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This section contains policy briefs, research, reports, legislation, news items, and featured MEFS products on topics that are related to the social mission of medical education, including health care reform, general physician workforce issues, medical education expansion, and other ancillary health care topics.

Archive »Policy Briefs

Physician Supply Follows Federal Policy: A Lesson From History
"Predictions of physician supply have swung from surplus to shortage and back again over the past century. While the answer to the question, "What is the right number of physicians?" is debatable, there is no question that physician supply is sensitive to legislative and policy changes." Read More...

Archive »Research

Anatomy of a New U.S. Medical School: The Commonwealth Medical College
May 2010 – Academic Medicine
"This article chronicles the development of one of these new schools, The Commonwealth Medical College (TCMC), a private, not-for-profit, independent medical college with a distributive model of education and regional campuses in Scranton, Wilkes-Barre, and Williamsport, Pennsylvania." Read More…

The Democrats' Last Ditch: Reconciliation or Bust
March 3, 2010 – New England Journal of Medicine
"The endgame has begun: with Republicans staunch in their opposition, the Obama administration and its congressional allies are poised to go it alone on a tortuous path toward enactment of ambitious health care reforms." Read More…

Abraham Flexner and his Remarkable Report on Medical Education: A Century Later
March 3, 2010 – Journal of the American Medical Association
"For 16 months, from January 1909 through April 1910, Abraham Flexner crisscrossed North America via train, horse and buggy, and the occasional Ford flivver. The result, his Herculean Report on Medical Education in the United States and Canada, was released to the public in June 1910. The opening chapters of this powerful text discussed the historical underpinnings and basic necessities of US medical education. The second section featured a school-by-school analysis and included allopathic, osteopathic, proprietary, and sectarian institutions." Read More…

Trends in the Work Hours of Physicians in the United States
February 24, 2010 – Journal of the American Medical Association
"The potential expansion of health insurance coverage and associated reform of the delivery system, combined with recent forecasts of physician shortages (particularly in primary care), have catapulted issues related to the adequacy of the physician workforce high up on the health policy agenda. Whether the workforce is equipped to handle the demand for physician services depends on both the quantity and specialty distribution of physicians and the number of hours worked per physician." Read More…

American Board of Family Medicine (ABFM) Maintenance of Certification: Variations in Self-Assessment Modules uptake within the 2006 Cohort
January 2010 – Journal of the American Board of Family Medicine
"In its recent shift to a Maintenance of Certification for Family Physicians (MC-FP) paradigm, the American Board of Family Medicine provides diplomates completing 3 self assessment modules (SAMs) in the first 3 years (or first stage of MC-FP) a pathway to extend their recertification cycle to 10 years provided additional requirements are met, versus a 7-year cycle for "non-completers." We use geographic information systems to report on variations in SAM participation and completion in a single cohort of diplomates followed during their first stage of MC-FP to better understand the communities impacted, barriers to uptake, and urban-rural differences." Read More…

Flexner Centenary Collection
February 2010 – Academic Medicine

Acceptance of Physician Assistants and Nurse Practitioners in Trauma Centers
January 2010 – Journal of the American Academy of Physician Assistants
"The physician assistant (PA) and nurse practitioner (NP) professions began in the 1960s as part of a strategy to cope with a lack of primary care medical providers in rural and underserved areas. PAs and NPs fi lled gaps in primary care services that were created as more physicians moved into specialty and subspecialty areas of medicine. However, recent employment trends in the PA and NP professions indicate movement away from primary care and into specialty fields." Read More…

Senate's Reform Package Wrapped Up in Time for Christmas
December 28, 2009 – New England Journal of Medicine
"With no votes to spare — because every Republican stood in opposition — the normally fractious Senate Democrats cast aside their differences to pass a landmark health care reform bill by a vote of 60 to 39 on Christmas Eve, the 25th straight day of debate over the measure. The Congressional Budget Office (CBO) estimated the bill's cost at $871 billion over 10 years — divided among public subsidies to help lower-income people pay for private insurance, expansions of Medicaid and the Children's Health Insurance Program, and tax credits for small businesses." Read More…

Accreditation Standards of DO- and MD- Granting Medical Schools: An Incomplete Comparison (Reply)
January 2010 – Academic Medicine
"We appreciate the comments offered by Drs. Hunt, Barzansky, and Sabalis. However, they imply that our objective in the article was to 'dispel these perceptions by analyzing certain aspects of accreditation across the two professions.' Instead, we aimed our article at the broader topics of accreditation rather than at this one issue and attempted, in a limited way, to determine whether the standards "and other issues could help account for real or perceived quality differences between the two types of medical schools." Read More…

Accreditation Standards of DO- and MD- Granting Medical Schools: An Incomplete Comparison
January 2010 – Academic Medicine
"In their June 2009 Academic Medicine article, Wood and Hahn reported "perceptions that the quality of osteopathic education, and therefore the graduates of DO medical schools, are of a lower quality than is the case with MD schools." They then sought to dispel these perceptions by analyzing certain aspects of accreditation across the two professions. There are fundamental problems with this approach. Simply assessing the similarities and differences between the accreditation standards for the educational programs that grant MD and DO degrees does not begin to provide an answer to this complex question, as we will presently explain." Read More…

Patient Centered Medical Homes in Ontario
January 7, 2010 – New England Journal of Medicine
"As the United States debates health care reform, the concept of "patient-centered medical homes" is receiving increasing attention.1 Many experts believe that medical homes with multidisciplinary teams and financial incentives for providing comprehensive care will lead to improvements in health, increase efficiency, and reduce costs of care while making practice more attractive for primary care physicians. Lessons regarding the implementation of medical homes and their ability to accomplish these goals can be gleaned from Ontario's experience with Family Health Teams (FHTs)." Read More…

The Doctor Can't See You Now: New York's Physician Shortage Grows
December 2009 – Healthcare Association of New York State
"Physician shortages threaten many New York residents' access to health care. While steps have been taken to begin to address this recognized problem, more state and federal action is needed to increase the number of primary care physicians, as well as physicians in other specialties that are in demand. Further, New York State must explore alternative ways to deliver care to underserved populations." Read More...

Settling in for a Long Debate
December 2, 2009 – New England Journal of Medicine
With virtually all Republicans in opposition and public opinion sharply divided, the Senate opened debate on a Democratic health care reform bill that would greatly expand insurance coverage and, its leadership hopes, reverse the erosion of the party's standing in the electorate's eyes. Prospects seem dim that the Democrats will be able to enact their proposal without scaling down its scope to accommodate the more conservative Democratic senators and two independents. Nevertheless, Majority Leader Harry Reid (D-NV) opened floor debate on December 1 by saying that 'the next weekends, plural, we will be working' on the reform bill, because there is 'not an issue more important than finishing this legislation.'" Read More…

Physician Assistants: Policy and Practice, 3rd Edition, 2010
Roderick D. Hooker, PhD, James F. Cawley, MPH PA-C, and David P. Asprey, PhD PA-C

What Attracts Students to Interprofessional Education and Other Health Care Reform Initiatives?
Fall 2009 – Journal of Allied Health
"An international consensus has emerged that interprofessional education (IPE) and other health care reforms are necessary to address the increasing complexity of patients' health needs. Despite overwhelming barriers to its system-wide implementation, health professional students worldwide have organized themselves to promote IPE and have achieved considerable attention. This study seeks to offer insights into what attracts students to IPE and other health care reform initiatives and how advocates of change can stimulate this interest." Read More…

