Fort Collins is one of the greatest cities in America, according to sources like Money magazine which tout its strong economy, bike paths and craft breweries. That momentum spills over to Loveland and Longmont, which are also experiencing a boom in development and growth. Good news all around for Northern Colorado, right?
What the magazines do not show is that are still a lot of people left behind, and that translates directly to people lacking access to health care. There is significant need for accessible, affordable primary health care in our city and the surrounding communities. If we do not act quickly, we could see this need evolve into a full-blown crisis in just a few years.
The reason for this pending crisis is because the number of primary care physicians is rapidly declining. Estimates say that today there are 65,000 primary care physicians, nationwide, over the age of 55. These are doctors who deliver babies, care for entire families, make nursing home visits. They provide quality preventative health care and treat symptoms before they turn into chronic illnesses. In addition, primary care doctors help Colorado residents maintain the kind of healthy lifestyles for which we are known. Yet most of them will be ready for retirement in less than a decade.
The care these physicians bring to their patients cannot be replaced.
Imagine Fort Collins – one of the country’s best places to live, and home to stunning, modern medical facilities – experiencing a significant physician shortage. Those who rely on Medicaid and Medicare for their insurance will be the first to notice how hard it will be to find a doctor who will accept them as patients. For those with private insurance, the physician shortage could result in experiences like families being wait-listed just to get a visit with a family doctor.
But medical schools are graduating new physicians each year, right? The facts are grim for primary care. Medical schools are graduating talented people every year, yet fewer graduates are choosing fields like family medicine, instead foregoing primary care for more lucrative specialties. Salary for primary care physicians is typically lower than other specialties, and those who work in one of Colorado’s burdened safety net clinics or those who serve large percentage of Medicaid and Medicare patients see an even bigger discrepancy.
The financial stresses of running a primary care medical practice in today’s costly health care industry are extremely burdensome. The first people who suffer from this financial reality are those lacking private health insurance, and those who aren’t the big winners of the post-recession economic growth. Additionally, medical school graduates in Colorado owe, on average, more than $250,000 in student loan debt. The incentive for a high-paying specialty is often hard to pass up when someone is facing that kind of financial burden.
Beyond finances, the funnel narrows for the field of primary care after medical school graduation. Even as medical schools continue to expand, graduate medical education slots in primary care residency programs have remained relatively static. In order to graduate more primary care physicians, we need to expand Colorado’s primary care residency programs.
We also need greater focus from the medical community – and from everyday Coloradans – on the value primary care brings to the overall health care picture. Primary care physicians provide the most cost-effective medicine: prevention. The primary care focus in other countries leads to decreased national healthcare costs per capita.
We cannot stand by and watch primary care degrade. Access to basic health care should not be reserved only for a select group of people.
There are programs trying to reverse this trend, such as the Family Medicine Residency Program at Poudre Valley Hospital. The program prepares residents for family practice in rural or medically underserved areas, as well as more urban locales along Colorado’s Front Range. Another terrific program is the Colorado Health Service Corps, which offers primary care physicians student loan relief in exchange for their service at clinical practice sites caring for Coloradans in greatest need. In addition, organizations like Health Care Aware Colorado are trying to raise awareness of the primary care and physician shortage issue.
I strongly encourage everyone to think about the role primary care plays in their lives and their communities. The implications by their doctor retiring or simply closing up shop leave very few alternatives. Are you prepared?
Mark Schifferns is Associate Director of Administration at the Fort Collins Family Medicine Residency and a ClinicNET Board member and partner of Health Care Aware Colorado.