Doctors With Debt Flee Small Family Practice
Today’s generation of young doctors is coming out of school saddled with enormous debt from rising college and medical school tuitions, only to enter residency training programs that pay “salaries that, on an hourly basis, work out to a little more than they could earn stocking shelves at Costco,” according to an article by George Mannes for CNN Money. Additionally, their future salaries are being squeezed due to health-care economics, so many are choosing more lucrative specialized careers rather than going into family practice.
Colleen Lamay recently wrote an article for McClatchy Newspapers about the shortage of family doctors in Idaho and nationwide, and it seems increasing debt is a primary cause. She quoted Dr Michael Patmas, executive director of Saint Alphonsus Medical Group, as saying, “Being a specialist helps pay off that debt the fastest. A new primary care doctor initially earns about $130,000 to $150,000 a year, compared with $250,000 to $500,000 a year for newly minted specialists.” According to the article, at the University of Washington medical school 87 percent of graduates are in debt, and the median debt was $105,202 in 2006 (from a UW study).
A shortage of primary care physicians is a growing problem. In fact, Patmas says, “We’ve been talking about (doctor shortages) for the past twenty years, and it has reached a real crisis point now.” According to Lamay, a new study commissioned by the Physicians’ Foundation says that nearly half of 150,000 primary care doctors (family doctors, pediatricians, and internal medicine doctors) want to quit or cut back in the next three years. While some of the problem is the long hours, massive paper load, and ever more complex health insurance rules, Patmas says these doctors are leaving to pursue masters in business or related fields because, “The sad truth is that most of those nonclinical positions pay more than primary care.”
If you are a young doctor in debt, the AAMC website has a financial advice section for young doctors in residency and early practice that might be helpful. The section covers:
- Managing your money: The key to reaching your financial goals is creating, implementing and monitoring monthly and annual budgets.
- Managing your Debt and Loan Repayment
- Understand your loan repayment terms and conditions.
- Determine which loans to target for early repayment.
- Be aware of your repayment options.
- Consolidate wisely and evaluate consolidation / refinancing options.
- Consider a forgiveness or repayment program as an option.
- Tailor your repayment strategy to your circumstances, personal and professional goals.
- Saving and Investing for Short- and Medium-Term Goals
- Using Credit and Protecting your Rating
Service-based loan repayment programs in particular are a good way young doctors can pay off student debt while simultaneously serving health professional shortage areas. Different programs offer various benefits, but on average young doctors work two to four years practicing in an under-served area in exchange for living stipends and repayment of educational loans. Below is a list of some organizations medical students can contact to explore service-based loan repayment programs:
- American Academy of Family Physicians
- Association of American Medical Colleges
- National Center on Minority Health and Health Disparities
- National Health Service Corps (NHSC) Scholarships
- NHSC Ready Responders Program
- NHSC Loan Repayment Program
- U.S. Department of Health and Human Services Bureau of Health Services Primary Care Loan Programs
- Armed Forces Health Professions Scholarship Programs:
- Air Force
- Army
- Navy
