South Carolina ranks 39th nationally for access to health-care services and 43rd for chronic disease, preventable hospitalizations and number of primary-care providers per capita. With federal law making insurance more affordable, we desperately need more primary-care providers: internists, pediatricians, family practitioners, nurse practitioners, physician assistants, psychiatrists and women’s health providers.
As a future primary-care provider and member of the Institute for Primary Care Education and Practice, a partnership between the students and faculty at South Carolina’s health programs, I believe there are three important steps our state needs to take.
States do a better job retaining physicians who attend both medical school and resident training there. But even as we have seen a significant increase in the number of graduating medical school students in South Carolina, there has been no equivalent increase in residency spots since 1997 due to a cap on Medicare funding. The lack of primary-care residency programs prevents those enrolled in S.C. undergraduate medical programs from completing their education in this state, and instead promotes brain drain.
To ensure that we benefit from South Carolina’s investment in undergraduate medical education, we must support more in-state residency programs by expanding our state’s funding for graduate medical education. Already, a bottleneck is forming between undergraduate medical education and residency programs.
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We also need to expand the practices of nurse practitioners and physician assistants. As of 2012, nurse practitioners can sign handicap-parking permits in 44 states, but not in South Carolina. South Carolina nurse practitioners are required to practice within 45 miles of their supervising physician and physician assistants within 60 miles. If that requirement were removed as is common in other states, primary-care services could reach our most resource-poor rural communities.
Increasing the services that they can provide will attract more highly qualified nurse practitioners and physician assistants to the state and will expand the pool of primary-care providers to meet our extensive need.
Finally, our state needs to continue funding for the Office for Healthcare Workforce Analysis and Planning, as a way to monitor our primary-care needs. The office is in the last year of its startup funding from the Duke Endowment.
South Carolina is in a position to be a national leader in forecasting health-care workforce needs, thus empowering our state to improve primary care by increasing access to high-quality health-care services. This cannot be done without the valuable research and analytics that this office provides.
Shannon Adele Looney