Narrowly Clearing the Next Hurdle – Passage of the Health Reform Bill
November 11, 2009 – New England Journal of Medicine
"With Democrats wielding their sizable majority to fend off strong Republican opposition and survive the defection of 39 members of their own party, the U.S. House of Representatives voted 220 to 215 to approve health care reform legislation after a day of contentious debate. On November 7, as midnight drew near, 219 House Democrats and 1 Republican approved a measure that would extend insurance coverage to virtually all Americans by 2013. The 1990-page bill would also restructure private insurance, bolster primary care, and make countless other policy changes — but would not eliminate the scheduled 21.2% reduction in Medicare's physician fees, a problem that Democrats plan to tackle in separate legislation before the cuts take effect January 1, 2010." Read More…

Doctoral-Level Programs Prepare Nurses for Expanded Role in Care and Research
November 18, 2009 – Journal of the American Medical Association
'The DrNP programs are typically 2 years long, including a 1-year residency, and accept individuals who have already earned a master's degree in nursing and have been licensed as a nurse practitioner. Eventually, programs will accept students with a baccalaureate nursing degree, but according to recommendations from AACN, these programs would take 3 to 4 years to complete. The programs emphasize evidence-based practice, quality improvement, and systems-level thinking, said Raines. 'We think people with the DrNP preparation will be particularly skilled at translating research into practice,' she said." Read More…

Are There Enough Doctors to Make Reform Work?
November 21, 2009 – National Journal
"Under the best of circumstances, it takes a few months for Allan Nichols, the executive director of Mainline Health Systems in rural Arkansas, to fill a primary-care position in one of his community health centers. But the worsening shortage of primary-care doctors means that the job search could last more than a year. The shortage of primary-care doctors has been a well-reported, chronic problem in medicine. The American Academy of Family Physicians estimates that by 2020, the patient load will require 40,000 more doctors than will be practicing. Many worry that expanding coverage under health care reform will exacerbate the problem." Read More…

Forestalling a Filibuster – Senate Reform Bill Cleared for Floor Debate
November 25, 2009 – New England Journal of Medicine
"Faced with unanimous Republican opposition, Senate Democrats, joined by two independents, closed ranks in a rare Saturday session on November 21 to advance consideration of a vast health care reform bill. Without a vote to spare on a motion to clear the way for floor consideration of the contentious bill, Democrats prevailed 60 to 39. Having defeated Republican efforts to derail the measure, Senate Majority Leader Harry Reid of Nevada can now open floor debate in early December." Read More…

Compromises and Controversies – Moving Forward on Reform
November 4, 2009 – New England Journal of Medicine
"Accelerating progress toward the Democrats' goal of enacting health care reform legislation, House Speaker Nancy Pelosi unveiled a bill on October 29 that would establish a mandate for most legal U.S. residents to obtain health insurance. The bill would extend coverage to some 36 million people, and according to the Congressional Budget Office (CBO), its net costs would be fully paid for — largely through an income-tax surcharge on high-income persons and a reduction in the growth of Medicare's payment rates for most services, except those provided by physicians. Meanwhile, Senate Majority Leader Harry Reid was preparing to introduce the Democrats' reform bill in the Senate, awaiting only a CBO estimate of its cost." Read More…

Reform and the Health Care Workforce - Current Capacity, Future Demand
November 5, 2009 – New England Journal of Medicine
As Democrats press to enact health care reform legislation, they have emphasized their commitment to greatly expanding coverage, slowing the growth of medical spending, and more tightly regulating private insurers, if not also creating a competing public insurance option. But among the major questions that their policy prescription leaves unanswered is, How would a health care workforce that many (though not all) observers agree is already inadequate in some regions and specialties provide medical care to an additional 30 million newly insured people?" Read More…

The Baucus Bill and the Hope for Reform
October 14, 2009 – New England Journal of Medicine
"After months of wrangling with Republicans over the appropriate role of government in health care, the Senate Finance Committee's 13 Democrats were joined by a lone Republican, Senator Olympia Snowe of Maine, on October 13 in approving a reform bill that would establish a mandate for most individuals to obtain health insurance. The 14-to-9 vote by the panel, chaired by Senator Max Baucus (D-MT), moved the reform process to the next step: blending the Finance Committee bill with a more liberal one previously approved by the Senate Health, Education, Labor, and Pensions Committee." Read More…

Comparison of Physician Workforce Estimates and Supply Projections
October 21, 2009 – Journal of the American Medical Association
"Recent projections indicate that the supply of US physicians may soon decrease below requirements, with some projecting a shortfall as high as 200 000 by 2020. Although debate over potential shortages has focused largely on the number and type of physicians needed in the future, concerns have also been raised about data used in physician supply estimates and projections." Read More…

How Many Physicians? How Much Does It Matter?
October 21, 2009 – Journal of the American Medical Association
"The analysis of current estimates of the number of physicians practicing in the United States by Staiger and colleagues in this issue of JAMA touches on a topic that is both arcane and central to policy debates. The arcane part is how physicians are counted; the policy part is how their contributions to the economy and to social needs are estimated." Read More…

Commentary: Flexner Redux 2010: Graduate Medical Education in the United States
November 2009 – Academic Medicine
"In 1910, the Carnegie Foundation for the Advancement of Teaching issued what is popularly known as the Flexner Report, clearly one of the most influential reports ever published by the foundation. But if Flexner could be brought back to rewrite his report today, I do not think he would focus on the state of medical students' education, assuming that his mandate was consistent with the one the Carnegie Foundation gave him long ago. In that case, he would spend no time examining how medical students are being educated; he would concern himself instead with how the country's graduate medical education (GME) system is preparing resident physicians for entry into clinical practice." Read More…

Physician Assistants and Nurse Practitioners as a Usual Source of Care
Chrisinte M. Everett, MPH PA-C et al., Journal of Rural Health, September 23, 2009
"The United States (US) is faced with an aging population, projected physician shortages, and an increase in the prevalence of chronic disease, health care costs, and the number of uninsured Americans, making access to health care a leading policy issue. Since 1967, non-physician providers such as Physician Assistants (PAs) and Nurse Practitioners (NPs) have been utilized to improve access and reduce health care costs. Approximately 110,000 PAs and NPs currently practice in the United States. Fifty percent of PAs and 85% of NPs practice in primary care and are more likely than doctors to practice in rural areas and with underserved populations." Read More…

Service Learning Helps Sustain the Status Quo
Arch G. Mainous III, PhD and Richard Baker, MD, Family Medicine, October 2009
"The strategy of selective ad¬mission and creation of socially responsible physicians to provide uncompensated care for the un¬insured assumes that we will not fix the problem of having a large segment of the population without health insurance. Volunteering and providing free care to uninsured patients is a societal good and should be applauded." Read More…

Baucus's Bill and the Long Road to Reform
John Iglehart, New England Journal of Medicine, October 8, 2009
"Although Baucus's proposed increase in physicians' fees is meager, primary care clinicians would receive 10% bonuses for certain evaluation and management services if more than 60% of their practice consists of these services. The bonuses would be targeted at physicians practicing family, geriatric, internal, and pediatric medicine, as well as advanced practice nurses and physician assistants. The bill would also extend a 10% bonus to general surgeons who practice for 5 years in a medically underserved area." Read More…

Disruption and Innovation in Health Care
Robert Brook, PhD, Journal of the American Medical Association, October 7, 2009
Successful health care reform may provide virtually all individuals in the United States an adequate health insurance package. However, the need to increase value for health care dollars will extend far beyond the current policy window. Achieving that goal will require disruptive innovation in the health care system." Read More…

