Medicare's formula for funding graduate medical education is receiving new scrutiny as the federal government barrels toward another round of budget negotiations as the debt ceiling approaches, possibly as soon as September. President Barack Obama has already called for reducing the $10 billion annual subsidy to teaching hospitals by an average of $1.1 billion over the next decade, according to his fiscal 2014 budget (PDF).
While no hospital executive favors a drop in federal funding, some say the formula should be revised.
“If you want to get desired behavior, you figure out a way to incentivize or encourage it,” says Dr. Susan Vanderberg-Dent, a family medicine practitioner and an associate dean at Rush. “That hasn't been there.”
Eleven precent of Rush's 598 residents completed their training in primary care, the study finds.
Many fledgling doctors don't find primary care attractive because of the pay. Family practice doctor salaries average $189,000 a year, while many specialists, ranging from cardiologists to ear-nose-and-throat doctors, make twice that, according to a survey by physician search firm Merritt Hawkins & Associates.
A reduction in funding for graduate medical education would come on top of decreases in reimbursements under Mr. Obama's Affordable Care Act, hospital executives say.
“Further cuts that would impact GME would go at the heart of our ability to respond to the demand for services,” says Benjamin Gibson, vice president of governmental affairs at U of C Medicine, which includes the medical center and the med school.
The study counted residents and fellows at hospitals with at least 150 graduates in 2006-08. Residents are med school graduates working under a licensed physician, while fellows have completed their residencies and are taking advance training.
"Which Chicago hospitals turn out the fewest primary care docs?" originally appeared in Crain's Chicago Business.