Spring 2013 – Funding the Future

Funding the Future.
David L. Ortiz.

Author Affiliations:
College of Human Medicine, Michigan State University, East Lansing, MI, USA

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Corresponding author: David Ortiz; ortizdav[at]msu.edu
Key Words: N/A

The problems facing healthcare training today are not simple. Predictions about future demand for physicians have a poor track record, as the GMENAC studies of the 1980s showed. Even if one could predict perfectly the demand for physicians in the future, history has shown that it takes 10-40 years for the full effects of increased medical school enrollment to be felt. The rate of GME must rise. In its present state, GME could sustain reductions as great as 10% of funding without the loss of total residency slots, but any decrease in GME funding will undoubtedly perpetuate the inadequacy of the physician workforce. By 2016, without increased GME funding, there will be a substantial increase in the number of unmatched US seniors and a substantial decrease in the number of foreign medical grads.

Published: May 31, 2013
Senior Editor: N/A
Junior Editor: N/A
DOI: Pending
Ortiz DL. Funding the Future. Medical Student Research Journal. 2013;2(Spring):36-39.
1. National Resident Matching Program. NRMP post-match press release. Washington, DC: National Resident Matching Program; 2013. http://www.nrmp.org/wp-content/uploads/2013/08/pressreleasepostmatch2013.pdf

2. Education USSGCG on M, Bane F. Physicians for a growing America: report. Washington, DC: Public Health Service, U.S. Department of Health, Education, and Welfare; 1959.

3. Ruhe CW. Present projections of physician production. JAMA. 1966; 198(10):1094-100. http://dx.doi.org/10.1001/jama.1966.03110230110024.

4. National Residency Matching Program. Results and data: 2012 main residency match SM. Washington, DC: National Residency Matching Program; 2012. http://sls.downstate.edu/student_affairs/documents/NRMP2012Results_Data.pdf

5. Health Resources Administration, Office of Graduate Medical Education. Report of the Graduate Medical Education National Advisory Committee, Volumes I-VII. Washington, DC: Health Resources Administration, Office of Graduate Medical Education; 1980.

6. Nicholson S. Will the United States have a shortage of physicians in 10 years? 2009. Available from: http://hdl.handle.net/1813/15101. Accessed May 1, 2013.

7. Office of Inspector General. Medicare hospital prospective payment system how DRG rates are calculated and updated; Washington, DC: U.S. Department of Health &
Human Services; 2001. https://oig.hhs.gov/oei/reports/oei-09-00-00200.pdf.

8. Reinhardt UE. Analyzing cause and effect in the U.S. physician workforce. Health Aff. 2002; 21(1):165-6. http://dx.doi.org/10.1377/hlthaff.21.1.165.

9. Center for Workforce Studies. Results of the 2011 Medical School Enrollment Survey. Washington, DC: Association of American Medical Colleges; 2011. https://www.aamc.org/download/281126/data/enrollment2012.pdf.

10. Center for Workforce Studies. 2011 State physician workforce data book. Washington, DC: Association of American Medical Colleges; 2011. https://www.aamc.org/download/263512/data/statedata2011.pdf.

11. National Resident Matching Program. NRMP residency match 2013 results. Washington, DC: National Resident Matching Program; 2013. http://www.nrmp.org/match-data/main-residency-match-data/.

12. Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (2003H.R. 1). GovTrack.us. Available from: http://www.govtrack.us/congress/bills/108/hr1 [cited 15 May 2013].

13. Chen C, Xierali I, Piwnica-Worms K, Phillips R. The redistribution of graduate medical education positions in 2005 failed to boost primary care or rural training. Health Aff. 2013; 32(1):102-10. http://dx.doi.org/10.1377/hlthaff.2012.0032.

14. Local hospital CEOs want private fund for more residencies Jacksonville Business Journal. Available at: http://www.bizjournals.com/jacksonville/print-edition/2011/11/18/local-hospital-ceos-want-private-fund.html?pageall [cited 6 May 2013]

15. Porter S. Federal dollars launch National Family Medicine Residency Program. AAFP. Available at: http://www.aafp.org/online/en/home/ publications/news/news-now/education-professional-development/20130307ntlfmresidency.html. Accessed May 6, 2013.

16. Innovative funding opens new residency slots amednews.com; 2006. Available from: http://www.amednews.com/article/20060130/profession/301309963/2/#minb [cited 1 May 2013].

17. Privately Funded Residency. AmeriClerkships.org; 2013. Available from: http://americlerkships.org/mentors/services-2/privately-funded-residency. Accessed May 13, 2013.

18. Oransky I. How much for that dermatologist in the window? Slate; 2005. Available from: >http://www.slate.com/articles/health_and_science/medical_examiner/2005/06/how_much_for_that_dermatologist_in_the_window.html [cited 15 May 2013].

19. Kirch DG, Henderson MK, Dill MJ. Physician workforce projections in an era of health care reform. Annu Rev Med. 2012; 63(1):435-45. http://dx.doi.org/10.1146/annurev-med-050310-134634.

20. Association of American Medical Colleges. AAMC physician workforce policy recommendations. Washington, DC: Association of American Medical Colleges; 2012. https://www.aamc.org/download/304026/data/2012aamcworkforcepolicyrecommendations.pdf

21. Rye B. 2012. Assessing the impact of potential cuts in medicare doctor-training subsidies. Washington, DC: Bloomberg Government. http://about.bgov.com/content/uploads/sites/2/2012/03/ryestudy.pdf

22. Office of Management and Budget. Fiscal year 2014 budget of the U.S. Government. Washington, DC: U.S. Government Printing Office; 2013. http://www.whitehouse.gov/sites/default/files/omb/budget/fy2014/assets/budget.pdf

23. Training Tomorrow’s Doctors Today Act (H.R. 1201). GovTrack.us. Available from: http://www.govtrack.us/congress/bills/113/hr1201. [cited 1 May 2013].

24. Resident Physician Shortage Reduction Act of 2013 (H.R.1180). GovTrack.us. Available from: http://www.govtrack.us/congress/bills/113/hr1180. [cited 1 May 2013]

25.Association of American Medical Colleges. House bill would increase residency positions, ease doctor shortage. Available from: https://www.aamc.org/newsroom/newsreleases/330948/031413.html. [cited 15 May 2013].

26. Resident Physician Shortage Reduction Act of 2011 (2011S. 1627). GovTrack.us. Available from: http://www.govtrack.us/congress/bills/112/s1627. [cited 15 May 2013].

27. Resident Physician Shortage Reduction and Graduate Medical Education Accountability and Transparency Act (2012H.R. 6352). GovTrack.us. Available from: http://www.govtrack.us/congress/bills/112/hr6352. [cited 15 May 2013]

28. Nasca TJ, Miller RS, Holt KD. The potential impact of reduction in federal GME funding in the United States: a study of the estimates of designated institutional officials. J Grad Med Educ. 2011; 3(4):585-90. http://dx.doi.org/10.4300/JGME-03-04-33.

29. The Center for American Progress Health Policy Team. The senior protection plan. Washington, DC: Center for American Progress; 2012. http://www.americanprogress.org/wp-content/uploads/2012/11/SeniorProtectionPlan-3.pdf

30. Wynn B, Guarino C, Morse L, Cho M. 2006. Alternative ways of financing graduate medical education. http://aspe.dhhs.gov/health/reports/06/AltGradMedicalEdu/report.pdf

31. Wan J. Medical students celebrate being paired with
hospitals. The State News. March 2013. Available from: http://statenews.com/article/2013/03/medical-students-celebrate-being-paired-with-hospitals. [cited 15 May 2013].