Community Health Center Provider Retention: Creative Approaches

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A variety of obstacles prevent people living in underserved communities from accessing sufficient healthcare. For many, an insufficient quality and quantity of healthcare providers is a contributing factor. A number of identifiable causes must be addressed before having an abundance of experienced doctors in every town is the norm. Making these changes, however, will improve conditions not only for underserved populations, but for healthcare providers as well.

Perhaps the most tangible facet of this issue is the sheer lack of doctors in underprivileged communities. Unfortunately, this is not a new issue. In 1993, there were only 28 properly qualified doctors to serve a population of 1.7 million in nine low‐income neighborhoods in Harlem, north central Brooklyn, and the South Bronx. Thanks largely to PCDC’s efforts, those numbers have greatly improved. Still, by 2025, primary care encounters will surge by about 100 million, extending the shortage of primary care physicians by an estimated 50,000 nationwide. This can be partly addressed by putting increased effort into placing providers in clinics that suit their capabilities and experience. Helping to integrate them into the staff has been proven to increase job satisfaction and, consequently, the length of time a provider is likely to stay at the same clinic. 

An undeniable cause of the high turnover rate in these positions, however, is the inability of many poorly funded care centers to provide their staff with competitive salaries. Currently, most cities prioritize hospitals over primary care as they allocate funding and other resources, making preventative medicine a less profitable career field. Consequently, primary care facilities see a high rate of staff turnover. Higher salaries and employer-established reimbursements help improve provider retention, especially since medical professionals usually pay a high price for education and training.

Simply calling for higher salaries is a tall order for already underfunded clinics, however. It’s for this reason PCDC’s Provider Recruitment and Retention (PR&R) Financing Program enables community health centers to either recruit new providers or retain one or more staff through alternative “loan-forgiveness/performance-incentive” financing. The PR&R Financing Program not only replicates the core benefits of more traditional loan-forgiveness programs, but also improves upon the model. Through a multiyear lending commitment, health centers previously excluded from traditional programs are provided multiple resources to help them compete with other employers. 

Additionally, increased funding allows professionals to seek continued training as they practice. PCDC’s capacity building programs have trained and coached more than 9,000 health workers and assisted more than 475 primary care practices to achieve Patient-Centered Medical Home recognition. This improves the care that more than 5 million patients nationwide will receive. Our Care Coordination Training ensures providers are especially prepared to address the needs of patients whose situations may complicate their ability to get consistent care.

Our approach to training primary care providers mirrors our approach to financing in the sense that it’s built upon a sustainable model. At PCDC, we’re about long-term over short term — about healing over band-aids. Because of this, the growth of our impact is exponential, improving the health of underserved communities long after we first got involved. We invest in health care providers because it’s an investment with more than worthwhile returns.