The study's findings are blunt: GME operates on public money—nearly $10 billion in funds from the Medicare program and another $3 billion from Medicaid—but apparently the nation's teaching hospitals can't address physician shortages that were identified and anticipated decades ago.
The problem is not just in rural and underserved areas. Chen says GME institutions produce primary care physicians at an "abysmally low" rate. This failure by a taxpayer funded program to address a dire public need is occurring despite the full knowledge that the need for primary care physicians will dramatically increase in the coming years as more Americans gain health insurance coverage under the Patient Protection and Affordable Care Act.
"If residency programs do not ramp up the training of these physicians, the shortage in primary care, especially in remote areas, will get worse," Chen says. "The study's findings raise questions about whether federally funded GME institutions are meeting the nation's need for more primary care physicians."
"Right now with the Medicare money that goes for GME there is very little requirement around that money other than that you train and report that you train 'X' number of residents," Chen says.