Is Congress adding to the Physician Shortage Burden?     


By Hope Williams, MD

Unlike traditional residency programs, the American Association of Teaching Health Centers (THCs) oversees the graduate medical education of community based primary care residency training programs in 24 states and the District of Columbia.  With approximately 1,000 residents dispersed between Family Medicine, Internal Medicine, Pediatrics, and Psychiatry, THCs are attempting to address the increasingly critical needs of the already underserved populations compounded with the/against the backdrop of the rising physician shortage in the United States.

Funding for these programs is in jeopardy every few years as this category of residency program training is not covered by the Centers for Medicare and Medicaid (CMS), unlike in traditional residency training programs.  In a recent HRSA study, one of the conclusions drawn is that residency programs need about $210,000 per resident for adequate training. Programs like Authority Health rely on this funding to pay their residents, GME support staff, training directors and preceptors, as well as rotation site facilities. Currently- funding allocates about $160,000 per resident. In the past, slashed funding, or funding not approved in a timely manner has led to the demise of some residency programs. Funding is due to end September 2023.

Last week, there was a major push in addressing members of the U.S. Senate and House of Representatives to not only remind them of the importance of the program, but to reinforce the crucial necessity of funding it. The latest news: despite support from all of the legislators engaged, THCs requested provisions were included as part of another proposed legislation in the House of Representatives. Some of those line items were objectionable and the legislation’s proponents decided to withdraw the bill from consideration on a vote this. Consideration for THCs funding has been tabled for another time.

This is at a time when the nation is experiencing a critical shortage of primary care physicians – such as those training in Teaching Health Centers. According to a recent article published in Kaiser Health News, the percentage of U.S. doctors in adult primary care has been declining for years and is now about 25% — a tipping point beyond which many Americans won’t be able to find a family doctor at all. And, more than 100 million Americans don’t have usual access to primary care, a number that has nearly doubled since 2014.

Without action from elected representatives, these vital residency programs are at risk of extinction. The number of primary care physicians that would enter the workforce would be significantly reduced. It is critically important for our nation’s elected officials to realize the importance of Teaching Health Centers – together with the nation’s community health centers and National Health Service Corps., and renew their funding, with funding increases that represent the true need to function.

Dr. Hope Williams is a psychiatry resident in Authority Health’s Teaching Health Center Program