Expanding the Primary Care Scholarship: Addressing Physician Shortages by Including Emergency Medicine in Rural and Underserved Arizona

Abstract

Arizona is facing an escalating Primary Care Physician shortage, with rural and underserved communities experiencing the most severe impacts. Despite their critical role in providing frontline care, Emergency Medicine physicians are currently excluded from the University of Arizona Primary Care Scholarship—a program designed to incentivize healthcare providers to work in Health Professional Shortage Areas. This thesis advocates for expanding scholarship eligibility to include Emergency Medicine physicians, highlighting their in-practice role as primary care providers in high-need settings. Through a comprehensive analysis, this thesis redefines what constitutes primary care in today’s healthcare landscape and examines the inconsistency in specialty classification across institutions, and further expansion of the scholarship criteria to accommodate and include Emergency Medicine. For instance, while the Association of American Medical Colleges does not classify General Surgery or Psychiatry as primary care, the University of Arizona includes them as eligible under the scholarship—raising questions about the criteria used. Meanwhile, the University of Arizona’s own Primary Care Physician Workforce Report recognizes Emergency Medicine as a primary care specialty and supports rural emergency rotations for Emergency Medicine residents. The thesis also presents original workforce data showing that Emergency Medicine ranks second behind Family Medicine in the number of physicians practicing in rural areas, surpassing Internal Medicine, Pediatrics, and General Surgery. It documents a growing national trend of patients turning to emergency departments for non-emergent, primary care-level services, and details how the Emergency Medicine physician shortage forces Family Medicine doctors to split time between clinics and emergency departments—ultimately reducing primary care productivity. Curriculum analysis from the University of Arizona South Campus Emergency Medicine residency program reveals that Emergency Medicine residents, especially those on the Rural/Border/Global Health Track, receive substantial primary care-relevant training. Additionally, this report explores how expanded training, integrated systems, and financial incentives—like loan repayment and scholarships—are crucial to supporting Emergency Medicine physicians' dual role. By making Emergency Medicine physicians eligible for the University of Arizona Primary Care Scholarship, Arizona can better align its workforce strategies with on-the-ground realities, ultimately strengthening care access and equity in underserved regions.