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Student loan forgiveness programs driving osteopathic physicians to primary care

About a third of osteopathic medical students intend to work in primary care, an 18 percent increase from 2007.

Jeff Lagasse, Associate Editor

Graduating osteopathic physicians are increasingly planning to practice in primary care, a trend researchers say shows that loan forgiveness incentives are influencing new doctors' choice of specialty, according to a new study in the Journal of the American Osteopathic Association.

A 2016 survey of graduating osteopathic medical students showed 33 percent intended to work in primary care. That represents an 18 percent increase from 2007, when only 28 percent of osteopathic medical students indicated a future career in primary care.


During that same time period, medical schools' tuition increased at a rate more than double that of national inflation, and the average medical education debt load for osteopathic physicians went up 54 percent, with the mean physician indebtedness at $240,331 in 2016.

The finding was that student debt has an influence in determining physician practice, and that programs offering loan forgiveness to physicians who choose primary care are working.

The researchers analyzed responses to annual surveys of graduating medical students' plans for residency, and evaluated graduating physicians in the top quartile for indebtedness, finding 35 percent who intended to practice in primary care would also use loan forgiveness programs.

But only 20 percent of those in the top debt quartile intended to practice in primary care without using loan forgiveness programs.

While existing loan forgiveness and repayment programs are helpful, the study said they should be expanded to keep pace with the ever-increasing costs of medical school. It estimated a primary care shortfall of between 7,300 and 43,100 physicians by 2030, and identified a need to reduce existing barriers to physicians choosing primary care in order to mitigate the problem.

The research added that primary care physicians not only improve individual health outcomes but also provide checks and balances for the use of health care dollars. Effective primary care is shown to decrease emergency department visits, hospitalizations and elective operations.


While the ranks of primary care physicians continue to decline, the number of nurse practitioners are on the rise in both rural and nonrural settings, making for more diverse practice care teams, June 2018 findings showed.

About 234,000 NPs are licensed in the U.S and can deliver most of the services a physician can, and research has shown the care they deliver is safe and "high quality" -- with the increases coming at a time when physician shortages, especially in primary care, loom large.

Twitter: @JELagasse

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