Physicians' Beliefs and U.S. Health Care Reform – A National Survey
September 17, 2009 – New England Journal of Medicine
"Previous research suggests that physicians endorse a public role for the profession and believe they have an obligation to care for people with limited resources. But it remains unclear whether physicians in 2009 see participation in the formation of health policy as part of their professional responsibility or accept the potential consequences of reform." Read More…

Graduate Medical Education, 2008-2009
September 23/30, 2009 – Journal of the American Medical Association
"The American Medical Association (AMA) and the Association of American Medical Colleges (AAMC) maintain a database of information on graduate medical education (GME) training programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) and of the residents and fellows in them. Every spring this database of residents is updated by adding to it the approximately 19 000 new residents who match into programs through the National Resident Matching Program (NRMP) as well as from information collected through the AAMC's follow-up report of medical schools." Read More…

Medical Schools in the United States, 2008-2009
September 23/30, 2009 – Journal of the American Medical Association
"The following tables contain data derived mainly from the 2008-2009 Liaison Committee on Medical Education (LCME) Annual Medical School Questionnaire. The questionnaire was sent in February 2009 to the deans of all 126 LCME-accredited medical schools with enrolled students and had a 100% response rate. Each questionnaire was reviewed and attempts were made to verify information and obtain missing data. Data for years other than 2008-2009 were obtained from previous LCME Annual Medical School Questionnaires and other sources, as indicated." Read More…

Doctors as the Key to Health Care Reform
September 24, 2009 – New England Journal of Medicine
"Primary care is rapidly becoming an endangered specialty; an important, but not the only, reason is its relatively low economic rewards. A system like ours, which is grossly deficient in primary care physicians and dominated by specialists who are trained to use expensive tests and procedures, is inevitably costly, particularly when most specialists practice as independent small businesses, competing for patient referrals and for income." Read More…

Regional Variation and the Affluence-Poverty Index
Journal of the American Medical Association, September 9, 2009
"As the nation embarks on health care reform, concerns have been raised that the United States is training too few physicians for the future. However, progress in responding has been stalemated by a broadly accepted view that there is unexplained geographic variation in both physician supply and health care spending and that correcting it could obviate the need for more physicians—indeed, that less care is a value that should be rewarded." Read More…

The End of Fee-For-Service Medicine? Proposals for Payment Reform in Massachusetts
New England Journal of Medicine, September 10, 2009
"Health care reform has multiple goals, including expanding insurance coverage, improving quality and access to care, and controlling costs. Since Massachusetts enacted reforms in 2006, the proportion of residents lacking health insurance has decreased to an estimated 2.6% — the lowest of any state. However, there are continuing concerns about quality and access, and health care costs per capita remain among the highest in the United States. A special commission has therefore proposed that Massachusetts effectively end fee-for-service medicine, the predominant form of payment for health care services, and replace it with a system of global payments that combines the approaches of risk-adjusted capitation and pay for performance with a strong focus on primary care." Read More…

Efforts Under Way to Prepare Physicians to Care For Growing Elderly Population
Bridget Kuehn, Journal of the American Medical Association, August 19, 2009
"In 2008, the Institute of Medicine (IOM) recommended that all physicians develop competency in geriatrics to help them provide good care for the growing population of older individuals in the United States. Now leaders from a variety of medical specialties have drafted a roadmap for providing such training." Read More…
To read the white paper referenced in this article, click here.

Medical Student Perception of Education in Health Care Systems

Mitesh S. Patel, MD MBA et al., Academic Medicine, September 2009

"Undergraduate medical education has been criticized for not keeping pace with the increasing complexity of the U.S. health care system. The authors assessed medical students' perceptions of training in clinical decision making, clinical care, and the practice of medicine, and the degree to which the intensity of education in health care systems can affect perceptions." Read More…

Sill Closing the Gap
July/August 2009 – Health Affairs
"In spite of the accomplishments of the safety net, we still have not closed the gap for many Americans. Equality in health remains an unfulfilled promise and is, in fact, much more complicated now than it was in 1965. Inequity in health care continues to plague not only blacks but numerous other people and communities around the country." Read More…

Congressional Action on Health Care Reform: An Update
John Iglehart, New England Journal of Medicine, June 18, 2009
"The pursuit of health care reform continues to gather steam, as Democrats, with a nudge from President Barack Obama, set an ambitious target for action — House and Senate passage of measures by July 31. At the same time, legislators intensified their discussions about how far the government should extend its regulatory reach into the health care system, and two new reports underscored the necessity of embedding cost-cutting policies in any reform proposal." Read More…

Building Momentum as Democrats Forge Health Care Reform
John Iglehart, New England Journal of Medicine, June 4, 2009
"In the midst of dealing with countless challenges, both foreign and domestic, and a deep ideological divide in Congress, the Obama administration and its Democratic allies have nevertheless made important strides in their aggressive pursuit of health care reform legislation." Read More…

Building Momentum as Democrats Forge Health Care Reform
John Iglehart, New England Journal of Medicine, May 14, 2009
"In the midst of dealing with countless challenges, both foreign and domestic, and a deep ideological divide in Congress, the Obama administration and its Democratic allies have nevertheless made important strides in their aggressive pursuit of health care reform legislation. In what President Barack Obama characterized as "a historic day, a watershed event in the long and elusive quest for health care reform," major organizations representing the nation's physicians, hospitals, health plans, and medical suppliers pledged to do their part to achieve the administration's goal of reducing by 1.5% annually the growth of health care spending over the next decade — saving an estimated $2 trillion." Read More…

Commitment to Care for the Community
Catherine DeAngelis MD, Journal of the American Medical Association, May 13, 2009
"With the variety of proposed solutions to the problem of so many Americans not having access to care, in this case primary care, the common theme is commitment to care for the community. This includes commitment by physicians and other clinicians to provide the kind of care they know is best for patients, commitment by all payers—private or public—to provide the resources needed for this care, and commitment by patients to pay for what they can and not to misuse the system that provides care for them. Some individuals might believe this effort to be a pipe dream, but without the commitments by all those involved, there will never be a health system in the United States to care for all who truly need it." Read More…

Commentary: Grow the National Health Service Corps
Jonathan Saxton MD and Micheal Johns MD, Journal of the American Medical Association, May 13, 2009
"President Barack Obama has called for the renewal and expansion of volunteerism and national service so that citizens everywhere can help address serious national challenges. This call has been embraced across the country and even across party lines. Both the US House of Representatives and the US Senate have responded with bipartisan legislation designed to encourage such service. This broad initiative presents the health professions with an extraordinary opportunity to renew health professions' basis in charity while modeling service, wellness, and chronic care programs essential to health care reform. The National Health Service Corps (NHSC) could be the best place to start." Read More…

The Separate Osteopathic Medical Education Pathway: Uniquely Addressing National Needs
Candice Chen, MD MPH and Fitzhugh Mullan, MD, Academic Medicine, June 2009
"As we reconsider the U.S. health care system, the osteopathic educational tradition should be recognized for the contribution it has made and continues to make to the physician workforce in primary care and underserved areas. The structure of today's osteopathic medical schools may be hard to distinguish from that of their allopathic counterparts, but the output of osteopathic schools remains clearly distinctive, and the nation's health care system benefits as a result." Read More…

The Separate Osteopathic Medical Education Pathway: Isn't It Time We Got Our Acts Together?
Jordan Cohen, MD, Academic Medicine, June 2009
"Those who wish to sustain the historic dichotomy between these two increasingly convergent medical professions point to the osteopathic profession's avowed commitment to primary care and to patient-centered, holistic care. To my mind, this is a distinction without a difference. After all, the calls for more attention to primary care and to patient-centeredness are as loud in the halls of allopathic medicine as anywhere." Read More…

