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Experts Say Increase in Residency Slots Needed to Mitigate Physician Shortage
According to family practice experts, legislative proposals introduced by various members of Congress as part of larger efforts to overhaul health care fail to adequately address the urgent shortage of family practice physicians, Kaiser Health News reports. The American Academy of Family Physicians suggests that the primary care physician shortage is expected to reach 40,000 in the next 10 years and grow to 160,000 by 2025. Moreover, experts assert that none of the existing proposals seek to increase the number of residency slots for family practice, which has been steadily declining as many medical students opt to pursue other specialties that offer more flexible hours, higher pay and more prestige than family practice. According to Kaiser Health News, residency positions for family practice have remained stagnant because of a 1997 Congressional budget cut that froze the number of Medicare-funded residency positions. To address the dearth in residency slots, Senate Majority Leader Harry Reid (D-Nev.) has introduced a proposal aimed at creating 15,000 additional residency positions. However, because of the proposal's cost, which was estimated at $10 billion over the next 10 years, the bill was deemed "dead on arrival," and the House and Senate have alternatively proposed bills that would redistribute 1,000 unfilled residency positions to teaching hospitals in states with significant physician shortages or that lack adequate numbers of medical residents. Contending that proposals to redistribute residents are just a "drop in the bucket" and fail to address the larger problem, the chief executive officer of the Association of American Medical Colleges noted that, if larger health reform efforts succeed in expanding insurance coverage to more Americans, demand for care will quickly overwhelm the small pool of current family practice physicians. Meanwhile, Congress has introduced a measure for a 10 percent pay bonus for primary care physicians over the next five years, which is "a step in the right direction," according to the President of the American Academy of Family Physicians. He argues, however, that at least a 30 percent increase would be necessary to entice young physicians to enter family practice. The proposed congressional bills also include proposals to increase funding to the National Health Service Corps, which helps physicians repay medical school loans in exchange for practicing in a workforce shortage area. Despite such legislative efforts, experts and physician advocacy groups fear the plans may fall short of yielding change, noting that "without expanding the number of residency slots, you are not increasing the pipeline" (Galewitz, Kaiser Health News, 10/12/09).