"Not everyone working in primary care has the same likelihood of working in rural or inner-city practices," said Kevin Grumbach, MD, UCSF professor and chair of family and community medicine and director of UCSF's Center for California Health Workforce Studies. "We found that physician assistants, family physicians, nurse practitioners and nurse midwives are more likely to work in needy communities than are general internists, pediatricians, and obstetricians."

According to Grumbach, physician assistants, nurses and family physicians have a history of having an explicit mission of service to the underserved as part of their professions. State and federal funds have been used in the past to increase the number of people practicing in these areas of the health care profession based on the assumption that many of these people would then practice in needy communities. "That's exactly what has happened," Grumbach said. "Those investments have paid off," he added.

However, training programs for physician assistants, nurses and family physicians are in danger of being drastically diminished or cut entirely because of state- and federal-level cutbacks, Grumbach said. "Cuts in primary care training programs exert a toll on patients living in needy communities. Every time a family practice or physician assistant program closes due to loss of funding, the health care system turns off another pipeline supplying the future primary care clinicians who serve needy communities."

The study, which appears July 29 in the July/August issue of the Annals of Family Medicine, reveals that physician assistants were most likely to work in underserved areas, such as federally designated "Primary Care Health Professio
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Contact: Camille Mojica Rey
cmrey@pubaff.ucsf.edu
415-476-8429
University of California - San Francisco
29-Jul-2003