Increasing Residency Slots is Key to Preventing Doctor Shortage

crowleyGuest post from Representative Joe Crowley, D-N.Y., Vice Chair of the House Democratic Caucus and a member of the powerful Ways and Means Committee. He is the author of the Resident Physician Shortage Reduction Act (H.R. 2124).

The past several years have seen tremendous attention paid to rethinking and improving our nation’s health care system. But a piece of the puzzle that cannot be overlooked is the need to invest in training more doctors to meet our nation’s needs.

There is no question our country is going to need more doctors. With estimates indicating that we will face a shortage of as many as 90,000 primary care physicians and specialists by 2025, now is the time to increase our investment in doctor training.

I represent New York State in Congress, where one in six of the nation’s doctors are trained. But this is not a New York issue alone. The doctors trained in New York may go on to practice in California, or Texas, or Idaho. They will practice in rural and in urban areas, in family practices and in hospitals, in primary care and in specialties. But they are all counting on Congress to step up and ensure that our nation’s system of training doctors remains strong for the future.

When I talk to people about the impending doctor shortage, they understand right away the need to bolster our training programs. What many people don’t realize, however, is something that’s familiar to every practicing physician — the need for graduating medical students to find and complete a residency in their chosen field. Without enough residency positions, even as medical schools increase their enrollment, many graduates will find no way to complete their required training. As a result, smart, talented medical students will be shut out from promising careers. Instead of just a physician shortage, we will face a physician bottleneck.

To address this problem, I have introduced legislation in Congress, the Resident Physician Shortage Reduction Act (H.R. 2124), to increase Medicare-supported residency slots by 15,000 over five years. This significant new investment in our graduate medical education programs continues and expands upon the long tradition of doctor training as a shared responsibility. The federal government, teaching hospitals, and medical schools have long partnered to train the next generation of doctors, and this must continue.

Importantly, the bill puts a stronger focus on expanding slots in areas of shortage, including both primary and specialty care, and requires an updated federal study to determine which specialties are most in need. The bill also encourages hospitals to emphasize training in community-based settings, because as our approach to health care in this country transforms, our teaching hospitals are making sure that doctors are ready to practice in this new world.

The bill also takes important new steps to address the problems we’ve seen of long wait times for veterans seeking care. An investigation by the Department of Veterans Affairs concluded that many VA hospitals do not have enough doctors, contributing to the delays that some veterans unfortunately experience. My Resident Physician Shortage Reduction Act recognizes this shortfall with a focus on encouraging teaching hospitals to affiliate with VA medical centers. Such a partnership would train young doctors in the unique needs of veterans, particularly onsite at VA centers, and would serve as a critical tool in recruiting doctors to return to the VA for their careers.

Every year that I have introduced the Resident Physician Shortage Reduction Act, support has grown. With over 100 bipartisan cosponsors so far in the 114th Congress, including my co-leading representative Dr. Charles Boustany (R-La.), we are on pace this year to eclipse previous high marks of support. Over two dozen leading national health organizations, including the American Association of Neurological Surgeons and the Congress of Neurological Surgeons, have expressed support for this bill.

This legislation focuses on the very real and immediate need to expand our physician training framework to accommodate more doctors. Medical schools have increased their classes, and many teaching hospitals have strained over their Medicare limits to respond to need — without this legislation, our physician training infrastructure is in jeopardy.

I have been proud to put this legislation forward, and I have been heartened by the strong show of support it has received both within Congress and from the broader medical community. I will continue to push my colleagues on both sides of the aisle to take up and enact this legislation and bring certainty and stability to our graduate medical education system. This is an urgent issue and one that is critical to making sure our health care system is strong, solid, and superior.

Editor’s Note: During the month of March, we encourage everyone to join the conversation online by using the hashtag #gmemonth.

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