Many barriers for primary care physicians

Congressman John Sarbanes had an excellent letter on the shortage of primary care physicians in Maryland (Readers respond, June 18 Baltimore Sun). His proposal for a public service loan forgiveness option is a step in the right direction to encourage physicians to enter primary health care practice.

However student loan burden is a vast understatement of the true costs of becoming a primary care physician. In addition to medical school tuition, there is forgone income for four years of medical school, reduced income for three years of residency training and accrued interest on all of the above amounts. The total costs to become a primary care physician is approximately $600,000. (For readers interested in details, see Maryland Medicine, Autumn 2007). In a subsequent letter to the editor (Readers respond, June 20) a spokesman for the American Academy of Pediatrics points out the major expenses in establishing a primary care practice.

If the Health Care Reform Legislation works as intended, we will have a population able to pay for services and inadequate numbers of physicians to provide those services.

Dr. Timothy Baker, Baltimore

The writer is a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health.

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