Increased primary care residency programs effect

[sanfran22]

Just wanted everyone's opinion on this topic. I am told that the AMA has/is making plans to increase the number of graduating physicians training in primary care specialties by the thousands within the very near future. Over the past decade a number of new medical schools have opened across the country and there are plans for many more (both MD and DO), in 2015 the ACGME is taking over all osteopathic residencies (thus adding in the ever expanding pool of DO graduates who historically stick to primary care), and apparently they are even alleviating restrictions to international MDs trying to do primary care residency in the states. Though the number of residency spots has been pretty much capped at a stagnant number for the past 15-20 years, the AMA is now pushing for Congress to increase GME funding to allow for an increasing pool of residency/fellowship trained physicians in the primary care setting. My concern is that should Congress help facilitate this (highly likely if not inevitable due to the physician shortage compounded by baby boomer population + 30 million more individuals insured under the ACA within the next 5 years) then before long there will no longer be a physician shortage (if not physician excess) and at that point where does that leave us NP's in a pursuit for autonomous practice rights...Is there anything the AANP can do to stop Congress from funding these extra residency programs..i.e. show them that the money would be better spent expanding NPs rather then pouring into increasing physicians who require the extra schooling/residency/fellowship training? Thanks..

[Corey Narry, MSN, RN, NP]

Personally, I have no strong opinion regarding ACGME and AOA moving towards a unified accreditation process for GME in the United States and actually feel that is a welcome move. DO's have been marginalized in terms of availability of quality residencies which historically have been available only to MD's. The separate AOA and ACGME residency sites makes this disparity more apparent and hopefully this move will resolve the issue through a unified accrediting body. I don't know the details and effects of this change but as someone who works in an institution that hosts a popular and well known Internal Medicine residency program, I know all the residents that match at our instituion are MD's and graduates from well known medical schools some of whom are at the top of their graduating class. Don't know if this change will give rise to DO's getting in but I assume if this does happen, the same caliber of DO grads will match at our program. It's also worth mentioning that many of these IM residents I know are eyeing fellowships in highly specialized fields, hence, have no interest in primary care to begin with.

AOA, ACGME Move Toward Unified Accreditation for Graduate Medical Education Programs

I believe that the impetus for increasing residency slots in primary care is a reaction to the implementation of the Affordable Care Act. Note that this act also makes provisions to increase funding to train more PA's and NP's, professionals who actually do have a desire to provide primary care. As many already realize, Primary Care is not usually an attractive option to medical school graduates due to the lifestyle, workload, and low pay it offers against a backdrop of high cost of student loans. Personally, I don't know of any effective effort discussed or planned that can attract more physicians to these fields.

Creating Jobs and Increasing the Number of Primary Care Providers | HealthCare.gov