When Dr. Josh Plavin was in medical school, a federal program supporting primary care providers, the National Health Service Corps, helped pay for some of his education costs.
“I was a National Health Service Corps scholar,” Dr. Plavin notes.
Upon graduation, the program required that he work two years at a National Health Service Corps approved site in a designated primary care shortage area. Dr. Plavin looked to rural Vermont.
“At the time there were no designated sites in Vermont with job openings,” says Dr. Plavin, who worked with his employer of choice – Gifford Medical Center – to have the Chelsea Health Center designated as an approved site. The site was approved in part because neighboring Tunbridge was, and still is, defined as a primary care shortage area.
That was in 2001 and Dr. Plavin served the Chelsea area as a both a pediatrician and internal medicine provider for the next seven years.
Today, Dr. Plavin serves as medical director of all of Gifford’s primary care practice locations – in Berlin, Bethel, Chelsea, Randolph and Rochester. As such, he sees the benefit of the federal program from new eyes – that of a hospital administrator trying to staff primary care practices in rural areas.
“Medical school is so expensive that there are fewer and fewer doctors going into primary care because the simple math is it is not viable without loan repayment. It’s certainly not viable in a rural area,” says Dr. Plavin on what nationally is Corps Community Day, held today during National Primary Care Week.
Part of the U.S. Department of Health and Human Services Health Resources and Services Administration, the National Service Corps is a federal program that improves access to health care for people living in both urban and rural communities with a shortage of primary care providers. About one in five people in the United States (21 percent) lives in a primary care shortage area, according to the program, which means those individuals go without essential health services, or they have to travel long distances to see a primary health care provider.
The National Service Corps offers financial, professional and educational resources, including scholarships and loan repayment, to qualified providers who want to bring their skills where they are needed most – to underserved areas.
Currently, there are 10,000 service corps doctors, dentists, nurse practitioners, physician assistants, mental and behavioral health specialists and other health providers treating more than 9.5 million people, regardless of their ability to pay, at more than 14,000 National Health Service Corps-approved sites throughout the U.S. and its territories.
Much of the credit for providing primary care coverage to the Randolph region and well beyond can go to Gifford and its Medicine Division leaders, who work tirelessly to bring primary care providers to the area to ensure access to care.
Without some of Gifford’s smaller clinics, such as the Rochester Health Center, Dr. Plavin has no doubt that some people would choose not to travel, or be unable to, and go without care.
And that would contribute to the state and nation’s health epidemics, such as uncontrolled diabetes and heart disease, and the associated costs of treating late stage disease versus preventative measures.
“Access to primary care not only improves health but also decreases costs to society through hopefully preventing disease, as well as managing chronic illnesses, such as diabetes, and therefore preventing their long-term negative health outcomes while at the same time maintaining and improving overall function and wellness,” Dr. Plavin says.
Still with all the effort Gifford staff puts in, the region has obstacles.
The state’s rural setting and mountainous terrain often contribute to a feeling of a lack of care. “People in Vermont have a geographic barrier, whether it’s true or perceived, that limits your access to care,” Dr. Plavin says.
And the average age of a doctor at Gifford is in the 50s, Dr. Plavin says. That means most will be retired in 10 years, making attracting medical students to the primary care field – versus higher-paying specialty fields – and programs like the National Health Service Corps more essential than ever.