Factors Affecting Specialty Choice Among Osteopathic Medical Students
Howard Teitelbaum, DO PhD MPH, Nat Ehrlich, MD, and Lisa Davis, MS, Academic Medicine, June 2009
"Worldwide, there has been a trend away from primary care by both allopathic and osteopathic medical school graduates in recent years. This is a cause for concern, because the availability of primary care directly and favorably affects the health status of local communities, socioeconomic regions, and countries. We carried out the research reported below to identify reliable predictors of students' choosing primary care as their specialty of choice." Read More…

Implementing Health Care Reform in Massachusetts: Strategic Lessons Learned
Jon Kingsdale, Health Affairs, May 28, 2009
"Massachusetts has been in continuous campaign mode on health reform since 2004, when then Gov. Mitt Romney (R) and advocacy groups from both parties began to promote universal coverage. The state has already enacted two sets of reforms (in 2006 and 2008), and it may soon consider an all-payer proposal aimed at containing costs. Much remains to be done, but the political strategy of enacting reform in stages has already produced big gains and momentum to do more." Read More…

Commentary: Aging in America: Meeting the Needs of Older Americans and the Crisis in Geriatrics
Academic Medicine - May 2009
"The aging of the United States population will offer unprecedented challenges and opportunities for the health care system at large, and particularly medical education. In this issue of Academic Medicine, three articles provide opportunities for medical educators and others to ponder anew how we can address this so-called age wave as the baby boomers become senior boomers."
Click here to read more of this letter.
Click here to see other articles on geriatrics in this issue of Academic Medicine.

An Open Letter to All Graduating Medical Students
Academic Medicine - May 2009
"The months of May and June are exciting times at many medical schools around the world as faculty prepare to anoint the next generation of physicians with a formal medical degree, and students prepare to make the transition to doctor. I wish to celebrate this juncture with the following letter." Read More…

The Struggle for Reform – Challenges and Hopes for Comprehensive Health Care Legislation
April 23, 2009 – New England Journal of Medicine
"Undaunted by a soaring federal deficit, competing legislative priorities, and skeptical Republicans, leading Democrats are relentlessly pursuing health care reform, as they hold hearings, engage key stakeholders, plot strategy, and draft legislation. Five congressional committees — two in the Senate and three in the House — are at work on major reform legislation. While underscoring his administration's strong support for reform, President Barack Obama has emphasized his preference that Congress lead in crafting a measure aimed at expanding coverage, improving care delivery, and constraining the growth of health care spending." Read More...

A Single Mission for Academic Medicine: Improving Health
Paul G. Ramsey, MD and Edward D. Miller, MD Journal of the American Medical Association, April 8, 2009
"It is time for academic medicine to return to its historic roots by focusing on the long-established mission of improving the health of the public. Academic medicine can do this by uniting and integrating its unique strengths—excellence in education, research, and clinical care—within an administrative structure that encourages and facilitates the use of all resources to support the mission of improving health. The administrative structure that best accomplishes this goal is an integrated health system in which the school of medicine, hospital(s), and research enterprise are within a single integrated structure with strategic planning occurring in all 3 activities and with the ultimate goal of improving the health of the public." Read More…

The Ethical Foundations of American Medicine
Darrell G. Kirch, MD and David J. Vernon, MD, Journal of the American Medical Association, April 8, 2009
"Following a historic electoral transition accompanied by an economic downturn unprecedented in the lives of most US residents, attention has once again turned to improving the cost and effectiveness of health care in the United States. While many have described the dysfunctional aspects of the US health care system, the focus has prioritized issues of payment systems2 and delivery models3 over a fundamental underlying ethical conflict. Within an ethical context, it is important to discuss how the commercialization of medicine has fostered a distortion of emphasis among the basic tenets of medical ethics, and how this unbalanced emphasis has created serious barriers to improving the health care system." Read More…

Report: Growth of Medical Schools Brings Opportunity to Redefine Their Mission
March 18, 2009 – Journal of the American Medical Association
Medical schools in the United States are not doing enough to find the right students to train for careers in medicine and are not adequately addressing the needs of a diversifying patient population. However, the current environment of expansion of US medical school slots provides an opportune moment to address these issues. So said medical education experts in a report, Revisiting the Medical School Educational Mission at a Time of Expansion, released January 29 by the Josiah Macy, Jr. Foundation." Read More…

Health Care and the American Recovery and Reinvestment Act
Robert Steinbrook, M.D., New England Journal of Medicine, February 17, 2009
"On February 17, 2009, four weeks after his inauguration, President Barack Obama signed into law a $787 billion economic stimulus package. The act also provides $650 million to support prevention and wellness activities…including $300 million to revitalize the National Health Service Corps (NHSC). The NHSC provides loan repayment, salary support, and scholarships for physicians and other providers who practice in underserved areas." Read More…

Great Expectations – The Obama Administration and Health Care Reform
New England Journal of Medicine, January 22, 2009
"Health care reform is back. For the first time since 1993, momentum is building for policies that would move the United States toward universal health insurance. President Barack Obama has made health care a central part of his domestic agenda, and key members of Congress have promised to introduce ambitious health care reform legislation in 2009. Groups long opposed to reform, including the insurance industry, are reportedly prepared to make a deal. There is thus growing sentiment that "the prospects for meaningful health care reform have never looked better." Read More…

Archive »Reports

Results of the 2009 Medical School Enrollment Survey
April 2010 – Association of American Medical Colleges

Project Medical Education: 2009 Year In Review
March 2010 – Association of American Medical Colleges
"Project Medical Education (PME) is helping to educate Congress and other policymakers about the process of medical education, the benefits it provides, its complex funding mechanisms, and the essential role of government in providing financial support.. The PME Year in Review is an annual report summarizing 2009 PME programs, highlighting the 10 years of the program, and offering resources for new program hosts." Read More…

Cost of Medical School Rises in Recession
March 9, 2010 – National Public Radio
"A New Jersey family is struggling to pay for their daughter's medical school education. They know that the average doctor graduates with about $150,000 of student loans, and wonder how they're ever going to pay it." Read More…

County Health Rankings
February 17, 2010 – Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute
"The County Health Rankings—the first set of reports to rank the overall health of every county in all 50 states—were released today by the University of Wisconsin's Population Health Institute and the Robert Wood Johnson Foundation at a briefing in Washington, D.C and on www.countyhealthrankings.org. The 50 state reports help public health and community leaders, policy-makers, consumers and others to see how healthy their county is, compare it with others within their state and find ways to improve the health of their community." Read More…

The Medical Education of Physicians
February 17, 2010 - National Health Policy Forum
"This background paper provides a descriptive overview of the process of education, licensing, certification, and continuing education involved in becoming and continuing to practice as a physician." Read More…

Future of Medical Education in Canada (FMEC): A Collective Vision for MD Education
February 2010 - The Association of Faculties of Medicine of Canada
"Just as Abraham Flexner's report did 100 years ago, The Future of Medical Education in Canada (FMEC) project looks at how the education programs leading to the medical doctor (MD) degree in Canada can best respond to society's evolving needs. In turn, the FMEC project is rooted in the Association of Faculties of Medicine of Canada's (AFMC's) articulated social accountability mission for medical schools." Read More…

Viewpoint: AHECs: A National Tool for Distribution
December 2009 – AAMC Reporter
"In 1971 Congress passed the Comprehensive Health Manpower Training Act to address the deterioration of the numbers, distribution, and composition of the nation's health professions. This landmark legislation created an innovative model for education of the nation's health professionals, the Area Health Education Center program (AHEC). The design of AHECs as a national tool to address geographic and specialty maldistribution was based on recommendations to Congress by the 1970 Carnegie Commission, which was led at the time by Clark Kerr." Read More…

Closing the Health Care Workforce Gap
January 2010 – Center for American Progress
"As our nation grapples with reforming the U.S. health care system to cover the uninsured, improve the quality of health care, and cut overall costs in the long term, we must consider provisions to assure an adequate health care workforce. Primary care clinicians—those providing the most basic, frontline health services—continue to decrease in numbers and there are many pockets around the country without enough health care providers overall."
To read the executive summary, click here.
To read the full report, click here.

