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1st
appeared 28 May 1999
Report Suggests Ways to Remedy Shortage of
Medical Care in Inner-City, Rural Areas
In many inner-city and rural communities, an inadequate supply of primary care physicians
compounds the difficulties millions of Californians face in obtaining needed care. A new
report from the California Policy Research Center (CPRC) in Berkeley, which is a UC
systemwide center, offers suggestions on how to attract doctors to California's
chronically underserved communities.
At least 4 million Californians live in federally designated "Health Professional
Shortage Areas," areas within the state that have fewer than one primary care
physician for every 3,500 persons. Rural and inner-city communities with high proportions
of African-Americans and Latinos tend to have the lowest supplies of physicians. People
who lack convenient access to primary care providers often do not receive adequate
preventive and primary care, which can compromise their health, the researchers reported.
"Physician shortages continue to plague many communities in California, especially
rural areas and inner cities with large minority populations," said Kevin Grumbach,
MD, UCSF associate professor of family and community medicine and director of the UCSF
Center for California Health Workforce Studies (CCHWS), which conducted the study for
CPRC. "This problem can be solved, but it will require more concerted efforts by
state policymakers. There is good evidence that a comprehensive state strategy can
alleviate these shortages."
The report, titled "Strategies for Increasing Physician Supply in Medically
Underserved Communities in California," offers recommendations that the California
legislature and state agencies can take to increase the number of physicians in medically
underserved areas. Most of the recommendations involve a greater commitment of resources
to successful programs currently in place or a refinement of current program objectives.
"California already has a number of successful programs that encourage doctors to
practice in underserved communities, but these programs need more resources" said
Janet Coffman, MPP, manager of the UCSF Center for California Health Workforce Studies and
co-author of the report. "Better coordination among programs is also needed."
Primary care physicians tend to shy away from inner-city and rural practices for a variety
of reasons. High rates of violence, poor quality medical facilities, and inadequate
reimbursement pose significant obstacles to retaining physicians in inner-city practices
while professional isolation and lack of urban amenities tend to drive rural doctors away,
the researchers reported.
The report identifies three areas of intervention that have been proven to improve
physician supply in underserved areas of California and other states. These include making
practicing in shortage areas more attractive, providing educational opportunities in rural
and inner-city areas during medical school and residency, and encouraging minorities from
disadvantaged backgrounds to develop career interests in health care.
Financial incentives, such as scholarships and loan repayments, and other interventions
can make practicing in underserved areas more attractive relative to other opportunities.
However, efforts to improve the practice environment must be complemented by longer term
strategies, said Grumbach. Medical students and residents need educational experiences in
underserved areas and medical school classes need to include more students interested in
serving rural and inner-city areas, said Grumbach.
A free copy of the summary and information about obtaining the complete report are
available on CPRC's website (www.ucop.edu/cprc/)
or by calling CPRC at 510/ 643-9328.
Links:
California Policy Research Center
Source: Rebecca Sladek-Nowlis, News
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