Latest news with #doctorshortage
The Guardian
3 days ago
- Business
- The Guardian
Loan plan in Republican bill could worsen doctor shortage, experts warn
Doctors' associations, medical schools and student advocates warn that a proposal in the Republican-led budget bill being considered by Congress restricts graduate federal student loans and could worsen a national shortage of doctors. The new Republican proposal would limit federal student loans for 'professional programs' – such as medical school – to $150,000, eliminate a federal graduate loan program and put limits on loan forgiveness. Medical students rely heavily on federal student loans to finance lengthy and expensive educations, particularly since 2006, when Congress broadly lifted caps on borrowing limits to allow for the full cost of tuition and living expenses. 'Our organization is very concerned about this,' said Dave Bergman, a spokesperson for the American Association of Colleges of Osteopathic Medicine (AACOM). He said about four in five students who attend osteopathic medical schools, which grant the doctor of osteopathy or 'DO' designation, use Grad Plus loans and many depend on student loan forgiveness. The changes are part of the 1,100-page Republican-led reconciliation bill dubbed the One Big Beautiful Bill Act that Donald Trump sees as core to his second term in office. The legislation passed the House last week and is now being considered by the US Senate. 'When there is a stated goal from these policymakers to increase the physician workforce, to increase the number of primary care physicians and expand access in rural and underserved areas – these policies just don't align with those priorities,' said Bergman. 'It's a really bad workforce decision.' The Association of American Medical Colleges estimates the US will face a shortage of between 37,800 and 124,000 physicians by 2034, with specialties such as primary care, psychiatry and geriatrics especially affected. Advocates warn the curtailing or eliminating federal student loan programs could drive low-income students away from pursuing medicine as a career, make loans harder to repay, or push students into the arms of expensive private lenders, advocates told the Guardian. In turn, these changes could also worsen the flight of doctors from lower paid specialties, especially family medicine, primary care and pediatrics, which tend to have lower match rates than higher paid specialties such as cardiology, experts said. 'I, along with many others, worry that these changes will make medical school unaffordable, turn loan repayment into a pipe dream for residents, and worsen physician shortages – especially in primary care and underserved areas,' wrote recent medical school graduate Kaley Parchinski in a Stat editorial. An analysis by the Urban Institute, which studied the proposal when it was first introduced by Republican North Carolina representative Virginia Foxx in 2024, found the limits could affect more than 60% of students pursuing medicine and other health professions. 'At a time when our country urgently needs more doctors – especially in underserved areas – this bill would create new financial and logistical barriers that disproportionately harm low-income students,' said Dr Shannon Udovic-Constant, president of the California Medical Association, in a statement. The limits on graduate education would join limits on student loans seeking four-year degrees in a way that critics warn could make completing college more difficult for low-income students. Sara Partridge of the Center for American Progress said the changes risk 'creating or exacerbating [shortages] in essential and medical and healthcare fields, and reducing pathways to high-paying, in-demand career fields for students in underrepresented backgrounds'. The federal government has guaranteed student loans as a form of financial aid since 1965, part of a program called the Federal Family Education Loan program. These loans are a major payor for American medical schools, whose tuition costs have increased dramatically in cost since the mid-20th century, in line with other forms of higher education. Because of the long training requirements for doctors, aspiring physicians often graduate with large debt burdens, and how to decrease that burden has been a subject of bipartisan debate. The median indebtedness of a medical student who carried loans was $205,000 in 2023 according to the AAMC – or more than $50,000 short of the limit placed by congressional Republicans. House Republicans argue that uncapped student loan access has driven up the cost for expensive professional degrees, and that limiting federal loans would help drive down the cost of tuition. Dually, Republicans have argued that if students need more financing they can go to the private market. 'It is extremely costly to get a medical degree,' said Sara Robertson, spokesperson for Republicans on the House committee on education and workforce, which drove the proposal. 'Reforms in the bill will help put downward pressure on prices at medical schools so that future medical students can pay lower tuition costs, thereby making medical school more accessible to individuals from all backgrounds.' Robertson argued that, although the bill would limit how students can earn credits toward loan forgiveness during residency, it would allow them to defer interest and that private student loans would become available. 