Health care is a hot topic in the 112th Congress. And the Student Osteopathic Medical Association (SOMA) is focused on a variety of important health-related issues, such as the number of funded residency positions and the patient-centered medical home. We encourage all students to stay informed, promote a healthy political dialogue, and support legislation important to the future of the profession and the patients we serve.
Added residency slots
Congress has not made any substantial adjustment to the number of federally funded residency slots—which stands at about 98,000—since the enactment of the Balanced Budget Act of 1997. This is becoming an increasingly important health care issue because of the impending shortage of physicians. The Association of American Medical Colleges (AAMC) projects a shortfall of about 90,000 physicians by 2020.
In response to such estimates, medical schools across the country have increased enrollments. For example, osteopathic medical student enrollment rose from 9,882 in 1998 to 19,427 in 2010, according to the American Association of Colleges of Osteopathic Medicine. Enrollments at allopathic medical schools also have been on the rise: from 69,929 in 2002 to 79,070 in 2010, according to the AAMC. But changes in the number of federally funded residency spots have not followed. The AAMC argues that Medicare-funded residency spots must increase by 15% (about 15,000) “to meet the needs of 2020 and beyond.”
When discussing this issue with lawmakers, please stress that prompt action is a priority. Increases in the physician workforce take years to achieve. That’s because residency programs must go through an approval process that can last several years. Even then, the initial class of residents will not graduate for at least three years after the program is approved.
Lawmakers usually agree that we have a physician shortage, but they fail to understand that simply increasing U.S. medical school enrollment will not solve the issue. We need adequate funding for additional residency positions.
Patient-centered medical home
According to the Robert Wood Johnson Foundation, caring for chronic conditions makes up 85% of medical costs. Patients with chronic conditions like diabetes mellitus and chronic obstructive pulmonary disease require regular monitoring to control their illness and prevent disease exacerbations that result in costly emergency and intensive care.
As future osteopathic physicians, we are in an ideal position to promote the patient-centered medical home, a model of care designed to renew our medical system’s focus on primary care and prevention. The medical home model encourages preventive care and better communication among not only physicians and patients but also physicians. This is possible because the primary care physician is the model’s centerpiece. Primary care physicians spend time educating patients about their conditions and how they’re best managed. Also, primary care physicians coordinate patient care across multiple areas of medicine, including physical therapy.
Physicians should be compensated for providing disease prevention measures and improved physician-to-patient and physician-to-physician communication—all of which ensures better health care.
Please discuss these issues with your members of Congress. For additional ideas, opportunities and links for contacting your representatives, please visit the political affairs section of SOMA’s website.