Opinion
State must act to overcome doctor shortage
EDMOND —
The Oklahoma Legislature has within its means the ability to begin to heal a problem that long has plagued Oklahoma — decreased access to health care, caused in large part by the state’s severe shortage of primary care physicians.
For many in Oklahoma, the inability to access primary health care in a timely manner has profound economic and health consequences. With fewer primary care physicians to care for our families, more and more patients are forced to get basic health care in our already overcrowded emergency rooms. Delayed care translates into more severe health problems, preventable suffering and longer hospitalizations. All at a much higher cost to patients, their families and taxpayers.
If we don’t act now to increase the number of primary care physicians in Oklahoma we will all pay an even higher price. The lack of doctors significantly dims the opportunities for economic development, particularly in rural areas.
Multiple factors contribute to Oklahoma’s inability to produce an adequate supply of primary care physicians. Chief among those factors is the crushing debt new physicians inherit after completing their training. The average medical school graduate amasses a debt of more than $160,000 during medical school. Faced with such a burden, an ever-growing number of medical school students are choosing more lucrative specialties than primary care or moving out of state.
A proposal now before the Oklahoma Legislature is designed to help solve our primary care shortage by encouraging more physicians to serve in rural and other medically underserved areas. This will improve patient access to care where the need is the greatest and, quite frankly, that is most of Oklahoma.
Oklahoma ranks last in the nation in the physician-to-patient ratio, according to the American Medical Association, with 59 of our state’s 77 counties failing to meet the national standard of one physician for every 3,500 people.
The Oklahoma Physician Recruitment and Retention Program now under consideration by state lawmakers is a loan repayment program for health care providers who agree to practice in underserved areas of the state. The fund would provide an incentive to new health professionals to both practice primary care and locate in critical shortage areas throughout Oklahoma.
The program would assist primary care physicians by helping pay off educational debt in return for practicing in an underserved area. For primary care physicians electing to practice in underserved communities for a full four-year commitment, the program would provide up to $160,000 in loan repayment, freeing those young physicians from strangling debt while ensuring patients are able to access the right care at the right time in the right setting.
The best news is the funding for this critical program would not come from state tax revenue, but by simply closing a tax loophole that allows discount smokeless tobacco products to avoid paying the same tax that all other tobacco products pay. Eliminating this loophole — treating all smokeless tobacco products the same — simultaneously will reduce smokeless tobacco consumption, thereby improving the health of our citizens and raising a significant amount of revenue to increase access to primary care in underserved communities.
The diverse coalition of organizations supporting the physician loan program includes the Oklahoma Hospital Association, Oklahoma State Medical Association, Oklahoma Osteopathic Association, Oklahoma Academy of Family Physicians, The State Chamber of Oklahoma, Oklahoma Academy of Pediatrics, Oklahoma Chapter of the American College of Physicians, Oklahoma State University Center for Rural Health, University of Oklahoma Health Sciences Center and Oklahoma Primary Care Association.
Texas recently adopted a similar program and it is actively recruiting Oklahoma physicians who were trained at our taxpayer-supported universities and medical schools. Many of these doctors would like to remain in Oklahoma but cannot afford to.
It takes at least 11 years to educate and train a physician for practice, and right now our supply line is in a precarious position. But we can take the first step to rectifying that by providing meaningful loan repayment to primary care physicians who commit to practice in areas of greatest need. And we can easily pay for this — not out of state tax dollars or with a new tax, but by simply closing the loophole in Oklahoma’s tobacco tax for discount smokeless tobacco products.
The Oklahoma Legislature can start right here, right now by approving the Physician Recruitment and Retention Program, an innovative loan repayment program for physicians and other health care providers to serve the state’s most underserved areas. This proposal represents an important investment in Oklahoma’s primary care infrastructure and will remove one of the most significant barriers to physicians choosing to practice primary care in our state. But time is running short and we must not delay.
SAM BLACKSTOCK is executive vice president of the Oklahoma Academy of Family Physicians.
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