The Covid-19 pandemic unveiled a truth that health experts had been echoing for years: the country faces a shortage of physicians.
In a 2020 report, the Association of American Medical Colleges estimated that by 2033 the U.S. could face a shortage of up to 139,000 physicians. Furthermore, a report by the California Health Care Foundation published last March showed that the Latinx population is underrepresented among physicians: “Latinx people represented 39% of California’s population, but only 6% of the state’s physicians and 8% of the state’s medical school graduates.”
A local health agency fighting to boost the number of physicians is L.A. Care Health Plan, the nation’s largest publicly operated health plan available for low-income individuals. Today, L.A. Care serves more than 2.5 Medi-Cal recipients.
In 2018, L.A. Care Health Plan launched Elevating the Safety Net, a long-term initiative to recruit and retain high-quality physicians in the Los Angeles County safety net.
In its 25th anniversary celebration on July 22, L.A. Care announced that the “Elevating the Safety Net” initiative will reach a committed $100 million milestone by the end of this year. As the initiative’s name suggests, the health plan is looking to elevate the pipeline of physicians and other providers and facilitate their medical journey through innovative programs, such as the Provider Recruitment Program, Provider Loan Repayment Program, and Elevating the Safety Net Scholarship Program.
Cynthia Carmona, Director of the Safety Net Initiative, said that these programs help address the shortage of doctors represent an investment in the future generation of doctors. “As we expand medical coverage in California, most recently to our immigrant population, we want to make sure we have doctors and programs that can support all the new patients that are going to need care,” Carmona said. “It doesn’t help to make people eligible for Medi-Cal if we do not have a physician or doctor for them to see. The more doctors that we can bring into the workforce, the better chance people have of not just finding any doctor but to get that care in a manner that makes sense for the patient.”
LA County is especially vulnerable to the looming shortage of primary care clinicians in the coming decade. The county falls short of the Department of Health and Human Services recommendation of having at least 60 primary care physicians per 100,000 people. LA County is projected to have 56 physicians per 100,00 people, as stated in the L.A. Care Health Plan website.
One of the most popular programs within the Safety Net initiative is the Provider Recruitment Program, which provides up to $125,000 per hired physician in salary subsidies, sign-on bonuses, and relocation costs. The money provided via grants aims to attract new primary care providers to L.A. Care Medi-Cal network.
A second program under the initiative is the Provider Loan Repayment Program, which aims to help current employees in L.A. Care’s Medi-Cal network pay off their educational debt. The program provides loan awards of up to $5,000 per month for 36 months for physicians recruited into the safety net in year one. Carmona said that there are a total of 108 doctors who have received loan awards since 2018, with 89% of these physicians successfully retained.
The Elevating the Safety Net Scholarship Program, which Carmona said is the most popular, provides $350,000 scholarships to eight medical school students each year.
Carmona said that 53% of the students who have received this scholarship identified as Hispanic or Latinx.
“We are extremely happy with the type of students we were able to support because it’s been very important to us that we are not just increasing the number of primary care doctors,” Carmona said, “but making sure those doctors can reflect and can relate to the members in the community that have Medi-Cal and that are coming to the doctor and clinics for care.”
As part of L.A. Care’s 25th-anniversary celebration, the fifth cohort of L.A. Care’s medical school scholarship recipients was announced. One of the recipients was Alejandro Quiñones Baltazar, a medical school student from Lynwood, CA, who will be attending the David Geffen School of Medicine at the University of California Los Angeles.
Baltazar began medical school recently and hopes to inspire other Latinos like himself to attend medical school and become a physician within their community.
Baltazar said that he considers this scholarship a blessing. “It’s life-changing not just for me but for my family and my community. I won’t have to worry about the financial aspect of medical school or having debt,” he said. “Instead, I can focus 100% on medicine and on offering the best service I can.”
Baltazar’s dream of becoming a doctor began at home, in the single room he shared with his parents and three siblings.
“I remember hearing a conversation my dad had with my mother where he was deciding whether to go to work or go see a doctor for his diabetes, at a time when his diabetes was getting bad,” Baltazar said. After hearing that, he realized that should his father miss one day of work, the family’s financial stability would be jeopardized.
“I realized that there were many families like mine throughout the nation,” he said, “families who had no health insurance, who did not know how to navigate the healthcare system and I knew then that those were the people I wanted to serve.”
Baltazar, 25, said that he identifies as a first-generation Mexican American. His mom immigrated to the U.S. from Michoacan, and his dad, who worked in construction, immigrated from Puebla.
In the past, Baltazar worked as a medical interpreter and translated for Spanish-speaking patients. He said that he has seen how the faces of patients light up when they see doctors that look like them and speak Spanish. “When I think about my parents and who their favorite physicians were, they were those that spoke their language and asked intentional questions to get to know them and their circumstances,” he said. “That’s the kind of physician I want to be.”
Carmona said that the need for hiring doctors that reflect the communities they are serving is more crucial than ever, as L.A. Care’s Medi-Cal population is approximately 40% Latinx. She said this will ultimately improve healthcare outcomes and improve access. “If our patients have a doctor that looks like them, it makes them more willing to be honest and upfront with their doctor. Patients feel better about talking to their doctors about issues that are impacting their health,” Carmona said. “Vise-versa, many of the physicians that the Safety Net initiative has supported have come from these communities and they already have an inherent understanding of the challenges their patients are experiencing. It opens doors of communication in ways that nothing else really can.”
Baltazar said that getting a financial full-ride to medical school from L.A. Care was not something he had expected. He had planned to apply for financial aid and student loans to fund his education. ”I would have had to find other scholarships and many of them require time, time always from my practice and my study,” he said. “My parents are extremely proud. My father cries every time he talks about me becoming a doctor. I’m doing this to help them and my community.”
Carmona said that aspiring physicians need to recognize and cherish the influence their communities have had on them and the influence they cam have on their communities.
She said that she hopes the Safety Net Initiative continues to support the next generation of doctors. “When we think about going into medical school, we put so much emphasis on good grades, good schools,” Carmona said. “But those are not the only things that are going to make you valuable as a doctor. It’s your relationships, your language, and your culture. Those things are going to bring even more added value to you as a physician in the safety net and I hope that that’s what our focus in these programs is promoting.”
Baltazar said that he plans on practicing as a general physician, but is open to other specialties he will learn more about in medical school. “Regardless of the specialty I do go into,” he said, “it’s more about the health equity lens that I hope to always incorporate in my practice.”
Baltazar said that he advises aspiring physicians not give up on their journey and seek support from programs, peers and agencies like L.A. Care Health Plan. “We can’t do it alone and oftentimes we are scared of asking for help, but I think my biggest advice is to lean into people that care and love you,” he said. “You might see my name here but there are so many people behind me that helped me get here.”
Carmona said that L.A. Care will continue to offer many of these programs as long as they can and in the next few months the organization will evaluate which programs under the Elevating the Safety Net are having the biggest positive impacts.
“We are hopeful that by L.A. Care doing big commitments like these, we will inspire other agencies to make similar commitments and invest in doctors and our healthcare system,” Carmona said. “It’s important that we inspire others and create a culture of obligation to continue to solve the workforce shortage.”
Many of the programs that make up Elevating the Safety Net initiative are currently accepting applications. For more information on the initiative and for the full list of programs and benefits you can visit the website here.