Residency shuffle makes no dent in primary care shortages

NEWS IN BRIEF — Posted Jan. 28, 2013

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The redistribution of nearly 3,000 residency positions failed to boost the supply of physicians willing to practice in rural or underserved areas or to choose primary care as a specialty, according to a study published in the January Health Affairs.

Few steps have been taken to hold residency programs accountable for training doctors to serve in needed physician shortage locations or specialties, despite the fact that hospitals receive about $13 billion each year to train medical residents, according to the study’s lead author, Candice Chen, MD, MPH. She’s an assistant research professor at the George Washington University School of Public Health and Health Services in Washington.

The Medicare Modernization Act of 2003 authorized the redistribution of 3,000 slots to encourage more training of residents in rural areas and in primary care. However, of the 304 hospitals that received the additional slots, just 12 were in rural areas, and they received less than 3% of the redistributed positions.

The study’s researchers found that nearly half of these hospitals actually reduced their primary care training while boosting their specialty training using the additional graduate medical education positions. “Future legislation should re-evaluate the formulas that determine GME payments and potentially delink them from the hospital prospective payment system,” the study suggested (link).

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