To Whom It May Concern:

We, the citizens and physicians of America, petition the US government to continue the Public Service Loan Forgiveness Program without establishing caps to future physicians. Per the American Medical Association, the loan of medical school graduates is $ 170 000.

The implications of this cap on future physicians with a concomitant decrease in reimbursement are multiple fold.

Physician satisfaction translates to increased patient satisfaction and better outcomes. Patients cared for by satisfied physicians declare more trust and confidence in their physicians, have better continuity and higher ratings of their care.

Higher job satisfaction is associated with lower likelihood of patient errors and suboptimal patient care.

Physician satisfaction can be influenced by intrinsic and extrinsic factors.

Modifiable factors associated with physician satisfaction are: income/incentives, physician autonomy/control, work demand and collegial relationships.

Placement of a cap on the Public Service Loan Forgiveness Program may potentially decrease motivation and satisfaction of future physicians, especially with the trend in decreasing reimbursements.

Health care reform can only be attainable with addressing physician dissatisfaction. In fact, According to a recent article published in the Mayo Clinic Proceedings (December 2013) middle career physicians (between 10 and 20 yrs of clinical experience) were more likely to be planning to leave their current practice out of frustration and to pursue a career that involved no direct patient care or was outside medicine altogether. “These findings are particularly concerning because middle career is often the most productive time of a physician’s career in terms of the amount of patient care provided. ..In addition, organizational costs for a hospital or practice group to replace a physician can be staggering with some studies suggesting that replacing a single physician can cost $115, 000 to $587,000, depending on specialty”.

Already many physicians, discourage medical students from entering medical school for the aforementioned reasons. The cost of physician dissatisfaction is too high. Attempts to decrease the costs of health care without addressing physician satisfaction are futile.