National Trends in the United States of American Physician Assistant Workforce from 1980-2007
November 26, 2009 – Human Resources for Health
"The physician assistant (PA) profession is a nationally recognized medical profession in the United States of America (USA). However, relatively little is known regarding national trends of the PA workforce. We examined the 1980-2007 USA Census data to determine the demographic distribution of the PA workforce and PA-to-population relationships. Maps were developed to provide graphical display of the data. All analyses were adjusted for the complex census design and analytical weights provided by the Census Bureau." Read More…

Physician Workforce in Nevada: Characteristics and Distribution
November 2009 - Medical Education Council of Nevada
"This volume contains current, historical, and comparative data on the allopathic (MD) and osteopathic (DO) physician workforce in Nevada. The principal purpose of this and future editions is to improve health workforce planning and policy development in Nevada through the preparation and dissemination of accurate information on the physician workforce." Read More…

New and Developing Medical Schools: Motivating Factors, Major Challenges, Planning Strategies
October 2009 – Josiah Macy, Jr. Foundation
"During the period from 1960 to 1980, 40 new medical schools were established in the United States, resulting in an almost 50 percent increase in the total number of schools in the country. The development of the new schools was largely a response to the widely held view that the country was facing a major shortage of physicians, which could only be avoided by increasing significantly the number of students graduating from the nation's medical schools." Read More…

Access to Care: Beyond an Insurance Card
November 2009 – The Alliance for Health Reform
"Policymakers are debating how to cover the more than 46 million uninsured in the U.S. But if tens of millions of Americans gain coverage, does the current health care system have the capacity to meet the new demand? It is estimated that more than 36 million people already live in physician shortage areas and are currently underserved. Projections indicate a worsening of the shortage even if coverage is not expanded." Read More…

2009 State Physician Workforce Data Book
November 2009 – Association of American Medical Colleges Center for Workforce Studies
"The 2009 State Physician Workforce Data Book is an update of the 2007 State Physician Workforce Data Book, examining current physician supply, medical school enrollment, and graduate medical education in the U.S. The report provides the most current data for each state and the District of Columbia in a series of figures and tables, including the U.S. average, state median (excluding DC), and state rank. Additionally, the 2009 edition includes key findings, a new series of U.S. maps, as well as several new figures and tables." Read More…

The Comprehensive Congressional Health Reform Bills of 2009: A Look at Health Insurance, Delivery System, and Financing Provisions
October 23, 2009 – The Commonwealth Fund
"This report provides an overview of key provisions of the two separate comprehensive health reform bills passed by the five committees of jurisdiction in the U.S. Congress: the Finance Committee and the Health, Education, Labor, and Pensions (HELP) Committee of the Senate, and the Ways and Means, Education and Labor, and Energy and Commerce committees of the House of Representatives." Read More…

Medicare Physician Services: Utilization Trends Indicate Sustained Beneficiary Access with High and Growing Levels of Service in Some Areas of the Nation
Government Accountability Office, August 2009

A Critical Match: Nebraska's Health Workforce Planning Project
September 2009 – Nebraska Center for Rural Health Research
"In September 2007, with funding from the University of Nebraska Foundation Larson Medical
Research Fund, staff of the Nebraska Center for Rural Health Research undertook a health workforce planning project for Nebraska. The purpose of this project was to develop a strategy for meeting the health care workforce needs of Nebraska. This project was completed in four phases over two years. Nebraska should act now on current health care workforce needs and on future projections, particularly because of the mal-distribution of the workforce and expected growth of the elderly population and coverage of the uninsured." Read More…

Physician Workforce Study 2009
September 14, 2009 – Massachusetts Medical Society
"The Massachusetts Medical Society's eighth annual Physician Workforce Study found that seven physician specialties in Massachusetts are operating under severe labor market conditions. The report's key findings include: 1. The primary care specialties of family medicine and internal medicine are in short supply for the fourth consecutive year; 2. The percentage of primary care practices closed to new patients is the highest it's ever been as recorded by the Medical Society; 3. Recruitment and retention of physicians remains difficult, especially at community hospitals and especially with primary care." Read More…

Estimated Effects of Sec. 1721 of Draft Bill HR 3200 on Physician Gross Revenue
September 2009 – Robert Graham Center
"House draft bill H.R. 3200 was introduced in the House on July 13, 2009. Since then it has undergone committee consideration and a mark-up session. This white paper reports on analyses to assess and estimate the effects of Section 1721 of draft bill HR 3200 on the total gross revenue of the average physician nationally and the total gross revenue of the average family physician in each state. It shows the widely variable but important impact." Read More…

Decreasing Self-Perceived Health Status Despite Rising Health Expenditures
The Robert Graham Center, September 1, 2009
"Despite steady increases in U.S. health care spending, the population's self-perceived health status has been in a long-term decline. Increased support for public health, prevention, and primary care could reduce growth in spending and improve actual and perceived health. Continuing to spend more on our fragmented health care system is unlikely to change the pattern of high expenditures and suboptimal health. Countries that invest in comprehensive primary care systems have better health outcomes, patient satisfaction, uptake of preventive services, and lower mortality." Read More…

Physicians and their Practices Under Health Care Reform
The Physicians Foundation, September 9, 2009
"A report commissioned by The Physicians Foundation, a national healthcare organization that represents the interests of physicians, raises new questions about the role of socioeconomic determinants as they relate to access, quality, and cost of medical care in the United States. The report, prepared by a team of noted physicians and economists headed by Richard "Buz" Cooper, MD, Professor of Medicine and Senior Fellow at the Leonard Davis Institute of Health Economics, University of Pennsylvania, was sent to the President and Congress in order to contribute to the national health care debate." Read More…
To read the press release, click here.
To read the executive summary, click here.
To read the report, click here.

Annual New York Physician Workforce Profile 2008

The New York Health Workforce Data System, The Center for Health Workforce Studies, 2009

"This report offers a profile of the supply and distribution of physicians licensed in New York based on the latest data collected from the Center for Health Workforce Studies' ongoing New York

State Physician Licensure Re-registration Survey. With presentations of physician workforce data at several aggregate levels, including state, region, county, and specialty, the report is intended to provide useful information for policy makers, educators, and other interested parties across the state." Read More…

Crossing Our Lines: Working Together to Reform the U.S. Health System
Bipartisan Policy Center and The Leaders' Project, June 2009
"This report presents key findings from the Leaders' sustained effort to develop consensus on bipartisan policy recommendations for health care reform. Their goal was to develop a comprehensive but achievable set of policies to ensure that all Americans have quality, affordable health insurance coverage, while constraining cost growth, promoting innovative delivery of care, and focusing treatments more on the patient, and not just the illness." Read More…

MedPAC Releases Report on Medicare Payment Policy
Medicare Payment Advisory Commission, June 15, 2009
"Today the Medicare Payment Advisory Commission (MedPAC) releases its June 2009 Report to the Congress: Improving Incentives in the Medicare Program. MedPAC's report focuses on how incentives in the Medicare payment systems could be changed to strengthen the Medicare program and promote quality care for Medicare beneficiaries."
To read the press release, click here.
To read the full report, click here.

