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Fiscal Fix Needed for Physician Training

Joe Cantlupe, for HealthLeaders Media, December 13, 2012

Over the last several years, medical schools committed to increasing their enrollment by 30%, and "they did that with very little government support," Mitchell says. Those enrollment goals should be reached by 2016. However, during that time, there has not been a proportionate increase in residency positions, which the students need to practice in the U.S. and get their license, Mitchell says. That's because government funding has been essentially "frozen" for the past 15 years; those funds were part of the balanced budget act of 1997.

"Not only are they not increasing (the funding), they are proposing significant cuts. It would seem only logical that Congress and the administration try to make sure Medicare beneficiaries have access to care," Mitchell adds.

"The logic of cutting funding at this point... there is no logic," she says. "It's a shortsighted view, not a long-term view. It takes three years at minimum to train a primary care physician, five to seven years for an orthopedic surgeon, and nine years to train a neurosurgeon."

For the last several years, the AAMC and other physician groups have lobbied intensely to seek financing changes. Recently, the AAMC has changed tactics, and has attempted to show they are training physicians for a changing world with "high performance healthcare systems." That includes instruction of physicians as part of "true patient care teams," Mitchell says.

That focus was part of bipartisan legislation that was introduced this year that would expand the number of residency training positions in Medicare by 15,000 over five years, with funding to back it. The legislation has not been adopted, and is not expected to be with a lame duck Congress.

"Everything came to a halt in the 112th Congress," Mitchell says. "We're hoping for a bigger policy discussion next year."

Indeed, they need a fiscal fix.


Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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