"Maryland is mirroring national trends," said Dr. Robert Barish, professor of emergency medicine at the University of Maryland and chairman of the steering committee that supervised the study. "For the future, we need to retain at least 50 percent of residents trained inside of Maryland and also make it more attractive for those who want to come from outside the state."
On of the main factors contributing to the shortage is that too few medical students choose primary care, which includes family practice and general pediatrics, internal medicine, obstetrics and gynecology.
Rich Bryson is a third-year medical student at the University of Maryland. Although he hasn't finished his clinical rotations, he is already leaning toward a specialty, not primary care. For one thing, he said, there would be lifestyle benefits.
"The hours and pay are better for specialists," said Bryson, 24, a native of Hagerstown. "And that is definitely appealing."
In addition, Bryson also worries about his student loans, which he estimates to be around $100,000. "I don't want to be strapped down with loans forever, and I know that primary care pays on the lower end of the spectrum."
Bryson alludes to another factor, which is that primary care physicians are not reimbursed to the same level as specialists by insurance companies. Since they are paid lower rates, general physicians need to work more hours to compensate for their rising expenditures, such as malpractice insurance and supplies.
"The largest insurance companies in the state ... have not raised their reimbursement rates," said Calvert County's Bennett, who now works around 50 hours a week, including some Saturdays. "Ongoing expenses, such as vaccines, cost me more than what the insurance companies pay me."
Despite these challenges, Bennett remains. "I love what I do, and I get to take care of people on an extended basis," he said. "I develop a relationship with patients, some through three, four generations."
Although Dr. Sylvia Batong enjoys practicing primary care for similar reasons, she left the private practice that she shared with Bennett for 15 years.
"It became economically unfeasible," said Batong, a family practitioner who now practices in Waldorf, in Charles County.
