Peach State grant helps fuel MCG program, get doctors to underserved areas

A $5.2 million grant will help boost an innovative three-year program at the Medical College of Georgia and help increase the supply of physicians to underserved areas of Georgia hit hardest by the COVID-19 pandemic, Dean David Hess said.

MCG at Augusta University and Peach State Health Plan announced the grant and a partnership to help supply physicians to rural, underserved areas of Georgia. Peach State has Medicaid managed care and Medicare Advantage plans in Georgia, and many of its patients are in those areas.

"They’re a managed care company, so they are interested in physician supply, having enough physicians in rural Georgia," Hess said. "A lot of their Medicaid population is rural. We’re kind of natural allies."

Georgia ranks among the lowest states in terms of physicians per population in many areas, such as 43rd in the number of active primary care physicians seeing patients per 100,000 population, according to the Association of American Medical Colleges.

"And with the population growing, the rate is just going to get worse," Hess said.

Even that picture is misleading because of the clustering of physicians in metro Atlanta and cities including Augusta. Nine counties in Georgia don't have any doctors at all, 60 don't have a pediatrician and 76 lack an OB/GYN, according to the Georgia Board of Health Care Workforce. 

MCG's new 3+ program, which began with this year's freshman medical school class, could help address that. Instead of the traditional four-year medical school, MCG now offers its students a three-year program that allows them to concentrate on an area of medicine, research or even a second degree in their fourth year. Those who are in the 3+ Primary Care Pathway go into a primary care residency after the third year in much-needed primary care fields, such as general surgery, family medicine or pediatrics.

The new grant will likely either be used as scholarships or a tuition forgiveness program, with students being obligated to spend one year working in an underserved area of Georgia, which is most of the state, for each year of support, Hess said. The huge amount of medical school debt is often a deterrent to students to go into the primary care field. MCG has relatively low medical school tuition but its students graduate with an average of $158,462 in debt, and it is not uncommon for students to enter with as much as $100,000 in debt from their undergraduate degrees, Hess said.

"That’s a lot of debt," he said. "And at the interest rates you pay, it takes a long time to pay off and it does dissuade people from going into primary care. They are generally going to go into a higher paying specialty to pay that off."

Having more primary care physicians and having them work in areas of greatest need is also part of what is attractive to MCG and Peach State, Hess said.

"There are also opportunities here for us to work on common goals, which is really to improve the health of Georgia," he said. In particular, to improve health in those areas with the worst outcomes, such as rural counties with higher poverty, higher levels of heart disease and obesity, and barriers to care, Hess said.

In terms of health, "your ZIP code is probably more important than your genetic code," he said. While having more physicians in those areas won't address all factors, "it will help the access problem because access is a big part of health," Hess said.

Many of those areas with the worst health outcomes were also where the pandemic took off in Georgia and wreaked the most damage, he said.

For medical students who want to be a part of the solution, and begin their careers without crushing debt, this primary care pathway will be attractive, he said.

"For people who are from Georgia who want to practice in Georgia, it’s a pretty good deal," Hess said.