Davis backs boost in Medicare funding for doctor training programs

Jul. 23--A proposed boost in federally funded slots for physicians completing specialty training programs would mean better care for central Illinois patients and easier access to doctors, a panel of health-care leaders told a local congressman on Monday.

"We know firsthand what it's like to recruit physicians to small towns," Dr. Loren Hughes, chief medical officer of Springfield-based HSHS Medical Group, told U.S. Rep. Rodney Davis, R-Taylorville, during a meeting of what Davis called his Healthcare Advisory Coalition.

"Typically, if you can train them locally, they will come back locally," Hughes said.

Davis said he is a co-sponsor of House Resolution 1763, a bill with bipartisan support in Congress that would increase by 15,000 the number of medical residency and fellowship positions funded through the Medicare program at hospitals nationwide.

The proposed addition of 3,000 slots each year over a five-year period would be the first increase in Medicare-funded slots since 1997.

There are currently about 80,000 residency and fellowship slots funded by Medicare. Another 15,000 slots are funded by hospitals without any help from Medicare, the federally funded health-insurance program for senior citizens and disabled people.

The Association of American Medical Colleges in Washington, D.C., says the United States will face a shortage of between 46,900 and 121,900 doctors by 2032, both in primary care and specialty care.

Because it takes seven to 15 years beyond a bachelor's degree to train a doctor, the AAMC says on its website that projected shortages "need to be addressed now so that patients will have access to the care they need."

The proposed 19 percent increase in residency and fellowship slots envisioned in HR 1763 is estimated to cost Medicare $10 billion over a 10-year period, according to Leonard Marquez, senior director of government relations for the AAMC.

The current situation is restricting efforts to deal with shortages of doctors, particularly in areas of the country outside big cities, advocates of the bill say.

The AAMC, which is among dozens of medical groups backing similar bills in the U.S. House and Senate, says medical schools have increased enrollment by almost 30 percent since 2002. However, the enrollment increase "will do little to help the growing demand for physician services" if the federal government doesn't raise the cap on Medicare-funded slots, the AAMC says on its website.

Medical school graduates must take part in residency and fellowship programs lasting three or more years before they can legally practice on their own.

"Physician shortages have got to be addressed," Davis told the panel during Monday's meeting at the Memorial Center for Learning and Innovation.

Davis said HR 1763, which has been proposed in various bills in Congress since 2009, would be a "good start."

The approximately 20 people on the advisory coalition came from hospitals, physician groups and other health care providers in central Illinois communities that included Springfield, Peoria, Taylorville, Bloomington-Normal, Champaign-Urbana and Greenville.

Hughes said many talented potential doctors are denied the ability to "fulfill their dreams" because of the limits in residency slots.

Others, especially graduates of medical schools overseas, may spend years doing research and working other jobs to bide their time after medical school graduation before they are finally accepted into a U.S. residency program, he said.

Residency programs in the United States typically give priority to graduates of American medical schools when filling residency slots, he said.

An expansion in residency slots would create a bigger pool of doctors to work in underserved rural communities, Hughes said.

Charles Callahan, president and chief executive officer of Springfield'sMemorial Medical Center, said the proposed increase would be "tremendously helpful" and "long overdue."

The 500-bed hospital and its parent organization, Memorial Health System, already pay for salaries and benefits for 85 doctors in SIU residency slots that exceed the cap and aren't covered by Medicare, he said.

Those residency slots cost Memorial $6.3 million per year -- an amount that is separate from the $40 million in annual support that Memorial provides the medical school for academic programs, Callahan said.

"The presence of the school of medicine has really been a great driver of innovation and services throughout the region," he said.

An increase in residency slots funded by Medicare beyond the current caps would allow local residency programs to expand, he said.

SIU has 284 residency slots in Springfield, with 157 funded by Medicare and 127 slots funded by Memorial and HSHS St. John's Hospital, SIU spokeswoman Rikeesha Phelon said.

It's unknown how many more Medicare-funded residency slots would be created in Springfield under the bill, she said.

Kimberly Bourne, president and CEO of Taylorville Memorial Hospital, said she would like to see more high school students in rural areas consider careers as doctors.

Children of doctors often see a medical career as an option, she said, but other bright students may not have such built-in role models.

"There are lots of kids in small communities who don't think that's attainable," she said.

Davis also heard from the advisory coalition about local shortages in nurses. Coalition members said enrollment in nursing programs can be constrained by a lack of nursing instructors and the availability of hospitals where nursing students receive training in a clinical setting.

Contact Dean Olsen: dean.olsen@sj-r.com, 788-1543, twitter.com/DeanOlsenSJR.

___

(c)2019 The State Journal-Register, Springfield, Ill.

Visit The State Journal-Register, Springfield, Ill. at www.sj-r.com

Distributed by Tribune Content Agency, LLC.