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Reporting on health and quality of life in South LA

Primary care doctor shortage continues, impact felt in South LA

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Fewer than 1 in 4 new doctors are going into the field of primary care, according to a new study – which is to say the primary care doctor shortage isn't going away anytime soon. 

That's particularly true in under-resourced South Los Angeles, where doctors in general come at a premium. The low- or no-cost health centers that provide safety-net care to the area's largely uninsured population can't pay a doctor as much as a private practice would, which is part of the reason why so much of the care provision falls on the shoulders of mid-level providers, like nurses and physician assistants.

But the shortage isn't unique to South Los Angeles. Earlier this year, a U.S. Senate report said the country needs 16,000 additional primary care doctors to meet the current need. One problem: It's not the most alluring field of medicine. Doctors who become specialists (e.g. cardiologists, neurologists, orthopedists) tend to have lower patient loads than those of primary care providers – and tend to make much more money.

Andy Gausepohl graduated this year from the Keck School of Medicine of USC, and recently learned he'd be starting an emergency medicine residency. In March, he explained to KPCC how finances can become a concern for med students:

"I have friends who have hit half-a-million dollars in student loans just from undergrad and medical school … You're starting to move toward a period in your life where you have to take care of a family, possibly start looking into retirement and just financial stability. Some people have to make those decisions."

The new study, which was published in the journal Academic Medicine, found that out of 759 medical residency sites, 283 didn't graduate a single doctor who'd practice at a Federally Qualified Health Center – places like UMMA Community Clinic, St. John's Well Child and Family Center or T.H.E. Clinic, all of which serve the southside.

It also found that of the nearly 9,000 doctors graduating from those 759 residency sites, only about 25 percent were going into primary care.

Dr. Candice Chen, the study's lead author, said in a statement that the U.S. is producing primary care physicians at "abysmally low" rates. And, she added, unless something changes, the shortage will only get worse once the Affordable Care Act expands health care coverage to millions more.

Dr. Felix Aguilar, the president and CEO of UMMA Clinic, has emphasized that it won't be doctors who fix the problems brought about by the doctor shortage.

"The future is not with physicians," he said in April. "The future of primary care will be with what we call mid-level providers." 

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