IOM to rec­om­mend re­forms in res­i­dency physi­cian train­ing

Modern Healthcare - - THE WEEK AHEAD - —Andis Robeznieks

The In­sti­tute of Medicine is putting the $15 bil­lion the fed­eral govern­ment spends each year on physi­cian train­ing un­der its microscope. On July 28, it will re­lease a re­port on how to re­form grad­u­ate med­i­cal ed­u­ca­tion fi­nanc­ing, gov­er­nance and ac­count­abil­ity.

The panel, which be­gan its work in Septem­ber 2012, is led by two for­mer Medi­care chiefs: Gail Wilen­sky, who served un­der Pres­i­dent Ge­orge H.W. Bush, and Dr. Don Ber­wick, who served un­der Pres­i­dent Barack Obama and is now run­ning for Mas­sachusetts gov­er­nor as a Demo­crat.

GME fund­ing has been flat since 1997. New med­i­cal schools have been opened and ex­ist­ing in­sti­tu­tions have in­creased ca­pac­ity, but this growth means lit­tle with­out a cor­re­spond­ing in­crease in res­i­dency po­si­tions.

The IOM has said its re­port would fo­cus on in­creas­ing the clin­i­cal work­force, ge­o­graphic dis­tri­bu­tion of pri­mary-care and spe­cialty physi­cians, train­ing sites, fed­eral laws and reg­u­la­tions, and the roles safety net providers, com­mu­nity health cen­ters and aca­demic med­i­cal cen­ters have in train­ing new doc­tors.

Be­cause $9.7 bil­lion of GME fund­ing comes from Medi­care, Dr. Kelly Caverza­gie, an as­so­ciate dean at the Univer­sity of Ne­braska Med­i­cal Cen­ter, said res­i­dency train­ing pro­grams fear the loss of Medi­care fund­ing and train­ing slots. “Where is the money go­ing to come from if Medi­care fund­ing is lost?” he said.

On the other hand, money alone is not the an­swer. He would like to see the IOM link fund­ing to fill­ing gaps in ge­o­graphic work­force and spe­cial­ist dis­tri­bu­tion. “We need ag­gres­sive re­form of GME fund­ing and so­lu­tions that don’t per­pet­u­ate the prob­lems that cur­rently ex­ist,” he said.


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