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On the morning of October 12, residents of the prestigious Columbia University/New York Presbyterian’s Family Residency Programs received some demoralizing news.
Steven J. Corwin, the CEO of New York Presbyterian, and Dr. Lee Goldman, the dean of Columbia’s medical school, mutually decided to shut down the joint-family-medicine residency program.
The program places trainee physicians into a community health center in upper Manhattan that focuses on family care – doing everything from yearly checkups to handling bad cases of the flu.
But the issue highlights a far bigger problem: There’s a massive shortage of primary-care physicians in America.
The decision resulted in the abrupt firing of roughly 30 residents (trainee doctors), according to an editorial posted on the American Academy of Family Physicians website, written by some of the residents who got the bad news.
According to the editorial, closing the program would mean leaving patients in the working-class upper Manhattan area without vital primary-care services. They’d also have to find new doctors, which is becoming more difficult for those on Medicaid plans.
The editorial also stated that the closure was not caused by a lack of revenue on the hospital’s part – as net profits exceeded $365 million in 2014 – but rather shifting priorities. Resources were to be spent developing “high-margin subspecialty care,” according to the residents, referring to practices such as dermatology.
Facing backlash, the hospital quickly reversed its decision and announced, on Twitter, that the family-care center would remain open and that the program would continue to accept new students for the next academic year.
STATEMENT: Family medicine residency program at The Herman “Denny” Farrell Jr. Community Health Ctr will stay open http://t.co/nO0issOHZV
— NewYork-Presbyterian (@nyphospital) October 13, 2015
A huge shake-up in care
Though the budding primary-care practitioners were happy to keep their jobs, the market they’re going to enter after graduating is in the midst of a huge shake-up.
Demand for primary-care physicians currently outstrips supply. As baby boomers age and increase the burden on the healthcare system, the gulf is only going to widen. A 2013 study by the Health Resources and Services Administration found that by 2020 there will be a massive shortage of primary-care physicians – 20,400 to be exact, based on current trends.
The shortage of family doctors is a serious problem, and medical schools are trying to do more to solve the issue. But there are challenges, and the problem has been brewing for a while. A 2012 New York Times article by Dr. Pauline Chen noted that only 2% of medical students in a survey from the year before expressed interest in primary-care training.
Primary-care physicians often work longer hours and end up making less money than their subspecialty counterparts. Specialists make 45% more than primary-care doctors, according to a survey released this year by Medscape.
Some medical schools are already creating novel approaches to entice more students into primary care. Harvard is educating students based on a medical-team model, which offloads some of the physician’s more onerous duties onto nurses and physician’s assistants. Texas Tech and New York University are currently experimenting with three-year accelerated family-medicine programs instead of the standard four-year program.
Business Insider reached out to a spokesperson from New York Presbyterian and we’ve included their response below.
“NewYork-Presbyterian is committed to providing exceptional and compassionate care to all of the communities we serve. After listening to feedback from our medical staff, we have decided that the family medicine residency program at The Herman “Denny” Farrell Jr. Community Health Center will stay open and the faculty will remain. We will be accepting an additional class of residents in its current form as we explore the development – in close collaboration with faculty, residents and medical students – of other potential models of primary care training and delivery in the future.”