Allison Campbell Jensen

Capturing the attention of lawmakers in St. Paul is a challenge because so many voices of committed people and worthwhile causes compete. In 2008, the Medical School wanted understanding and, if possible, help from the Minnesota State Legislature to promote education of primary care physicians. We knew our leadership, faculty, and medical students had the direct experience and passion to tell their stories to legislators. They would, however, benefit from a few facts. So, working with the Department of Family Medicine and Community Health and Academic Health Center public affairs team, I put together a one-page brief to help them prepare to talk face-to-face with their state senators and representatives.

The brief follows:

Facts to share

• Minnesota’s overall supply of primary care physicians is as good or better than many other states, but many rural areas in the state are experiencing physician shortages and the need for primary care physicians is expected to increase in both rural and urban areas because of national trends.
• While Minnesota remains ahead of most medical schools in graduating new doctors who choose primary care specialties, its statistics are on a downward trend, mirroring that of the rest of the country.

• Declining interest in primary care has been associated with perceptions that it does not pay as much as other specialties (particularly considering high levels of medical education debt). In addition, there are concerns about meeting lifestyle aspirations and degree of intellectual challenge. Practice site choice is also affected by spousal considerations and geographic aspirations.

What can we do?

• This year, we increased Medical School class size by 10% (22 incremental students per year).

• To increase the number of primary care physicians, we need to look at class size. We need to keep in mind, however, that with additional increases, our Medical School accreditation standards would require major investments in faculty and in facilities.
• We may need to increase economic incentives for primary care, specifically, enhance loan repayment programs for primary care physicians in underserved areas or enhance smaller communities’ ability to recruit new physicians and their spouses.

We may need to deliver primary care delivery differently than in the past

• Transform education to develop and test new models of care delivery

• In partnership with health systems and community, develop a long range model around new models of care delivery, and build a body of evidence and scholarship about the effectiveness of new models.