March 2, 2011 | In a rural state with an aging, mostly medically underserved population, Arkansas’ only medical school and the state’s largest insurer are teaming up to improve access to health care.

A $1 million grant announced today to the University of Arkansas for Medical Sciences (UAMS) College of Medicine from Arkansas Blue Cross and Blue Shield will go toward increasing the number of primary care physicians in the state. The gift will create scholarships for medical students pledging to practice primary care in Arkansas, preferably in the more rural parts of the state.

“We already have a shortage of primary care physicians,” said UAMS Chancellor Dan Rahn, M.D., during the news conference announcing the grant. “We are glad to be able to work in partnership with the stakeholders to address our primary care needs.”

Rahn noted that the oldest of the baby boomer generation will turn 65 this year. The total of 35 million Americans aged 65 or older is expected to grow to 72 million by 2030, he said.

The grant will create the Arkansas Blue Cross and Blue Shield Primary Care Scholarship to be given to a junior or senior medical student in the College of Medicine. Scholarship recipients will be chosen from those planning to pursue post-graduate training in family medicine, general internal medicine or general pediatrics.

“We share the concerns about the need for primary care physicians in the state,” said Mark White, president and chief executive officer of Arkansas Blue Cross and Blue Shield. “We already have a shortage and those doctors currently practicing are aging, too.

“It is important to have a system in place to replace and expand those numbers of primary care physicians.”

Primary care is in critical condition, particularly in rural Arkansas. The main reasons for the crisis are:
• A shortage of primary care physicians, including family practice, pediatric and general internal medicine doctors
• An aging population and an illness burden higher than the national average, which creates high patient volume for the physicians who are available
• The potential projected influx of more than 251,000 Arkansans to the Medicaid program in 2014 under health care reform

A big reason for the shortage of primary care physicians is the high cost of medical school. The Association of American Medical Colleges estimates that the average medical student ends up $157,944 in debt by graduation. The average student debt for the UAMS class of 2010 was $125,627.

College of Medicine Dean Debra Fiser, M.D., said another reason medical students choose other specialties than primary care is that they pay more, which in turn makes student debt less of a burden.

“That is why these scholarships are important as we free those students to choose their career path less encumbered by debt,” she said. “The scholarships will help us place new physicians where they are needed the most.”

“This will have a long-lasting impact on health care in Arkansas.”

Fiser credited Arkansas Blue Cross for support of the College of Medicine’s patient-centered medical home initiative. The effort to promote team-based care and a renewed focus on preventative medicine has drawn national recognition.

In September 2010, the UAMS Family Medical Center was selected as one of eight practice sites to collaborate with Arkansas Blue Cross on a pilot project to further develop the concept. Then in December, UAMS received a $149,000 grant from Arkansas Blue Cross’ Blue & You Foundation for resources to provide more comprehensive primary care to patients seen by physicians in the Department of Internal Medicine.

The scholarship funded by the Arkansas Blue Cross grant will be given in honor of the Board of Directors of Arkansas Blue Cross each year, beginning with the 2012-2013 academic year. It is estimated that about $40,000 will be available each year for the scholarship, using interest accrued from the grant.

According to the Arkansas Department of Health, in 2008 the majority of the state met the definition of “medically underserved,” with one primary care physician available for every 3,000 people. That same year, the Healthy Workforce in Arkansas study by the UAMS Center for Rural Health indicated there were almost 1,000 vacancies for PCPs in the state. Instead of improving, these trends are steadily worsening.

Founded in 1948, Arkansas Blue Cross and Blue Shield, an Independent Licensee of the Blue Cross and Blue Shield Association, is the largest health insurer in Arkansas. UAMS is the state’s only comprehensive academic health center, with colleges of Medicine, Nursing, Pharmacy, Health Related Professions and Public Health and a graduate school.