Health Care Reform and the Federal Budget
Congressional Budget Office, June 16, 2009
"Because the Congress is now considering major legislation affecting health care and health insurance, the possible effects on the federal budget have received significant attention. To elucidate those effects, this analysis examines the budget outlook under current law; the likely budgetary effect of efforts to expand the scope of insurance coverage; the potential for reducing health care spending; the likely impact of specific changes in the health system; and mechanisms for engendering efficiency gains in health care over time." Read More…

The Effect of Facilitation in Fostering Practice
The Robert Graham Center, June 2009
"Working with facilitation agents measurably improves the ability of motivated primary care practices to move towards improved models of care. Widespread primary care practice transformation will likely require facilitation capacity in most communities." Read More…

Access to and Affordability of Care in Massachusetts as of Fall 2008: Geographic and Racial/Ethnic Differences
The Urban Institute - May 2009
"Massachusetts continues to move forward on comprehensive health reform, with improvements in coverage, access to care and the affordability of care in the state. This policy brief provides a supplement to a recent Health Affairs article on health reform in Massachusetts, examining geographic and racial/ethnic differences in access to care and affordability of care across the commonwealth in Fall 2008." Read More…

Financing Community Health Centers as Patient- and Community-Centered Medical Homes: A Primer
The George Washington University - May 27, 2009
"This report shows that although health centers play a critical role in providing preventive and primary care for many uninsured and insured Americans who cannot afford health care, they face numerous payment policy challenges which could undermine their mission. Any effort to improve health care financing should not only incentivize high performance but also recognize and support fairly the higher burden of costs associated with medically vulnerable populations." Read More…

Graduate Medical Education: Trends in Training and Student Debt
Government Accountability Office - May 4, 2009
"The federal government invests significantly in medical education through various programs to help ensure that the anticipated supply of new physicians meets the nation's health care needs. Medicare, the federal health care program for elderly and certain disabled people, subsidizes training for medical school graduates in hospitals and other teaching institutions by helping to support the increased costs associated with postgraduate medical training." Read More…

The Public and the Health Care Delivery System
Kaiser Family Foundation, NPR, Harvard School of Public Health - April 2009
"This survey by NPR and researchers at the Kaiser Family Foundation and the Harvard School of Public Health highlights the public's attitudes and experiences with the American health care delivery system. The new survey sheds light on Americans' experiences with issues more typically discussed by health policy experts – including electronic medical records, coordination of care and comparative effectiveness – all of which have become serious components of reform plans and some of which have been signed into law this year. It also covers public opinion on possible policy changes." Read More...

Specialty and Geographic Distribution of the Physician Workforce: What Influences Medical Student and Resident Choices?
The Robert Graham Center - March 2, 2009
"Unlike many Western nations, the United States does not manage or actively regulate the number, type, or geographic distribution of its physician workforce. As a result, medical trainees choose how and where to work. As with most free markets, equitable distribution is at risk without well-informed, evidence-based policies and incentives capable of promoting equitable access to appropriate care. This study contributes to understanding of important policy options and incentives by identifying factors that influence medical student and resident choices about medical specialties and location of practice. Specifically, it identifies factors that are associated with choice of primary care specialties, particularly family medicine, and with caring for rural and underserved populations."
Click here for the full report

Macy Foundation Releases Chairman's Summary of the Conference on Revisiting the Medical School Educational Mission at a Time of Expansion
Josiah Macy, Jr. Foundation - January 29, 2009
"Calling this period 'an unparalleled opportunity' for change, an influential group of medical leaders today urged the nation's medical schools to reform their educational model because it too often fails to give new physicians the right mix of competencies and experiences to practice medicine effectively. The call to action for education reform comes as medical schools are expanding their enrollments for the first time in 30 years to address a shortage of physicians in the United States."
Click here to read the press release.
Click here to read Chairman's Summary.

The Complexities of Physician Supply and Demand: Projections Through 2025
Association of American Medical Colleges - November 2008
"Using the most recently available data, a new report by the AAMC Center for Workforce Studies projects future supply and demand for physicians and concludes that a national shortage is likely driven by such factors as U.S. population growth, aging population and doctors, and increased physician visits, the demand for doctors will outstrip the supply through at least 2025." Read More…

Archive »In Legislation/On The Hill

Coming Soon: Part Time National Health Service Corps Part Time Service Option
March 2010 – Health Resources and Services Administration
For application and eligibility information, click here.
To sign up to be notified when the Application Bulletin becomes available, click here.

Health Insurance Reform at a Glance: Strengthening the Nation's Health Workforce
March 20, 2010 – House Committees on Ways and Means, Energy and Commerce, and Education and Labor

House Passes Historic Health Care Reform Legislation
March 21, 2010 – Washington, DC

President Signs Health Care Bill into Law
March 23, 2010 – Washington, DC

White House Holds Televised Bipartisan Health Care Summit
February 25, 2010 - Washington, DC

Pelosi: House Won't Pass Senate Bill to Save Health-Care Reform
January 22, 2010 – Washington Post

Senate Passes Patient Protection and Affordable Care Act (H.R. 3590)
December 24, 2009 – Washington, DC

President Obama Announces Recovery Act Awards to Build, Renovate, Community Health Centers in More Than 30 States
December 9, 2009 – Washington, DC

Senate Releases the Patient Protection and Affordable Care Act (H.R. 3590)
November 18, 2009 – Washington, D.C.

House Passes Affordable Health Care for America Act (H.R. 3962)
November 7, 2009 – Washington, D.C.

House Democrats Release Health Care Bill
October 29, 2009 – Washington, D.C.

Senate Finance Committee Approves America's Healthy Future Act
October 13, 2009 – Washington, D.C.

Tiberi to Chair New Congressional Caucus on Academic Medicine
October 8, 2009 – Washington, D.C.

Senate Finance Committee Holds Open Executive Session to Consider an Original Bill Providing for Health Care Reform
September 22, 2009 – Washington, D.C.

Modifications to the Chairman's Mark: America's Healthy Future Act of 2009
September 22, 2009 – Washington, D.C.

Congressional Budget Office Analysis of America's Healthy Future Act
September 16, 2009 – Washington, D.C.

Senate HELP Committee Passes Affordable Health Choices Act
July 15, 2009 – Washington, D.C.
"The Senate's Health, Education, Labor and Pensions (HELP) Committee today passed The Affordable Health Choices Act, landmark legislation that will reduce health costs, protect individuals' choice in doctors and plans, and assure quality and affordable heath care for Americans."
To read the full press release and summary of the bill, click here.

Chairman's Mark: America's Healthy Future Act of 2009
September 16, 2009 – Washington, D.C.

President Obama Addresses the Joint Session of Congress on Health Care
September 9, 2009 – Washington, D.C.

HHS Secretary Sibelius Releases $33 Million in ARRA Funds to Train Health Professionals
September 11, 2009 – Washington, D.C.

