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ACP member testifies before House Small Business Committee about mounting student loan debt and its limitations for physicians

July 12, 2019 (ACP) – When it comes to student debt, general internist Dr. Tracey Henry is an overachiever. First, she piled up more than $200,000 in student loans. Then, as her career progressed to an assistant professor position at Emory University School of Medicine, interest piled up. Despite her payments, her debt has topped $400,000 nearly a decade into her medical career.

Henry, a member of the �鶹ֱ��app, has questioned her career choice as she faces mounting debt. For now, however, she is making her voice heard on behalf of U.S. physicians like herself.

In June 2019, Henry traveled to Washington, D.C., to bring a message to the U.S. House of Representatives Small Business Committee: The nation's leaders must act to protect physicians – especially internists – from overwhelming medical school student debt. “I am hopeful that there are several steps that Congress can take to reduce student loan debt,” she told the committee in oral testimony, “and in turn, to encourage medical students to pursue careers in primary care.”

ACP was invited by the committee to provide testimony regarding increasing student loan debt and a decline in small medical practices. According to the committee, student loan debt now holds at $1.49 trillion and continues to break records. This debt has made it difficult for physicians to pursue sole or private practice and has influenced medical specialty choice.

During her testimony, Henry expressed support for the What You Can Do for Your Country Act, which would increase access to loan forgiveness for individuals who pursue careers in government service or nonprofit organizations. She also advocated for increased funding for scholarships and loan repayment programs for primary care physicians through the National Health Service Corps and maintaining the loan programs under Title VII.

In an interview with the ACP Advocate, Henry said interest prevented her from paying her student debt during residency and fellowship. Later, the debt grew because of interest growth even as she made timely payments. “It keeps getting larger, and it's making it harder to stay where I am,” she said.

Henry explored options other than a career change to help reduce her debt burden. But as she told the congressional committee, she was unable to apply for the National Health Service Corps loan repayment program even though she treats a medically underserved population at Grady Primary Care Center in Atlanta. She's not eligible because Grady, which she serves as assistant health director, is not a designated Health Professional Shortage Area.

“While I find great joy in my work, my student loan debt may prevent me from being able to continue to do so in the future,” said Henry, who is African-American, in her oral testimony. “Further, having physicians of color in clinical settings like mine is paramount, as research has shown that the health outcomes for people of color are better when treated by a physician of color. When physicians like myself are financially constrained from working in these clinical settings, patients suffer.”

Henry hopes to get relief through the Public Service Loans Forgiveness program, which requires 10 years of on-time student loan payments while working for a nonprofit or the government. “However, this is a risky proposition,” she said. “The current administration has proposed eliminating funding for the program. Even if funding continues, the vast majority of applications under the program have been rejected.”

What about a career in private practice? That's out of the question for some physicians with heavy debt, Henry told the congressional committee. “The instability of starting and maintaining a private practice would not allow for the work-life balance that many of today's physicians value,” she said. “To cover the overhead costs of running a practice and to also keep up with student loan payments, you would have to see an overwhelming number of patients a day.”

What's next for Henry? Her debt burden looms large. “Even though I enjoy primary care, it makes me think I should consider something else, such as being a hospitalist, that will help me pay off my loans sooner,” she said.

She remains hopeful that Congress will take steps to bring relief to many physicians with student loan debt, which will give her and others a chance to continue the career they love.

Back to the July 12, 2019 issue of ACP Advocate