Funding of Primary Care Training in Need of Major Reform

Dr. Kenny Lin, a family physician at Georgetown University School of Medicine, recently addressed funding issues for residency programs that produce primary care physicians. Researchers have estimated that in order to meet the projected U.S. population need for primary care physicians in 2035, residency production will need to increase by 21%. However, the number of available training positions and funding for training programs is significantly lower for primary care than other medical specialties.

For the past 5 years, a grant program from the HRSA has supported the training of 900 additional residents in family medicine, internal medicine, and pediatrics. Past trends predict that about 600 of them will practice primary care, but the funding unfortunately will expire this year. In 2012, the CMS contributed $10 billion to fund medical training and offset major costs in teaching hospitals. An analysis of the outcomes of residency training found that the 20 institutions that produce the most primary care physicians unfortunately received much less CMS funding than those that produced the least.

Last year, the Institute of Medicine called for reforming the allocation of taxpayer-supported residency funding to make teaching institutions accountable for producing a physician workforce that provides better care at a lower cost. Dr. Lin affirms that the bottom line is that, “primary care physicians and our professional organizations need to push not only for reforms in how we are paid for patient care, but also reforms in how residency programs are funded in order to increase our numbers and produce a balanced workforce that meets the health needs of our nation.”

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