National Advocacy Conference - Tuesday's Sessions
Addressing physician shortage requires GME changes, experts say
Unless some dramatic changes are made to the current situation for graduate medical education (GME), the nation will suffer a devastating shortage of physicians, national experts said during a panel discussion Tuesday.
The United States is expected to see a shortage of 90,000 physicians by the end of the decade, said Atul Grover, MD, chief public policy officer for the Association of American Medical Colleges (AAMC).
This isn’t for a lack of medical school graduates, though. The AAMC anticipated the impending shortage nearly a decade ago, and U.S. medical schools responded by increasing the number of students they accept each year. Allopathic medical schools have since increased their annual number of graduates by about 30 percent, and the number of students graduating from osteopathic schools has nearly doubled, Dr. Grover said.
The heart of the problem is that Congress has limited the number of residency slots since 1997, even while demands of the growing patient population have multiplied. The number of U.S. medical school graduates will exceed the number of available residency slots by as early as 2015.
Medical students are referring to the situation as the “jaws of death,” Dr. Grover said.
Thomas Ricketts, commissioner of the National Health Care Workforce Commission, said the physician shortage already is becoming evident among more generalized specialties.
General surgeons, for instance, completely disappeared from 195 counties across the United States between 2006 and 2011, Ricketts said. Small hospitals depend on general surgeons to keep them afloat.
But the panelists cautioned that reallocating existing slots isn’t a solution.
“Fifty percent of residency programs are primary care specialties,” Dr. Grover said. “You can’t solve this problem by stealing slots from specialties.”
Specialty slots already are minimal, and there’s also a real need for the care physicians provide in those specialties, he said.
On Monday, more than 300 medical students met with their members of Congress and congressional staffers, explaining the urgency of protecting GME funding and lifting the cap on residency slots. Physicians also are raising this concern during conversations with their representatives and senators this week.
Physicians, medical students and others can share the message with their own members of Congress through the AMA’s Save GME campaign. This grassroots initiative makes it easy to email lawmakers and urge them to address this important issue.
Delivery and payment reform: It’s about quality and affordability
Physicians heard from experts in the private and public sectors about innovations in health care delivery and payment during a panel discussion Tuesday.
Chester “Chet” Burrell, president and CEO of CareFirst BlueCross Blue Shield, and Nancy Nielsen, MD, senior advisor for the Center for Medicare & Medicaid Innovations and a former AMA president, explained how new health care models are enhancing patient care and strengthening physician practices of all sizes.
New models enable physicians to provide care in a way that improves quality, promotes practice sustainability, and makes health insurance and care affordable for their patients, panelists said.
“I think we are at a tipping point,” Dr. Nielsen said. “This is an enormous opportunity for physician leaders to step forward.”
One of the three focus areas of the AMA’s new strategic plan is shaping new delivery and payment models to enhance physician satisfaction and practice sustainability. Numerous resources already are available to help physicians participate in new models.
AMA gives physicians a strong voice in the regulatory process
Staff from the AMA Department of Regulatory Affairs updated physicians on the AMA’s recent efforts to advocate for physicians during the development of federal regulations. The AMA’s work has led to a number of positive changes to such areas as physician audits, ePrescribing and the Medicare Physician Quality Reporting System. Read more about these activities.