When newly minted doctors graduate from medical schools throughout the country each year, most head for lucrative jobs in specialties and large metropolitan regions.
Few want to practice family medicine for relatively low pay in America’s backwaters.
The doctor shortage is a problem across the country, but it’s worse in Alabama than most states. According to a report last year by the Association of American Medical Colleges, Alabama had 193.2 active care physicians for every 100,000 residents. Only eight states had fewer doctors per 100,000 residents.
A bill aimed at addressing the rural doctor shortage in Alabama was scheduled for a vote Thursday in the state Senate Finance and Taxation Education Committee, the bill sponsor Sen. Larry Stutts (R-Tuscumbia) held it over until next week.
“What the bill really is about is helping people afford to go to school who can’t otherwise go,” he said in an interview.
The bill would provide money to pay medical school tuition for 25 students, who then would agree to practice family medicine in an underserved part of the state for five years.
Stutts said the legislation not only would help talented lower-income students afford the substantial cost of medical school and provide more doctors to communities that desperately need them, it also would support struggling rural hospitals.
“We pay lip service all the time to, we want to help rural hospitals,” he said.
Stutts pulled a different version of the bill last month amid questions concerning its designation of the Alabama Medical Education Consortium to run the scholarship program. The organization teamed up with the Southeast Alabama Medical Center to found the Alabama College of Osteopathic Medicine in Dothan in 2013.
What’s more, Stutts’ son is a medical school student, and some raised questions of conflict of interest.
Stutts said the insinuations are nonsense. He said his son has no need for a scholarship and no interest in the post-graduation commitment it would entail.
As for the governing body, he said, the revised bill places the Board of Medical Scholarship Awards in charge of the program. The organization already administers scholarship programs aimed at increasing the supply of doctors in underserved areas, and its board has appointees of both the state House and Senate, giving the Legislature input into its decisions.
“I’ve tried to address all the concerns that people had about it,” Stutts said.
Rep. Steve McMillan (R-Orange Beach), who is sponsoring the bill in the House, said he believes the committee chairman is on board and that lawmakers will advance it next week.
“We’re hoping to work out a compromise,” he said. “But it’s been real difficult. … We’re proposing a very reasonable compromise.”
McMillan cited one statistic indicating the need — life expectancy is nine years lower in Alabama’s rural areas than its urban regions. He said about 60 percent of doctors stay in the states where they complete their residencies after medical school.
That indicates that doctors contractually obligated to serve rural areas in Alabama likely would put down roots and stay even once they complete their obligation.
“Even if they do move on, we’ve gotten five good years of service from them,” he said.
Jeffrey Flier, the former dean of the faculty of medicine at Harvard University, said in an interview that family physician shortages are a major problem in underserved areas and that state-funded scholarships are one possible solution.
“That’s a good thing,” he said. “There should be more of it. It works.”
Flier this week co-wrote a paper for George Mason University’s Mercatus Center examining a number of ways that America could boost the number of doctors. He called for reducing barriers to licensing new medical schools, for instance.
Another idea is to make it easier for foreign doctors to come to the United States. Flier said currently, Canadian doctors who move to the United States are treated the same as doctors who graduate from U.S. medical schools.
But most states follow guidelines from the Educational Commission for Foreign Medical Graduates and require doctors from other countries to pay for and take a medical exam in the United States and compete for a limited number of residency programs.
This is true even for doctors in First-World countries who have completed similar training programs in their home countries.
“Why do you have to do your training again if you’ve already done your training?” he said.
Flier said about a quarter of doctors in the United States were born in foreign countries. He said data indicate that they perform as well as native-born doctors and have similar levels of patient satisfaction.
“We want to shake things up a bit,” he said. “When you’re in the medical world … you’re in kind of a bubble.”
Brendan Kirby is senior political reporter at LifeZette.com and a Yellowhammer contributor. He also is the author of “Wicked Mobile.” Follow him on Twitter.
