Wednesday, February 21, 2018
Opinion

Column: Working to grow number of primary care doctors in Florida

As access to health care continues to expand, Florida policymakers have correctly noted that our state is facing a very real shortage of primary and family care physicians and nurses.

The Florida Medical Association, an association representing more than 20,000 of our state's physicians, is taking this concern seriously. We are working toward policy solutions that will effectively — and immediately — address the shortage of primary and family care doctors.

What are we proposing?

First, Florida's medical schools will need additional and targeted funding for family practice residencies. While our state has done a great job of expanding the number of medical schools in Florida, the number of residency slots (clinical training positions necessary for medical school graduates) has simply not kept pace.

As a result, we are educating physicians in Florida only to send them out of state to complete their educational requirements. Unfortunately, a vast majority of them never come back. Most physicians settle down within a few miles of where they complete their residency training — and right now, that's in other states. Our plan helps end the exportation of these new doctors by advocating for additional residency funding.

Second, we need to restart student loan forgiveness programs in a way that will encourage new graduates to practice in the areas of primary care and family medicine. Eight-six percent of medical students graduate with astounding education debt. A significant number of medical students graduate with loans of $250,000 or more. For this reason, states that offer loan forgiveness opportunities will have a competitive edge in their efforts to attract physicians. Offering state-funded loan forgiveness initiatives will encourage new doctors to direct their practices into needed areas almost immediately.

Third, our physician members are revamping their business and practice models to expand the collaborative relationship between physicians and physician assistants and advanced registered nurse practitioners. By doing this, we can properly use these "care extenders" in a way that does not jeopardize patient safety. With continuing education and outreach, increasing numbers of Florida physicians are building these types of care teams in a way that will help them reach more patients without sacrificing quality.

Fourth, we must fully enact and continue the new programs that fairly reimburse family physicians for serving Medicaid patients. Just this summer, due to a policy change supported by the Florida Medical Association, many family physicians are no longer being asked to lose money when they see and treat Medicaid patients. This program must be continued and expanded to more of our state's family doctors. It will not only save tax dollars in the long run; it will (if administered correctly) encourage more family doctors to treat those Floridians who receive Medicaid.

Fifth and finally, we are working with lawmakers to implement the promise of new technologies via telemedicine. We have the opportunity to dramatically expand access to areas where there are too few doctors or where a second opinion is needed quickly. Our goal is to expand the use of telemedicine while ensuring high standards, protection against fraud and, of course, patient privacy. As with all technological innovations, this will take a great deal of hard work, thought and innovative thinking.

The Florida Medical Association takes our charge seriously. We recognize that the projected shortage of primary care and family care doctors is a very real concern to every Floridian. We will continue our work to grow the number of these doctors and expand access to care in a way that is safe and affordable for patients and physicians.

Dr. Neal P. Dunn has been a urologist in Panama City for 20 years. He is chair of the Florida Medical Association's Council on Legislation. He is also president and managing partner of Panama City Urology Center and Bay Regional Cancer Center and serves as the managing partner of the Florida Urologic Physicians Network.

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