House Democrats Unveil Health Care Reform Plan
July 14, 2009 – Washington, D.C.
"House Democrats unveiled their revised version of health care reform Tuesday, offering a proposal that includes a government-funded health insurance option, requires both individuals and employers to participate, and taxes the wealthy to help cover costs. Democratic House leaders said the measure, titled "America's Affordable Health Choices Act," met the requirements set by President Obama for health care reform by lowering costs to consumers and businesses, letting people keep their current plan if desired, and preventing denial of coverage due to pre-existing medical conditions." Read More…

House Introduces the Access to Frontline Health Care Act of 2009
June 16, 2009 – Washington, D.C.
On June 16, Bruce Braley (D-IA) introduced H.R. 2891, the Access to Frontline Health Care Act of 2009. The bill will create a new loan repayment program, help place health care personnel in underserved areas, and allow flexibility for States to help bring health care providers to specific areas of need. Read More…

Congressional TriCaucus Introduces Health Disparities Bill
June 26, 2009 – Washington, D.C.
On June 26, members of the Congressional TriCaucus — the Congressional Black Caucus, Congressional Hispanic Caucus and Congressional Asian Pacific American Caucus — introduced the Health Equity and Accountability Act of 2009. The bill outlines some of the TriCaucus priorities for health reform legislation to eliminating racial, ethnic and other disparities in access to health services and health status. Read More...

House and Senate Introduce Rural Veterans Health Care Improvement Act of 2009
July 1, 2009 – Washington, D.C.
The House recently introduced a bill that will give rural veterans better access health care and services, and is a companion bill to the Senate version introduced in March. The House version (H.R. 2879) was introduced by Ann Kirkpatrick (D-AZ) and the Senate Version (S. 658) was introduced by Jon Tester (D-MT).
To read the House bill, click here.
To read the Senate bill, click here.

House Small Business Committee holds hearing on The Looming Challenge for Small Medical Practices: The Projected Physician Shortage and How Health Care Reforms Can Address the Problem
July 8, 2009 – Washington, D.C.
"On July 8, the House Small Business Committee held a hearing to examine the future physician shortage and how it will impact small medical practices. The witnesses will provide their views on measures to address the workforce shortfall as part of comprehensive healthcare reform." Read More…

Centers for Medicare and Medicaid Services Proposes Rule that Would Increase Medicare Payments for Primary Care Physicians
July 1, 2009 – Washington, D.C.
"The Centers for Medicare & Medicaid Services (CMS) announced today proposed changes to policies and payment rates for services to be furnished during calendar year (CY 2010) by over 1 million physicians and nonphysician practitioners who are paid under the Medicare Physician Fee Schedule (MPFS). CMS is making several proposals to refine Medicare payments to physicians, which are expected to increase payment rates for primary care services." Read More…
To read the complete rule, click here.

House Energy and Commerce Committee Holds Series of Hearings on Tri-Committee Health Care Reform Bill
June 23-25, 2009 - Washington, D.C.
The House Energy and Commerce Subcommittee on Health held a series of legislative hearings on the health care reform draft bill.
For information on the full set of hearings, click here.
For Day 1 witnesses and testimony, click here.
For Day 2 witnesses and testimony, click here.
For Day 3 witnesses and testimony, click here.

House Committee on Education and Labor Holds Hearing on the Tri-Committee Draft Proposal for Health Care Reform
Washington, D.C. - June 23, 2009
"On June 23, The House Education and Labor Committee held a hearing on the forthcoming draft proposal for health care reform developed by the House Ways and Means, Energy and Commerce, and Education and Labor Committees. The draft proposal is designed to achieve President Obama's goals of controlling health care costs, preserving health care choices, and ensuring quality, affordable health care for all Americans."
For complete information on the hearing including witness testimonies, click here.
To watch Dr. Mullan's testimony on workforce, click here.

House Releases Tri-Committee Health Care Reform Bill
Washington, D.C. - June 19, 2009
"On June 19, the chairmen of the three committees with jurisdiction over health policy in the U.S. House of Representatives unveiled their discussion draft for health care reform. The draft would reduce out-of-control costs, improve choices and competition for consumers and expand access to quality, affordable health care for all Americans. It would also guarantee that almost every American is covered by a health care plan that is both affordable and offers quality, standard benefits by 2019."
For more information on the bill, click here.
To read a summary of the bill, click here.
To read the full text of the bill, click here.

Secretary Sebelius Makes Recovery Act Funding Available to Bolster Health Care in Needy Communities, Relieve Providers' Student Debt
Washington, D.C. - June 5, 2009
"HHS Secretary Kathleen Sebelius today announced the availability of nearly $200 million from the American Recovery and Reinvestment Act to support student loan repayments for primary care medical, dental and mental health clinicians who want to work at National Health Service Corps (NHSC) sites. In exchange for the loan repayments, clinicians serve for two years with the Corps. The new funds are expected to double the number of Corps clinicians and make 3,300 awards to clinicians that serve in health centers, rural health clinics and other health care facilities that care for uninsured and underserved people. " Read More…

Kennedy and the Senate Health, Education, Labor and Pensions Committee Announce the "Affordable Health Choices Act"
Washington, D.C. - June 9, 2009
"For the past year, Chairman Edward M. Kennedy and Democratic Members and staff of the Senate Committee on Health, Education, Labor and Pensions (HELP)have been working to develop legislation that reduces health care costs, allows Americans to keep the coverage they have if they want it, and makes health insurance affordable to those who do not have it today. Today, while discussions between HELP Committee Democrats and Republicans on key outstanding issues continue, Chairman Kennedy released the landmark 'Affordable Health Choices Act.'"
To read entire press release, click here.
To read the bill, click here.

Senate Finance Committee Releases Health Reform Options Paper
Washington, D.C. - May 20, 2009
On May 20, 2009, the Senate Finance Committee released a document outlining policy options for financing health care reform. This is the final paper to be released before health reform legislation is drafted.
Click here to read the options paper.

House Introduces Preserving Patient Access to Primary Care Act
Washington, D.C. - May 12, 2009
On May 12, 2009, Rep. Allyson Schwartz (D-PA13) introduced the Preserving Patient Access to Primary Care Act (H.R. 2350). The purpose of the bill is to strengthen the nation's primary care infrastructure by providing scholarships, loan forgiveness, deferral of loan repayments and grants.
Click here for more information about the bill.
Click here to read the full bill.

Senate Finance Committee Holds Roundtable on Expanding Health Care Coverage
Washington, D.C. - May 5, 2009
Last week, the Senate Finance Committee held the second in a series of roundtables on health care reform. This discussion focused on Increasing Access to Health Care Coverage. Witnesses included Sara Rosenbaum, Diane Rowland, Jennie Chin Hansen, Ron Pollack and others. The series concludes on May 14 with a discussion on Financing Comprehensive Health Care Reform. To read the statements of the committee chairmen and witnesses, click here.

House Votes to Affirm Option to Use Budget Reconciliation Process to Fast Track Health Care Legislation
San Francisco Chronicle - April 27, 2009
"Democrats controlling the House went on record again Wednesday in favor of advancing health care legislation while allowing only limited debate, which would minimize the ability of Republicans to wrest concessions on one of President Barack Obama's top domestic priorities. By a 227-196 vote, the House affirmed Democrats' plans to move health care legislation under rules that block Republicans in the Senate from being able to slow — or even stop — it from proceeding." Read More…

Senators Baucus and Kennedy Write Letter to President Obama Committing to Delivery of Health Care Reform Bill by Summer
Washington, D.C. - April 20, 2009
Senate Finance Committee Chair Max Baucus (D-Mont.) and Senate Health, Education, Labor and Pensions Committee Chair Edward Kennedy (D-Mass.) confirmed in a letter to President Obama their intentions to mark up separate health care overhaul bills in June. The letter to the President stated, "Our intention is for the legislation to be very similar, and to reflect a shared approach to reform, so that the measures that our two committees report can be quickly merged into a single bill for consideration on the Senate floor". The senators wrote, "We have a moral duty to ensure that every American can get quality health care," adding, "We must act to contain the growth of health care costs to ensure our economic stability; to help American businesses deal with the health care challenge; and to make sure that we are getting our money's worth". Read More…