'For borrowers who do need to borrow more than the bill's loan limits, private student loans – particularly for medical students – will be widely available and often have interest rates,' said Robertson. However, because of relatively high earnings, medical students are also among some of the least likely students to default – limiting government risk. An average of 8.15% of all student loan debt is in default at any time, according to the Education Data Initiative, while just over 1% of osteopathic medical students miss loan payments, according to AACOM. Further, economists who have studied the issue – including those whose work Republicans have cited – warned there could be unintended consequences to altering these programs. 'The private loan market looks very different than it did in the years before Grad Plus,' in 2006, said Lesley Turner, an economist and associate professor at the University of Chicago Harris School of Public Policy. Turner and her co-authors wrote a paper which found that graduate loans, unlike loans for four-year degrees, likely raise the cost of graduate tuition. Robertson cited the paper to Axios. Turner said the Republican bill proposes a far lower limit for federal student loans than in 2006, the time before the Grad Plus program was created. Aggregate loan limits adjusted for inflation and for health-related programs, such as medical degrees, were 'almost $300,000 … so almost double the limit the House proposed.' 'This isn't going back to where we were in 2006, this is going back to that and then cutting it in half,' Turner said. 'It's not clear that the private student loan market would fill in that gap.' Turner's co-author, labor economist Jeff Denning at the University of Notre Dame, said he had 'mixed feelings' about the proposal. 'Uncapped borrowing is probably not a great policy,' said Denning, 'but capping it might have these unintended consequences particularly for high tuition programs including medicine.'
CTV News
7 days ago
- Business
- CTV News
‘Concerning:' New research reveals trend that may be contributing to family doctor shortage
A doctor wears a lab coat and stethoscope in an exam room at a health clinic. THE CANADIAN PRESS/Jeff McIntosh New research has found that many family doctors are choosing to work in emergency departments or other areas of hospitals instead of practicing comprehensive family medicine, potentially exasperating Ontario's family doctor shortage. The study published Tuesday in the Annals of Family Medicine looked at 30 years of data in Ontario, covering a period from 1993-1994 through 2021-2022. It concluded that there was a substantial decrease in the number of comprehensive family doctors in the province on a per capita basis. In fact over the study period, the data showed that while the number of family physicians increased from 104 to 118 per 100,000 people, the number of comprehensive family physicians decreased from 71 to 64 per 100,000 people. The data further showed that of the 6,310 additional family doctors who entered the workforce over the study period, nearly 40 per cent were in focused practice. Researchers have called this trend 'concerning'. The study found that despite training more family doctors, the numbers do not add up to balance the need, the study's senior author Dr. Tara Kiran, a family physician and researcher at St. Michael's Hospital and the University of Toronto told CP24 on Wednesday. 'It's not enough to just train more family doctors,' Kiran said. 'We have to support them and ensure our systems and incentives are in place so that they preferentially choose family medicine in the community.' Kiran added that building infrastructure, incentives and support systems within family medicine can help drive more physicians towards full-service family medicine instead of seeking employment in larger hospitals. 'We don't have enough family doctors, but we also have don't have enough doctors working in other parts of the system,' she said. 'And that's partly why family doctors are struggling.' Around 2.5 million Ontarians are without a family doctor, according to data published by Ontario College of Family Physicians. The findings show that the province needs to work harder to encourage family physicians to choose this specialty, the research says. The Ford government recently revealed plans to set up to 80 new or extended team-based primary care facilities in marginalized neighbourhoods across Ontario in an attempt to get around 300,000 people off waitlists as a part of a $1.8 billion undertaking. The government has vowed to combat the crisis by connecting every Ontarian with a family physician by the year 2029. According to Ema Popovic, a spokesperson for Health Minister Sylvia Jones, this year's Canadian Resident Matching Service (CaRMS) saw 621 students match into family medicine – 113 more than 2022. The spokesperson added that more doctors are choosing to practice family medicine in Ontario as the government's investments 'enhance digital tools to save primary care providers 95,000 hours and add new medical school seats.' 'We continue to break down barriers for family doctors to enter our workforce new programs such as the Learn and Stay Grant and Practice Ready Ontario that will add nearly 1,500 new family doctors with full rosters, practicing in rural and northern communities across the province,' Popovic said. Although the authors of the research note that further study is needed to explain the trend, they say that physicians moving away from family medicine and toward specialized areas could be attributed to higher pay, better working conditions, more freedom and flexibility – during vacations and leaves and reduced responsibilities of running a small business. Another notable concern is that family physicians are constantly occupied with paperwork, that takes hours out of their schedules, Kiran added. The study found that the number of family doctors working in roles like emergency medicine or addiction medicine rose 'substantially' over a 30-year period between 1993 and 2021.
