Cutting physician education funds creates lasting pain for short-term gain

Slashing Medicare funds for graduate medical education (GME) may create short-term gain, but the long-term pain would be intolerable.

That’s the view of the American Academy of Family Physicians, the American College of Physicians, the American Medical Association, and 37 other healthcare organizations representing both physicians and hospitals.

“Medicare GME cuts that jeopardize physician training and limit critical services are a step in the wrong direction. Reducing our national deficit is important, but threatening access to care for millions of current and future patients is not the appropriate mechanism to achieve true savings,” the groups stated in a letter to Congress’ Joint Select Committee on Deficit Reduction.

The letter said that cutting GME would make the national physician workforce shortage even worse. It cited statistics from the Association of American Medical Colleges (AAMC) and others projecting a shortage of 91,500 physicians by 2020 and 130,600 by 2025, with one in three practicing physicians likely to retire by 2020. At the same time, the associations said, an estimated 10,000 senior citizens enter the Medicare program each day.

Medical schools are expanding their enrollments but are stymied by limits on residency training programs, according to the letter, which stated, “Unfortunately, Medicare’s current cap on financial support for GME prevents teaching hospitals from expanding the number of training positions and often prevents new hospitals from establishing teaching programs. Now is the time for our nation to invest in physician training programs, not reduce them.”

The 40 associations suggested that physician training has been “disproportionately” targeted as a way to reduce the nation’s deficit.

The AAMC, meanwhile, endorsed a bill introduced by three Democrats in the Senate that would increase the number of Medicare-supported training positions for medical residents by 15%-about 15,000 slots-over 5 years.

AAMC President and Chief Executive Officer Darrell G. Kirch, MD, said of the bill, known as the Resident Physician Shortage Act of 2011: “As the nation faces a critical doctor shortage, we support this proposal and applaud the leadership of these senators to expand the number of residency positions. Such efforts are important to the future of healthcare in this country.”

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