For Residents

Spike in patients highlights impending doctor shortage

The physician shortage is entering the spotlight again as the health care system prepares for the 30 million patients who will gain access to health insurance in 2016 under the Affordable Care Act.

The Association of American Medical Colleges (AAMC) has cautioned that the shortage is projected to reach more than 90,000 by 2020, a gap that will not be closed unless the number of residency training positions increases dramatically. Although medical schools have increased enrollment over the last six years, the number of federally funded residency positions has remained frozen since 1997.

In a recent news release, AAMC President and CEO Darrell G. Kirch, MD, urged Congress to "move quickly to provide more federal support for additional doctor training to ensure that Americans have access to care—not just an insurance card."

AMA policy recognizes the importance of graduate medical education to ensure patients receive the care they need and is working actively against reductions in funding for residency programs.

Joint Commission renews focus on improving handoffs

Residents just beginning their training are entering a health care arena that is still adapting to the new duty-hour restrictions issued by the Accreditation Council for Graduate Medical Education. While the restrictions are intended to improve resident health and patient care, the actual results may miss the mark, Kiran Gupta, MD, recently wrote in health care blog White Coat Notes.

A resident in the Department of Medicine at Brigham and Women's Hospital, Dr. Gupta recounts many of the adverse consequences she has witnessed since the duty-hour rules went into effect last July. For instance, the number of handoffs has increased, leaving patients confused and frustrated. Residents also now have fewer supervised learning opportunities.

This discontinuity of patient care has led to a heightened focus on improving patient handoffs. The Joint Commission reports that 80 percent of serious medical errors involve miscommunication during patient handoffs. According to the commission, flawed handoffs can lead to delays in treatment, inappropriate treatment and longer hospital stays.

On June 27, the Joint Commission unveiled a new tool that helps measure the effectiveness of each step of the handoff process and provides solutions to improve weak areas. Accredited organizations can access the tool and hand-off communication solutions through their secure Joint Commission Connect extranet.

Recognizing the importance of handoff training in residency programs, the AMA recently updated its resources on improving patient handoffs, including educational videos and a collection of specialty-specific articles.