Fredericks Peebles & Morgan LLP   712.224.5420

Health | Opinion
Mark Trahant: Indian Country deals with shortage of doctors

"A generation ago about half of all medical students picked general medicine over a specialty practice; today’s it’s only about 30 percent. In the larger health care system the main reason for that disparity is wealth. Specialists earn far more than general practioners; a gap of more than $100,000 per year.

The Patient Protection and Affordable Care Act addresses this shortage with several provisions. For example bonuses will be paid for Medicare and Medicaid for primary care practices and repayment of student loans for underserved areas with the National Health Service Corps.

The Indian health system represents one of those underserved areas. The Congressional Research Service recently reported: “The IHS has a high vacancy rate in many of its health professions, 20 percent for physicians, dentists, and nurses, for instance, as of December 2008.” The new law opens up a number of options for American Indians and Alaska Natives interested in health careers: scholarship and loan repayment programs; incentives designed to encourage health professionals to work at Indian health, funds for continuing education and new demonstration projects using students. There will be new grants for “teaching health centers” and for expanding or creating primary care residency programs. The law also allows for newly accredited or expanded primary care residency programs.

But even then will that be enough? How long will it take to fill those pipelines? The answers might not come from a doctor."

Get the Story:
Do you need to see a doctor? Queue up. (Mark Trahant 6/7)

Related Stories:
Mark Trahant: A new debate emerges on health care reform (6/1)
Mark Trahant: Questions about tribes and health reform law (5/24)
Mark Trahant: IHS not threatened by health reform litigation (5/17)
Mark Trahant: An employee's view of Indian Health Service (5/10)
Mark Trahant: Measuring progress of Indian Health Service (5/3)
Mark Trahant: Health care reform brings more jobs to IHS (4/27)
Mark Trahant: IHCIA brings hope for urban Indian health (4/19)
Mark Trahant: Health reform debate to continue for years (4/12)
Mark Trahant: Should Native Americans buy own insurance (4/5)
Mark Trahant: Obama's exciting pick for Medicaid agency (3/30)
Mark Trahant: Delivering promises for Indian health care (3/22)
Mark Trahant: Health care reform vote as a litmus test (3/15)
Mark Trahant: Facebook group gathers IHS war stories (3/8)
Mark Trahant: IHS not mentioned at Blair House summit (3/1)
Mark Trahant: Reaching consensus on Indian health (2/22)
Mark Trahant: Alaska Natives create a model system (2/15)
Mark Trahant: Growing the IHS budget in tough times (2/8)
Mark Trahant: Transparency and Indian Health Service (2/1)
Mark Trahant: Transparency in health care reform bill (1/25)
Mark Trahant: Starting over on Indian health reform bill (1/20)
Mark Trahant: IHS Director Roubideaux on passing IHCIA (1/18)
Mark Trahant: Business model for Indian Health Service (1/12)
Mark Trahant: Some resoluting on Indian tobacco use (1/6)
Mark Trahant: IHCIA now a part of Senate health bill (12/21)
Mark Trahant: Projects improve Indian health care (12/14)
Mark Trahant: Work together for health care reform (12/8)
Mark Trahant: Health care system tied to economy (12/7)
Mark Trahant: Health reform bill tests democracy (11/30)
Mark Trahant: Health reform boosts Indian Country (11/23)
Mark Trahant: Health care reform dead in Senate (11/17)
Mark Trahant: New Republican 'interest' in IHCIA (11/2)
Rep.Hastings objects to IHCIA in health reform bill (10/30)
Mark Trahant: Send Medicaid funds right to IHS (10/29)
Mark Trahant: Health care debate drags on and... (10/26)
Mark Trahant: Guaranteed rights to health care (10/19)
Mark Trahant: Health care debate not over (10/12)
Mark Trahant: Effortless Indian Country care (10/5)
Mark Trahant: Tribal provisions in health reform (9/28)
Mark Trahant: Taxation of tribal health benefits (9/21)
Mark Trahant: Indian Health Service paradox (9/17)
Mark Trahant: Indian exemption and insurance (9/16)
Mark Trahant: Revive the public health hospital (9/14)
Mark Trahant: Grandma and health care reform (9/9)
Mark Trahant: Ted Kennedy steps aside for health (8/31)
Mark Trahant: Tribes, IHS and health coverage (8/25)
Mark Trahant: Ideas for health care reform (8/17)
Mark Trahant: Duality in Indian health care (8/10)
Mark Trahant: Health care from a different view (8/4)
Mark Trahant: Indian businesses and health care (7/28)
Mark Trahant: First Americans are last in health (7/21)
Mark Trahant: Getting into Indian health reform (7/14)
Mark Trahant: Lessons from Indian Country health (7/10)
Mark Trahant: IHS isn't broken, just underfunded (7/9)
Mark Trahant: Indian health care at the local level (7/8)