Why zero-tuition medical school won't solve the shortage of primary care doctors

Tuition-free medical schools might be great for students, but they aren't growing the ranks of primary care doctors. 

April 28, 2024 Check out STAT+

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By Pat Skerrett First Opinion Editor

While trekking from one place to another in downtown Boston this week, I did what I try to do as often as possible: walk through Boston's Public Garden. Move away from the iconic swan boats and you find yourself in a peaceful botanical garden that's nearly 200 years old. Green benches line the garden's perimeter. I gravitate toward the one that honors Sharon Begley, a colleague of mine at STAT who died in 2021. The view from her bench is a peaceful one, looking into the heart of the garden. I had the honor of working kitty corner from Sharon, and then back to back with her. I learned a lot from her about interviewing people, and was always secretly pleased when she'd say in her no-nonsense tone, "Now, wait a second there," to a Nobel laureate or the head of a national research institute. She was a quiet leader in the newsroom and, as STAT reporter Damian Garde recently wrote to the staff as he moved on to Bloomberg, "in time I saw that Sharon used her influence, properly earned over decades in a sometimes punishing line of work, not to advance her personal standing but to assist, promote, and just generally improve the lives of her colleagues who were younger, were less experienced, or otherwise didn't experience the workplace benefits of being Sharon Begley." The Sharon Begley Science Reporting Fellowship aims to keep her spirit alive by diversifying the ranks of science and health journalists and taking to new heights coverage of science that is relevant to all people. This one-year fellowship combines a paid reporting position at STAT with an educational component through the Knight Science Journalism program at Massachusetts Institute of Technology. If you know an early-career U.S. journalist from a racial or ethnic group underrepresented in journalism, please encourage them to apply for the fellowship. Now onto this week's First Opinion essays, which ranged from essays on the grim reality of families leaving their homes to find gender-affirming care to psychiatrists' roles in the CIA's 1950s-era mind control programs and paying for gene therapies. You can read them all here.

Spencer Platt/Getty Images The grim reality of relocating to get access to gender-affirming care More and more families are moving to a different state to get access to gender-affirming care for a family member. By Melissa Santos Lessons to psychiatrists-in-training from the CIA's mind-control projects The troubling history of the CIA's work with psychiatrists in the 1950s should prompt self-reflection about treatment methods and outcomes. By Casimir Klim Free med school tuition won't solve the shortage of primary care physicians Tuition-free med schools aren't boosting the number of med school graduates who choose to go into primary care. Other solutions are needed. By Ezekiel J. Emanuel and Matthew Guido Brandon Bell/Getty Images EMTALA, a vital health law you've never heard of, is in danger The Emergency Medical Treatment and Labor Act (EMTALA) guarantees emergency care. A SCOTUS case could begin chipping away at it. By Nicole Huberfeld Solving academic medical centers' existential crisis Academic medical centers are at a breaking point due to record inflation, workforce shortages, drug costs, and reduced reimbursements. By Ravi Thadhani and Anne Klibanski Déjà WTO: The WHO's pandemic agreement shouldn't water down intellectual property obligations IP rights can promote innovation, but also severely restrict access to needed therapies. Negotiators shouldn't water down IP obligations in talks. By Cynthia M. Ho Adobe An FDA pathway can accelerate innovation for Duchenne muscular dystrophy Few treatments are available for people with Duchenne muscular dystrophy. The FDA's accelerated approval program can help change that. By Jennifer Handt STAT+ | Use evidence to support early coverage of gene therapy after accelerated approval With little known about the long-term risks of gene therapy, payers are reluctant to cover it. Collecting novel evidence can help. By Lee A. Fleisher and Matthew A. Fleisher Balancing hope and reality: The promise and peril of blood-based colorectal cancer screening A blood test to detect colorectal cancer would be a step toward more widespread screening. But it can't do what colonoscopy does. By Folasade P. May Justin Sullivan/Getty Images Bashing accelerated approval isn't supported by the data In-depth survival data question a new study suggesting that accelerated approval drugs often do not improve clinical outcomes. By Peter J. Pitts and Timothy R. Franson Shortages of generic drugs can't be blamed solely on group purchasing organizations Shortages of generic drugs are often a "common-agency problem." Breaking up group purchasing organizations might worsen the problem. By James B. Rebitzer and Robert S. Rebitzer True peer-to-peer conversations will improve prior authorization Prior authorization, when done right with true peer-to-peer conversations, can be good for doctors and their patients. By Matthew Walker

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