Residency funding freeze exacerbates doc shortage

A doctor shortage is prompting U.S. medical schools to expand, graduating 5,000 more doctors per year by 2019. But the shortage will remain unless the number of federally funded residencies increases from levels frozen since 1997, medical educators warn.

Medicare funds most residencies, paying $9.5 billion per year to subsidize 94,000 positions at teaching hospitals, with Medicaid and other sources funding another 10,000 residencies, The Wall Street Journal points out.

The Balanced Budget Act of 1997 froze the number of Medicare-funded spots.  Congressional gridlock has led to zero change to the law. But Reps. Allyson Schwartz (D-Pa.) and Aaron Shock (R-Ill.) plan to reintroduce a bill Thursday to create 15,000 more residencies over the next five years--a tough sell at a cost of $1 billion per year.  

"The United States is on the cusp of a crisis in access to both specialty and primary care physicians. We have an urgent need to take action to ensure Americans have access to quality, well-trained doctors," Schwartz said in a statement. The bill is known as the "Training Tomorrow's Doctors Today Act."

The legislation authorizes the redistribution of residency positions when a hospital closes, and also would give hospitals more flexibility to train residents in clinical settings such as community health centers and physician offices, according to AHA News Now.

Alex Falvo, 25, a third-year medical student at the Penn State College of Medicine in Hershey, Pa., currently doing a OB/GYN rotation at the Lehigh Valley Health Network in Allentown, Pa., told FierceHealthcare that the exceedingly competitive nature of today's residencies worries her as she begins applying in the fall. 

The timing is off, Falvo said. America desperately needs more doctors, but the years of schooling required to produce them may not get them into the system in time to help treat the increase of newly insured Americans under the Affordable Care Act.

"It's not like we'll be able to fix the problem quickly," she said. "It's forethought that's not happening. The fact of the matter is that all specialities across the board need more doctors."

Falvo said medical students looking to go into a field where more physicians are desperately needed may be deterred by the lack of residencies in those fields. She said radiology, opthamology, anesthesiology, dermatology and surgery residencies, all of which interest Falvo, seem to be among the most competitive.

"I wish I could say everyone should be able to go into what they want to go into," she said.

To learn more:
- read the article from The Wall Street Journal
read the announcement from Schwartz's office
- check out the AHA News Now brief