Loan effort lures recruits to health centers

By Elizabeth Cooney
Globe Correspondent

Twice as many doctors and nurse practitioners than expected took or remained in jobs in Eastern Massachusetts community health centers during the first year of a program that helps pay off their student loans, the initiative's architects will announce today.

The clinics, which serve many lower-income people, are expected to see more patients now that state law requires most previously uninsured residents to sign up for health coverage. The new practitioners should help the centers handle the influx, said the program's sponsors. Last year about 10 percent of the clinics' primary care positions were unfilled.

Launched last year with a $5 million grant from Bank of America, the program has placed 35 physicians and 12 nurse practitioners at 23 health centers. Most were new hires, but six were current staffers who agreed to stay either two or three more years.

"I never expected them to be able to recruit 47 clinicians," Dr. JudyAnn Bigby (left), secretary of health and human services and also a primary care physician, said last week. "Some community health centers spend years trying to recruit new physicians. Being able to offer loan repayment has had an incredible impact."

The program pays up to $25,000 a year for three years in loan repayments, about 60 percent of the average burden of $130,000 graduates carry when they leave medical school. Recipients agree to work in primary care at a community health center for at least two years.

The state matched Bank of America's commitment with $1.7 million last year, and a second $1.7 million is part of the proposed budget for the coming fiscal year. Partners HealthCare is giving $250,000 a year for five years to the Massachusetts League of Community Health Centers, which administers the program. New funding is coming from Neighborhood Health Plan and the Blue Cross Blue Shield of Massachusetts Foundation.

Community health centers can't compete with the salaries that private practices or hospital physician groups offer, said Dr. Nisha Thakrar, medical director of South Boston Community Health Center.

"It's hard to recruit when they can be making twice as much in other settings," she said. "Even if they have the desire to work in a community health center, eventually they have to pay those bills."

A starting salary at community health centers ranges from $110,000 to $130,000, she said. It is common for doctors leaving medical school to restructure the amount they owe into loans lasting up to 30 years.

Some of the doctors taking part in the program said it didn't influence their choice of primary care. But it helps.

"I do think the loan repayment program does make a difference. When you start looking at the numbers and calculate how much you're going to make and how long before you reach retirement, the numbers do start to matter," said Dr. Lars-Eric Reinhold, a Boston University School of Medicine graduate who has worked at the South Boston health center since September. "For me it was a foregone conclusion that I would end up in a setting like this. This was really icing on the cake. I don't have to stay up nights tossing and turning.

"Not as much," he added quickly.