rural hospital closures have been documented in 44 states. North Carolina has had 11 closures since 2005, and at least five closures have been destabilized. COVID federal relief funds have helped slow the bleeding, but those funds are drying up and rural hospitals face tough decisions.
It is no exaggeration to say that the number of primary care physicians needs to increase dramatically. Medical schools in East Carolina, Campbell, UNC are placing renewed emphasis on rural family medicine by increasing medical school intake from rural students. I expect the doctor to go home and practice. To eliminate the shortage dramatically, more funding is needed for scholarships for family medicine students who have pledged to practice in rural areas.
The average medical graduate spends eight years in education and three years in residency training. It’s not uncommon for a new doctor to open up with her $200,000+ in student loans. According to Salary.com, the average North Carolina family doctor makes $184,179 a year to $239,970 for him. Income is expected to be higher in urban areas and lower in rural areas. That income may sound appealing to many, but it’s not that big of a deal since you have to wait years to enter the workforce and have to pay off $200,000 in debt.
At least two organizations in our state, Community Care North Carolina (CCNC) and the North Carolina Academy of Family Physicians, are working together to encourage more family physicians. CCNC is trained by MIT to establish a new business mentoring program. New doctors generally have little knowledge of business issues and mentoring helps them conduct their practice. Mentoring also helps local communities learn what they must do to attract and retain GPs. Financial support for buildings and office space, student loan retirement benefits, and other support services ensure that new doctors not only survive, but thrive. The goal is for both doctors and the community to live happily married for years to come.Here’s my take.We’re looking down the barrel of a “code blue” medical crisis.Especially in rural communities, Having more family doctors can go a long way toward avoiding crises. We have to help our family doctor help us.
Tom Campbell is a North Carolina Hall of Fame Broadcaster and columnist who has covered public policy issues in North Carolina since 1965. He recently retired from writing, producing, and hosting his half-hour statewide TV show, NC SPIN, which ran for 22 and a half years. Please contact [email protected].
