EAST CLEVELAND -- Kirtishri Mishra is a second-year medical student at Case Western Reserve University. He hopes to be a family doctor one day, but the challenge will be staying in that career.
On average, about 35 percent of local med students go into primary care upon graduation, but about two-thirds may switch practice within five years.
One reason is the cost of their education.
"You're still graduating with $200,000 in debt," Mishra says.
Administrative costs associated with running a primary care practice, lower income, and burnout also contribute to the switch.
"Being in a specialty just pays more and I think that's what eventually attracts people from being in family medicine," Mishra says
Healthcare Reform and an aging population may contribute to a crisis. According to the American Academy of Family Physicians, but the year 2020 the nation will need at least 39,000 more primary care doctors.
Ohio will need 5,000 alone.
"It's a perfect storm waiting to happen. The baby boomers asking for more services, us having more technology, people living longer having newer medication, and 30 million who's going to get health insurance shortly," says Dr. George Kikano, Chair of the Department of Family Medicine at University Hospitals Case Medical Center.
The CWRU School of Medicine is taking an early approach to keep doctors in family practice by allowing first year medical students to help treat the underserved. It's called Urban Health Pathway.
"They're preparing themselves that when they practice in 2020 they're going to be prepared," says Clint W. Snyder, PhD, MBA Interim Vice Dean for Education and Academic Affairs Professor and Vice Chair of Family Medicine Case Western Reserve University School of Medicine.
The Urban Health Pathway program is just one element trying to keep primary care doctors in Northeast Ohio, but financial incentive is also important.
"There currently are programs that offer some or complete loan repayment so we are doing what we can to try to attract and retain people to practice in these sorts of environments," Snyder says.
It's an experience that may shape Mishra's future.
"Finances will be in the back of my mind but it won't hold me back from what I really want to do," he says.