"GME reform alone will not be the thing that magically fixes the system," Chen says. "But there is a definitely a sense and there is research evidence out there that shows that GME residency training programs can do things that would increase the likelihood of people going into primary care and underserved areas. Where we locate our residency programs and the exposure to different kinds of mentors in GME and the exposure to positive experiences in rural and underserved areas, those do make a difference to trainees."
Chen believes the failure of GME to respond to glaring shortage of primary care physicians will prompt that review.
"The fact remains that there is no accountability in the system currently," she says. "Even with the system the way it is, [could you] layer in an accountability system could that make the difference? It could depending upon what it looks like. There are definitely things going on now. People are looking at GME and they're interested in how you can start to align it with producing the physicians that we ultimately need."
Simply building more accountability into GME and ignoring other issues such as compensation won't remove all the hurdles that keep physicians away from rural America. But it's a good start and it's long overdue.