CBC
23-05-2025
- Health
- CBC
Western faculty unions call on school to do more to alleviate London's doctor shortage
Social Sharing Faculty unions at Western University and its affiliated colleges are continuing to push back on the school's decision to restrict access to its employee and family health clinic, saying it should be expanding access, not exacerbating London's doctor shortage. Earlier this year, CBC News reported the university was bumping patients from the clinic's roster who weren't full-time main campus employees, citing limited treatment capacity and a growing waitlist. Full-time faculty at Huron and King's university colleges, part-time and contract Western employees, and full-time Western employees with fixed-term contracts can no longer use the clinic as of mid-August, along with full-time employees who retired after February 2025. The new rules also limit eligibility to full-time main campus employees and immediate family who don't have a family doctor within 30 kilometres of London. The faculty unions claim those impacted weren't consulted about the change, and say Western hasn't "adequately considered the role it can play in working towards a solution." "With a leading medical school, Western should be expanding access by leveraging its teaching clinics and civic footprint to ease the city's burden, not intensify it," the unions say in an online campaign form, using McMaster University's Family Health Team as an example. In January, one local official involved in recruiting doctors estimated that at least 100,000 Londoners don't have a primary care physician. The waitlist for Western's own clinic demonstrates the need, the unions say. It numbers around 250 employees and their dependents. Roughly 2,700 patients were on the clinic roster in March, Western says. "De-rostering a lot of patients from the Western clinic is actually going to cause more problems in the community," said Johanna Weststar, president of the University of Ontario Faculty Association (UWOFA). "Given Western has a medical school, and has this clinic set up already, there are likely some creative solutions to be had there (to increase capacity) in consultation with all three universities, perhaps in consultation with the City of London," she said. UWOFA alone has roughly 100 full-time members on fixed-term contracts, and about 300 on part-time contracts, she said. The larger group of concern is future retirees, who now have to find a doctor at a later stage of their lives. In a statement, a Western spokesperson said the school had run and subsidized the clinic for over 20 years to serve full-time employees and their families, while reducing pressure on the surrounding region. The clinic had made efforts to support as many additional patients as possible over the years, but without access to "any of the primary care funding models available in community practice … we must prioritize those it was originally meant to serve," it adds. While some Huron and King's staff may have accessed the clinic, they aren't employed by Western, and there's no longer capacity to continue the service, the statement said. More than 800 people were contacted by the clinic about losing access, Western told CBC News in March. At least 600 had not accessed the service in the last two years. "Our faculty, students and alumni ... are integrated with local hospitals and clinics, actively working to improve the health and wellbeing of thousands in our community – not to mention a number of university-operated clinics serving the London community." The faculty unions allege patients were removed "unilaterally and without any direct interaction or communication," in violation of regulator policy around ending physician-patient relationships. "Western has a lot of money, a lot of resources. I think they're always going to be judged by a high standard in terms of looking at a situation like this," said Lad Kucis, a partner at Toronto-based Gardiner Roberts LLP specializing in health law. "If they want to downsize, I can see there may be some rationale for it, but they still have an obligation to deal with their existing patients that were there in the past." While Western is making the decisions, any regulatory complaint would fall on the clinic's physicians, he said. At the same time, it's incumbent on the physicians to ensure Western is compliant. Some negative optics may stem from Western's major healthcare presence, with its medical school and hospital connections, making it important that it do everything it can to assist impacted patients. "The clinic has communicated directly with patients and all communications have adhered to the appropriate regulations," Western said in a statement Thursday. The school adds it's offered ineligible patients six months' notice to remain in the clinic's care, and is "working diligently to provide space for all eligible employees while also providing support to ineligible patients in finding alternative care."
