Advocacy and policy news for internists
ACP Urges Changes in Graduate Medical Education
Preferential funding for internal medicine is among the points supported by the College
The Institute of Medicine is preparing to issue a report about the future of graduate medical education that could inspire significant change in a system that isn't churning out enough internists.
The problem? "Residents and medical students are not choosing to practice internal medicine," said Dr. Charles Cutler, who will take over this spring as chairman of the ACP Board of Regents. "We need more doctors practicing internal medicine. But by and large, they're choosing medical specialties."
The Institute can be part of the solution, Cutler said, by urging Congress to change priorities to emphasize internal medicine and expand the funding of graduate medical education by including insurance companies in the picture. Cutler, a Philadelphia-area internist, testified on behalf of the ACP at a public meeting on the topic sponsored by the Institute and held in December in Washington, D.C.
The Institute committee that's developing recommendations on the training of physicians is exploring, among other things, the financing of graduate medical education and the geographic distribution of various types of physicians.
The committee has had several public meetings and is expected to issue a report late this year. Christine Stencel, a spokeswoman for the institute, said the committee is still figuring out what it believes.
"There's a lot of work ahead, and committee members generally refrain from expressing comment on any piece or group of information they've looked at so far lest any comment now be taken as a final conclusion or recommendation that will be in the report," she said. "There's a lot of deliberation and report drafting ahead and lots of opportunity for their thoughts to evolve."
Cutler said that ACP is worried about cutbacks in funding for graduate medical education. One option would be to find a role for insurance companies in the funding process, something that Cutler said ACP supports. The College also is concerned about the current system's failure to allow for adjustments to be made as fields experience shortages.
"The money is spread more or less evenly across the system," he said. "Dermatology, where there is virtually no shortage, gets funded to a similar extent as internal medicine. What we're advocating for is preferential funding to internal medicine so there will be more slots and more opportunities for students to go into internal medicine."
He noted that there's justification for such a focus.
"A lot of research establishes that good primary care saves money," Cutler said. "Let's say you go to a primary doctor and get screened for colon cancer. The cancer is picked up at an early stage, and you don't need a $50,000 operation and $100,000 worth of chemotherapy and radiation."
But there's a major gap between the pay of internists and specialists. In 2010, primary care physicians made $202,000 a year, on average, compared with $357,000 for specialists, according to the Medical Group Management Association.
That can be especially important to doctors just starting out, explained Dr. Tiffany Groover, a resident in Boston Medical Center's primary care program who served as a health policy intern in ACP's Washington, D.C., office last spring.
"Throughout my medical school training and most notably in residency, many of my colleagues made it clear that primary care would not be an option and specializing was the only viable decision," Groover told the Institute committee when she testified at the meeting in Washington, D.C. "One of the most prominent reasons was the need to repay the staggering educational loans acquired during medical school, in addition to those from prior education. Many of my fellow students and trainees also expressed that primary care is a field that may not survive health care reform, raising concerns about a stable career in medicine."
"Unfortunately for many, a focus in primary care is an afterthought," she said.
But in addition to improving compensation, Cutler said, the system needs to improve the quality of work life for internists by reducing paperwork and boosting teamwork, which is rewarding.
In the big picture, he said, "we're optimistic that new payment models will encourage more doctors and more students to go into or stay in primary care."
January 23, 2013
Copyright © 2013 HealthDay. All rights reserved.
|»||Leadership Day 2017 Set for May 23 & 24 |
Leadership Day, ACP's annual two-day advocacy event in Washington, enables members from across the country to bring ACP's issues to U.S. lawmakers. It's a great opportunity for ACP and its members to bring policy priorities to Congress and try to influence the legislative process on behalf of internal medicine. The registration deadline is May 1.
|»||Heading to ACP's Internal Medicine 2017 Meeting? Check out Health Policy courses |
Fri. Mar. 31, Examining the Rise in Prescription Drug Pricing and Costs (9:30am-10:30, Rm 1).
Sat. Apr. 1, 60 Minutes: Special Report on Hot Issues in Health Policy (9:30am-10:30, Rm 8), Climate Change: The Health Perspective (4:00pm-5:00, Rm 2).
|»||Heading to ACP's Internal Medicine 2017 Meeting? Check out Medical Practice Management courses |
Thur. Mar. 30: Patients before Paperwork: What Can Be Done to Ease Administrative Burdens on Physicians and Their Patients? (8:15am-9:15, Rm 2), ACP's Dragon's Lair: Breathing Fire into Health Care Transformation (11:15am-12:45, Rm 14), Implementing Revenue-Positive and Time-Saving Adult Immunization in Your Practice (11:15 am-12:45, Rm 1), Hospital Inpatient Coding: Thinking inside the Box (2:15 pm-3:45, Rm 7), Opportunities for Subspecialists: Navigating Alternative Payment Models under MACRA (4:30pm-5:30, Rm 8),
Fri. Mar. 31: There Is No Place like Home: Why Patient-Centered Medical Homes and PCMH Specialty Practices Are Here to Stay (7:00am-8:00, Rm 7), Promise and Peril of Value-Based Payment: What Will You Be Measured On—and Will You Measure Up? (11:15am-12:45, Rm 8), More News You Can Use: Current Best Practice Advice (11:15 am-12:45, Rm 20A), MIPS Reporting: Managing the Health IT Challenges (11:15am-12:45, Rm 7), New Physician/Provider Boot Camp (11:15am-12:45, Rm 2), Outpatient Coding: Do It Right and Get Paid for What You Do (2:15pm-3:45, Rm 1), iPatient/Electronic Health Records (2:15pm-3:45, Rm 7), What May Change Your Practice Tomorrow: Hot Topics in Medical Informatics (4:30pm-5:30, Rm 2),
Sat. Apr. 1: C. Wesley Eisele Lecture: The Good, the Bad, and the Ugly: Physicians in the Digital Age (8:15am-9:15, Rm 7), Team-Based Care: Interprofessional Practice Innovations in Primary Care (11:15am-12:45, Rm 1), Billing and Coding: What You Didn’t Learn in Residency, and Why It Matters (11:15am-12:45, Rm 8), MIPS or APM: Making the Most of Medicare Payment (11:15am-12:45, Rm 7).
|»||Heading to ACP's Internal Medicine 2017 Meeting? Check out Health Information Technology courses |
Thur. Mar. 30: Looking Toward 2020: New Care Delivery Models Enabled by Existing and Near Future Technology (11:15am-12:45, Rm 7),
Fri. Mar. 31: Beyond the Hype and into the Real World: Making Mobile Health (mHealth) Matter for Your Practice (8:15am-9:15, Rm. 7), MIPS Reporting: Managing the Health IT Challenges (11:15am-12:45, Rm 7), iPatient/Electronic Health Records (2:15pm-3:45, Rm 7), What May Change Your Practice Tomorrow: Hot Topics in Medical Informatics (4:30pm-5:30, Rm 2),
Sat. Apr. 1: C. Wesley Eisele Lecture: The Good, the Bad, and the Ugly: Physicians in the Digital Age (8:15am-9:15, Rm 7), Blogging and Social Media in Health Care (8:15am-9:15, Rm 2), Telemedicine Use in Providing Quality Care (9:30am-10:30, Rm 7), What Physicians Really Need from EHRs to Be Successful in a Value-Based World (2:15pm-3:45, Rm 7), Wearables, Smartphones, Trackers—Oh My: The New Age of Patient Technologies (4:00pm-5:00, Rm 8).