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We need more primary care physicians in rural communities

By Nick Jacobs 4 min read

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America’s health care system prioritizes sickness over wellness and prevention. According to the Commonwealth Fund, despite spending the highest percentage of gross domestic product on health care, the United States ranks last among 11 of the wealthiest countries in the world.

The Commonwealth Fund’s findings show that we continue to lack access, quality, efficiency, and equity in health care. To understand better, we can look at COVID-19 statistics from Japan, where the country’s citizens suffered exponentially less and had a much lower death rate per capita than in America.

The focus on sickness rather than wellness and prevention in the United States also explains why fewer than 20% of all physicians in our country are primary care physicians, while the majority of medical schools orient their programs toward specialties.

Some may say, “Follow the money,” which explains a system that is inundated with illness caused by successful lobbies in the fast and junk food, alcohol, and tobacco industries. These companies prioritize profits and refer to the physical destruction caused to our population in the form of obesity, diabetes, heart disease and cancer as collateral damage.

The Association of American Medical Colleges (AAMC) projected a continuing shortage of primary care physicians across the United States through 2033, with rural areas being particularly affected. A Graham Center report found that as specialist training continues to grow, the number of family practice physicians dropped by 31%.

The perfect storm of our aging population, more physicians heading toward retirement age, and an increased demand for health care will all contribute to this gap. The National Center for Healthwork Analysis showed that in 2021 only 17.5% of our physicians were classified as primary care and that 17,400 more primary care doctors are needed.

The Organization for Economic Cooperation and Development iLibrary notes that when the European Union faced a similar lack of primary care physicians, countries like France dedicated at least 40% of all new postgraduate training places to general medicine. Even with this effort, attracting a sufficient number of candidates to fill these positions has been challenging.

What’s one answer? In 2020, after initial discussions with key external stakeholders followed by a pre-feasibility study in 2022, and with support of the Indiana University of Pennsylvania Council of Trustees, IUP moved forward to explore the possibility of a college of osteopathic medicine.

Osteopathic medical schools have a long tradition in rural communities, and physicians who are trained in osteopathic medicine are more likely to select family medicine as a specialty than those trained in allopathic medicine (46% versus 11%) and to practice in rural areas (18.1% vs 11.5%). The proposed IUP College of Osteopathic Medicine is centered around an osteopathic-focused foundation in accreditation-tailored to meet the needs of Indiana and Pennsylvania’s rural communities-to create a flagship model for rural health training throughout the country.

What does this mean for the region? IUP’s College of Osteopathic Medicine will be uniquely positioned to provide family practice physicians trained specifically to provide care in rural health areas with significant emphasis on wellness and prevention. The uniqueness of this training will include techniques in both integrative medicine and genomics. Graduates serving underserved, especially rural communities, are projected to contribute to health care cost savings in excess of $136.8 million annually.

Creating a college of osteopathic medicine is no small undertaking. As the only public university-based college of osteopathic medicine in Pennsylvania located in a rural community, IUP’s proposed College of Osteopathic Medicine could offer lower attendance costs and reduced student loan burdens.

As part of the State System of Higher Education, Pennsylvania’s retention of these primary care physicians will also be enhanced. Besides creating over 400 jobs, the IUP College of Osteopathic Medicine will bring nearly an additional $70 million into the local economies.

Founding dean, Dr. Miko Rose and President Michael Driscoll, are committed to finding the $103 million in funds necessary to start the project and identify the individuals and organizations that will help underwrite the cost of tuition for the medical students. Rose and IUP have answered the call for action.

Achieving this vision, however, requires the support of the health systems, foundations, legislatures, leaders, and engaged citizens of this region and state. We stand on the precipice of a rural health care crisis, and this initiative offers one potential local solution.

Nick Jacobs is a Windber resident.

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