CTV News
22-05-2025
- Health
- CTV News
Doctor shortage to close Thessalon ER
North Shore Health Network warns Thessalon Hospital's ER will close from 8 a.m. Friday to 8 a.m. Saturday, due to a doctor shortage, patients may need to visit Blind River, Richard's Landing or Sault Area Hospital if alternate arrangements aren't made.
CBC
18-05-2025
- Health
- CBC
Kamloops, B.C., exploring city-owned and operated medical clinic
Social Sharing After watching another B.C. community launch a medical clinic owned and operated by the municipality, the City of Kamloops is considering whether the same model could solve a longstanding doctor shortage at the confluence of the North and South Thompson rivers. In January, the City of Colwood, just outside Victoria on Vancouver Island, opened the Colwood Medical Clinic. Rather than having doctors see patients and also handle paperwork, like in a private practice setting, the city deals with administration and business issues so physicians can focus on providing care. "The doctors of today like to work eight to 10 hours a day," Kamloops city councillor Kelly Hall told CBC's Daybreak Kamloops host Shelley Joyce. "They do their shift, they want to jump on their mountain bike, they want to go skiing at Sun Peaks. They want to enjoy quality time with their family." Having the city handle the business side of running a clinic would give doctors that opportunity, he said. Hall pitched the idea to the city's mayor and fellow council members, who in turn voted unanimously earlier this month to have city staff work up a clinic proposal. The Colwood clinic came about in response to data showing that more than half of Colwood residents did not have a family doctor. The city plans to hire eight physicians in total, each able to take on about 1,250 patients. Colwood Mayor Doug Kobayashi told The Canadian Press there have been a lot of applications, but they're only trying to recruit from out-of-province to avoid poaching physicians with active practices in other B.C. communities. "You don't rob Peter to pay Paul," he said. "This is what's making the process a little bit slower than we were hoping." WATCH | Colwood launches city-owned clinic: To deal with a doctor shortage, this B.C. city has decided to start paying them directly 5 months ago Duration 2:09 One Vancouver Island city is trying out a new health clinic model to address the provincial shortage of doctors. At Colwood's new city-run clinic, physicians will be paid as municipal employees. Michelle Gomez reports. Kobayashi said the city-owned clinic currently has one doctor, and employment contracts are soon to be inked with two more. A fourth is expected to be on board by September. He said several municipalities, including Kamloops, have inquired about the city-owned model, and though it has experienced "growing pains," the facility's first staff doctor has "become part of the community." "She's been absolutely involved in our community, which is a great thing," he said. "It's just been phenomenal." While Kamloops does have several family physicians, residents still struggle to find a GP. The city of some 100,000 is also lacking when it comes to in-person walk-in clinics. "This is a game changer for the community, in my opinion," Hall said. He suggested the doctors would be treated as city employees and have access to all the same benefits as city staff — including medical and dental benefits and access to a pension. They would show up to work, treat patients and go home, Hall said, without having to worry about pesky paperwork. The Kamloops model would be different than the one in Colwood, he added, in particular because Kamloops is five times the size of the Island city. But first, he said, they need to sell doctors on the city. He envisions a video explaining the benefits of living in the heart of B.C.'s Interior.
