Grants have added to number of primary care doctors

The American Academy of Family Physicians is highlighting a study that shows Title VII funds are paying off and belong in the federal budget.

By Jay Greene, amednews staff. June 18, 2001.

Just a little federal money appears to go a long way in producing more family practice physicians and increasing the numbers of primary care physicians in underserved areas, according to a new study.

But those federal dollars -- $50 million in fiscal 2001 awarded to dozens of allopathic and osteopathic medical schools -- were not included in President Bush's 2002 proposed budget.

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And with Congress still talking about a huge tax cut, officials with the American Academy of Family Physicians are worried that 40 million people -- the 15% of the nation's population that lives in underserved areas -- will be shortchanged if funding for health profession training programs are cut.

"The truth is we have few doctors in those high areas of need, and cutting this program will only reduce health care access," said Bruce Bagley, MD, AAFP chair.

The study found that 36% of medical students from schools that received the federal grants chose a primary care specialty compared with 31% of students who attended schools that did not receive the grants, said Larry Green, MD, director of the AAFP's Robert Graham Center for Policy Studies. Dr. Green said more data linking the grant money to physicians practicing in shortage areas is expected to be published later this year

Moreover, primary care doctors from Title VII-funded schools are more likely to practice in rural and underserved areas, said Dr. Green, the study's author. The family practice grants, which average $127,000 each, have been awarded through Title VII of the Public Health Service Act since 1978.

Numbers tell the story

"This is an inexpensive competitive grant program that appears to develop interest in primary care programs," said Dr. Green, a family practice doctor and former chairman of the family medicine department at the University of Colorado School of Medicine in Denver. "The bottom line is the program appears to be succeeding. This is no time to stop it."

During the study period, 1981 to 1993, schools that received Title VII grants produced 50% more family physicians than schools that did not receive funding, the study said.

In addition, schools that received Title VII grants graduated more than 10% more primary care physicians than those that did not receive funding. Primary care includes family practice, general practice, general internal medicine, general pediatrics and obstetrics-gynecology.

"If we stopped the supply of family practitioners to underserved areas, people in those areas would wind up in the emergency department, might have to seek [nonphysician] care or might not get care at all," said Dr. Bagley.

The federal grants help medical schools in three primary ways. The money supports family practice departments, helps train academic physicians in primary care and funds research-oriented, predoctoral medical education programs, Dr. Green said.

"The grants also are used by medical schools to help students go out into the community to see what family practice is all about," said Dr. Bagley, a family physician in Albany, N.Y.

"Without the grants, preceptor programs could be cut. That could lead to even fewer primary care physicians," he said.