Harvard University, citing a critical U.S. need for more community doctors to treat everyday ailments, said it raised $30 million to create a center for the study of primary care.
The gift from a donor who asked not to be named will help develop new educational programs as well as foster research into more cost-effective ways to pay doctors and improve the delivery of care, said Jeffrey Flier, dean of Harvard Medical School in Boston. The university will be starting a national search for a director, and the center may be operational by the beginning of the next academic year, he said.
The U.S. health care overhaul enacted in March helped to spotlight the shortage of primary care doctors with its promise to provide 32 million uninsured Americans coverage for medical treatment. Harvard recognizes the need to transform the ways primary doctors are paid and deliver care, and for education programs to attract more medical graduates to the field, Flier said.
“Unless some interesting solutions are developed, the next five to 10 years could prove even more problematic,” Flier said. “Harvard would like to populate the future leadership of this changing wave of primary care academics and come up with some of these answers.”
The center is the product of months of debate after Harvard Medical School cut funds for a small primary care division in July 2009 that conducted seminars and mentoring programs. The move upset professors and students, who felt the decision gave the impression that the school didn’t care about the area of study, Flier said. The division’s budget was $200,000.
In response to the criticism, the dean convened a task force to re-evaluate what action Harvard could take in primary care, a specialty that is attracting more federal research funding because of the U.S. health-care overhaul. The No. 1 recommendation of the task force’s yearlong effort was to create a center to serve as a “physical and intellectual home” for the field, Flier said.
“The gift allowed us to make this much more than just a symbolic gesture to primary care,” he said. “We can now do what we aspired to do.”
Underserved areas in the U.S. need more than 17,000 additional primary-care physicians to reach a “medically appropriate” target of 1 for every 2,000 residents, according to data from the Department of Health and Human Services.
The average annual salary offered to recruit primary care doctors, including pediatricians, internists and family practice physicians, ranges from $175,000 to $191,000, according to a 2010 survey of recruitment incentives done by Merritt Hawkins & Associates, a research and recruiting firm in Irving, Texas. In comparison, radiologists can make on average $417,000 a year and orthopedic surgeons, $519,000.
As a result of low pay and long hours, the field has attracted fewer medical graduates in recent years, said Roland Goertz, the president of the Leawood, Kansas-based American Academy of Family Practitioners, representing 94,700 doctors and medical students.
“Last year that changed I think because of the health-care debate, and we saw a 9 percent increase in the number of graduates pursuing family practice residencies,” Goertz said.
Goertz’s group sent a letter protesting Harvard’s decision to shut down the division. He welcomed the university’s announcement about the center.
“This is definitely a positive step in the right direction,” said Goertz, a family practice doctor in Waco, Texas. “Harvard’s recognition as an institution is very important for primary care.”
The center, like the health care debate, should also attract more students to the field at Harvard and nationally, said David Gellis, a first-year resident in internal medicine and primary care at the Harvard-affiliated Brigham and Women’s Hospital. Gellis helped start a petition drive last year urging the medical school focus on primary care.
“There’s a lot of excitement among people in my position about what’s happening in the field,” he said. “Many of us are choosing to come to primary care explicitly because of the opportunity to be part of the kind of change this center will foster.”