Medical Schools Accused Of Inflating Number Of Graduating Primary Care Doctors
RACHEL MARTIN, HOST:
In Delaware, there are literally dozens of places to get a COVID vaccine. But in rural Park County, Colo. - which is almost as big as the state of Delaware - there's just one. And the clinic exists only because a 70-year-old doctor agreed to come out of retirement. It typically takes rural clinics years to replace family medicine doctors who leave because there just aren't enough primary care doctors. Colorado Public Radio's Dan Boyce reports.
KATHERINE FITTING: And you're from Bailey.
UNIDENTIFIED PERSON: Yes.
FITTING: Well, welcome to Fairplay.
DAN BOYCE, BYLINE: Seventy-year-old physician Dr. Katherine Fitting pops into an exam room in the small South Park Health Care Clinic.
FITTING: Ready? One, two, three - poke.
BOYCE: Fitting is the only primary care doc in Park County - or, should I say, she's once again the only primary care doc in Park County.
FITTING: Well, I was - yes, I was retired. I'd been retired since 2013.
BOYCE: With her gone, the South Park clinic closed for six years. Fitting helped spearhead a local sales-tax effort to open it back up and recruit a new doctor. He quit within six months.
FITTING: There's no escape. That's the thing, is you - if you don't have the personality for this type of practice, you're going to feel very trapped.
MARK DEUTCHMAN: People don't want to work 24-7, 365. And medicine is more complicated than it used to be.
BOYCE: Dr. Mark Deutchman directs a program at the University of Colorado Medical School dedicated to placing new physicians in rural areas. It is not easy.
DEUTCHMAN: So many rural doctors are, on the average, older and close to retirement.
BOYCE: He says that trend is accelerating and that medical schools are vastly overestimating how many doctors are in the pipeline to replace them. Deutchman recently published a study suggesting schools overestimate by almost double the real number.
DEUTCHMAN: You don't know what somebody's going to do until they finish residency.
BOYCE: Medical schools report that about 40% of their graduates enter residencies in primary care. But when Deutchman and his fellow researchers followed up with nearly 18,000 medical doctors around the country after residency...
DEUTCHMAN: And the 42% that the schools would have claimed primary care turned into 22%.
BOYCE: The American Association of Medical Colleges has problems with Deutchman's premise and his findings. They say 30 new medical schools have opened nationwide since 2006, and they're doing their part to address the primary care shortage. However, others say Deutchman has a point.
ADA STEWART: We may have to look at a more focused analysis of how many individuals are actually going into the specialty of family medicine.
BOYCE: Dr. Ada Stewart is president of the American Academy of Family Physicians. She says schools have been graduating record numbers of doctors into family medicine residencies in the last decade, but she acknowledges many switch into much higher-paying subspecialties post-residency, and most of those jobs are in cities. Further compounding the rural problem, Dr. Mark Deutchman says younger docs want greater work-life balance.
DEUTCHMAN: We know that it takes more than one new physician to replace a really active, dedicated retiring physician.
FITTING: I won't make it hurt. All right, come right in.
BOYCE: Back at the rural South Park clinic, Katherine Fitting is one of those docs, continuing to see patients eight years after she first retired.
FITTING: I feel like I am back where I belong. This is what I want to be doing.
BOYCE: Still, if the right doctor came along, a few decades younger...
FITTING: I'd give it up in a minute in order to secure that.
BOYCE: Even in that circumstance, she says she would still want to cover their days off.
For NPR News, I'm Dan Boyce in Fairplay, Colo.
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