SALISBURY, MD – Thousands of women living in rural, eastern Maryland have few options when it comes to finding someone to birth their children.
The local hospital doesn’t have an obstetrician on staff, so most women in the area, surrounded by sprawling farmland and antique shops, turn to the Chesapeake Health Care clinic.
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Five out of 10 obstetricians and midwives are in clinics because of national health service corpsWhich promises to pay back $50,000 in medical school loans for every two years that a doctor works in rural, urban or poor areas.
“Recruiting OBs is notoriously difficult, and I’m not sure exactly why,” said Dr. Lee Jennings, the clinic’s chief medical officer. “We’re isolated, we’re in an area where we’re the only OB group in the whole area.”
Over the past three years, millions of dollars were pumped into the National Health Service Corps to hire thousands of doctors and nurses willing to serve in the most desperate areas of the country during the COVID-19 pandemic in exchange for medical school loan forgiveness. Now, with the health emergency over, the program’s expansion is in jeopardy – even as people struggle to access timely and quality care due to an industry-wide labor shortage,
Funding for the program expires at the end of September, although President Joe Biden asked Congress to sign off on an additional half a billion dollars for the project in his budget.
The numbers of nurses, physicians, dentists, counselors and midwives have swelled thanks to an additional $800 million the US Congress launched for the program in stimulus packages unveiled as the coronavirus spread. Last year, a little over 20,000 people were members of the Corps – up 50% from 13,000 people in 2019.
The program has placed medical professionals in a wide variety of disciplines – from occupational therapists in Ohio to counselors who treat drug and alcohol addiction in Alaska – community health centers across the country, Those clinics receive federal funding to provide primary care for patients, regardless of their health insurance status or ability to pay.
The program has received rare bipartisan support from Republican and Democratic lawmakers, who say they are grateful for the void corps members are filling in rural and needy communities alike that are facing shortages. The US is facing a shortage of thousands of family doctors, OB-GYNs and nurses, a problem that is expected to worsen over the next decade.
Sen. Bernie Sanders of Vermont, who oversees the powerful Health, Education, Labor and Pensions Committee, has made the issue a top talking point at the hearings. Sanders said that in his state, people have complained to him about waiting as long as five months to get a physical with a doctor.
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The situation will worsen, he told The Associated Press, if corps funding is not renewed and increased.
“People are going to struggle to find a dentist, to find a mental health counselor,” Sanders said. “If it’s bad now, it’s only going to get worse.”
Last month, a group of House Republicans sponsored a bill that would continue funding for the CORE program, but not give it the same amount of cash that Biden has requested.
“One of the most frequent issues I hear in my district in Pennsylvania is the shortage of physicians and health care workers,” Republican Representative John Joyce, who introduced the bill, said during a congressional hearing on the shortage of health care workers. month.
Still, the future of the program hangs in the balance with a divided Congress just weeks away from allowing the US to default on its debts. Uncertainty over funding for the program also makes it difficult Health clinics to recruit providersCarroll Johnson, who heads the federal Health Resources and Services Administration that oversees CORE funding.
“We are hopeful of continued growth. We know there is pure demand,” Johnson said. “All the conversations we have had have been very positive; It doesn’t make it any easier.”
One of the biggest areas of program growth has been in mental health, with more than 2,000 additional counselors, social workers, psychologists and substance abuse counselors being hired in the last four years.
At Chicago’s largest, 24-hour treatment center, about eight Haymarket Center Providers are members of the corps. The center sees approximately 12,000 patients each year, many of them homeless. The CORPS program allows the nonprofit Haymarket Center to recruit healthcare workers in a competitive marketplace with a distinct advantage: as much as $250,000 in student loan repayment, said Jeffrey Collard, vice president of operations at the center.
“We may not be able to compensate employees at the highest levels, so being able to be part of the program allows us to provide a benefit that other sites don’t have access to,” Collord said. “
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Student loan forgiveness allowed Dr. Stephen Robinson to become the family doctor he’d always hoped to be. He worried about the mountain of student loan debt that was piling up to get through medical school and noticed that many of his classmates pursued more lucrative salaries as specialty doctors. But his father researched options and discovered the National Health Service Corps program.
“If more providers thought they could come out and still be able to pay their debts, they would go to primary services,” Robinson said. “It’s allowed us to do that.”
His wife, Caitlin, is one of the prestigious OB-GYNs Chesapeake Health Care Appointed through the program. Pregnant women drive up to an hour to see him.
After spending seven years in the program, the two are almost debt free. But they aren’t planning on leaving this small Maryland town anytime soon. The Robinsons prefer to raise their children close to the shore, fresh air, and parks.
Stephen Robinson said, “We have no plans to go anywhere, even if we did.”