Senators Introduce the Resident Physician Shortage Reduction Act of 2009
Washington, D.C. - May 5, 2009

House of Representatives Introduces Companion to Resident Physician Shortage Bill
Washington, D.C. - May 5, 2009

Senate Confirms Sibelius as HHS Secretary
The Washington Post - April 29, 2009
"President Obama's Cabinet was finally filled yesterday after the Senate, on the eve of President Obama's 100th day in office, voted 65 to 31 to confirm Kathleen Sebelius to head the Department of Health and Human Services. Hours later, the former Kansas governor was sworn in in an Oval Office ceremony." Read More…

Senate Finance Committee Holds Roundtable on Delivery System Reform
Washington, D.C. - April 21, 2009
Last week, the Senate Finance Committee held the first in a series of roundtables on health care reform. The first discussion, moderated by Health Affairs Founding Editor John Iglehart, was on "Reforming America's Health Care Delivery System" and focused on improving the quality and efficiency of care and strengthening the system's primary care base. The series continues on May 5 with a roundtable discussion on Increasing Access to Health Care Coverage and concludes on May 14 with a discussion on Financing Comprehensive health Care Reform.
To read the statements of the committee chairmen and witnesses, click here.

MedPAC Releases Report on Medicare Payment Policy
Medicare Payment Advisory Commission - February 27, 2009
"MedPAC's report offers a set of recommendations for Medicare payments designed to assure beneficiaries' access to care and preserve Medicare's long-term sustainability." The latest report reiterates previous recommendations to establish a budget-neutral primary care payment adjustment and recommends an adjustment to the Medicare graduate medical education indirect payment adjustment.
Click here to read the full report.
Click here to read the press release.

President Signs The American Recovery and Reinvestment Act Into Law
Washington, D.C. - February 17, 2009
Last week Congress approved the economic stimulus package (the House by a vote of 246-183 and the Senate by a vote of 60-38) and on February 17 President Obama signed into law The American Recovery and Reinvestment Act of 2009. The law provides $500 million to the Health Resources and Services Administration for health professions workforce development. Of this provision, $300 million is allocated for the National Health Service Corps and the remaining $200 million is allocated for Title VII and Title VIII programs.
Click here for a summary.
Click here for complete information including overview, summary, full text, committee assignments, and related legislation.
Click here for the House conference report and accompanying explanatory statements.

Archive »News

Teaching Physicians the Price of Care
May 3, 2010 – New York Times
"When Dr. Ryan Thompson, an internist, was a medical resident at Massachusetts General Hospital in Boston a few years ago, he worried that he and his fellow trainees weren't learning about the cost of medical treatments, the financing of health care and the impact of high medical bills on their patients." Read More…

For Health Centers, State Cuts Loom Even as Federal Funds Rise
May 3, 2010 – North Bay Business Journal
"While community health centers are widely seen as winners with the passage of a sweeping health bill in late March, such centers in California face potentially crippling state budget cuts, which could offset potential gains that won't take effect until 2014, according to clinic directors throughout the North Bay." Read More…

With Medicaid Cuts, Doctors and Patients Drop Out
March 15, 2010 – New York Times
"It has not taken long for communities like Flint to feel the downstream effects of a nationwide torrent of state cuts to Medicaid, the government insurance program for the poor and disabled. With states squeezing payments to providers even as the economy fuels explosive growth in enrollment, patients are finding it increasingly difficult to locate doctors and dentists who will accept their coverage. Inevitably, many defer care or wind up in hospital emergency rooms, which are required to take anyone in an urgent condition." Read More…

Obama Signs Health Care Overhaul Bill, With a Flourish
March 23, 2010 – New York Times
"With the strokes of 20 pens, President Obama signed his health care overhaul — the most sweeping social legislation enacted in decades — into law on Tuesday during a festive, at times raucous, White House ceremony." Read More...

Match Results: 2010 Fill Rate for Family Medicine Highest Ever
March 18, 2010 – AAFP News Now
"After a downturn in 2009, more U.S. medical students chose family medicine as their specialty this year, resulting in a fill rate of 91.4 percent, the highest percentage for family medicine ever, according to the results of the 2010 National Resident Matching Program, or NRMP, also known as the Match." Read More…

More U.S. Medical School Seniors to Train as Family Medicine Residents
March 18, 2010 – National Residency Matching Program

Obama Hails Vote on Health Care as Answering the 'Call of History'
March 21, 2010 – New York Times
"House Democrats approved a far-reaching overhaul of the nation's health system on Sunday, voting over unanimous Republican opposition to provide medical coverage to tens of millions of uninsured Americans after an epic political battle that could define the differences between the parties for years. With the 219-to-212 vote, the House gave final approval to legislation passed by the Senate on Christmas Eve." Read More…

House Passes Health-Care Reform Bill Without Republican Votes
March 22, 2010 – Washington Post
"House Democrats scored a historic victory in the century-long battle to reform the nation's health-care system late Sunday night, winning final approval of legislation that expands coverage to 32 million people and attempts to contain spiraling costs." Read More…

Doctor Shortage Fuels Nurses' Push for Expanded Role
February 22, 2010 - National Public Radio
"There are no doctors in rural Tyrrell County, N.C. There is only Irene Cavall, a licensed nurse practitioner and the sole source of primary care for 4,000 residents spread out over 600 square miles. Nursing leaders say large numbers of practitioners like Cavall will be needed to fill gaps in primary care left by an increasing shortage of doctors, a problem that would intensify if Congress extends health insurance to millions more Americans." Read More…

Northwestern Med Students Practice Improv
February 15, 2010 – Chicago Tribune
"In the only such program in the nation, Watson — a lawyer, medical ethicist, improv performer and faculty member at Second City — teaches improvisational theater at Northwestern's medical school, where she is an assistant professor in the Medical Humanities and Bioethics Program. Learning improv will help students to be better doctors, Watson said. For example, learning not to make assumptions about new characters will help them avoid making assumptions about new patients." Read More…

New Med School Aims to Shrink Doctor Shortage
February 16, 2010 – WHYY News and Information

Expecting a Surge in U.S. Medical Schools
February 14, 2010 – New York Times
"Peter Allen applied to 30 medical schools after graduating from the University of Pittsburgh last year. Twenty-eight said no. Of the two that said yes, one had something in common with Mr. Allen: It, too, was starting out in medicine. He enrolled in the inaugural class of The Commonwealth Medical College in Scranton, Pa." Read More…

Stimulus Money Funds Doctors
January 26, 2010 - CNN

New Medical School to Strengthen Health Care
January 15, 2010 – Indiana Business
"Officials for Marian University and the Indiana Osteopathic Association say the school's new college of osteopathic medicine will help boost the availability of quality health care in the state. President Dan Elsener says the college fits the state's strategy for growing medical and life sciences and it can help fill the ranks of primary care physicians." Read More…

Do you Have the "Right Stuff" to Be a Doctor?
January 14, 2010 - New York Times
"Not long ago, a friend confessed that her son, who spends much of his free time volunteering at a children's hospital and who is applying to medical school, has been particularly anxious about his future. 'His test scores are just O.K.,' my friend said, the despair in her voice nearly palpable. 'I know he'd be a great doctor, but who he is doesn't seem to matter to medical schools as much as how he does on tests.'" Read More…

Nurse Practitioners Play Key Role in Providing Health Care
November 22, 2009 – Yakima Herald
"But nurse practitioners and other allied health professionals are poised to become important warriors on the front lines of primary-care medicine, where projections of a shortage have many policy experts worried about the real impact of health care reform that expands coverage to nearly everyone. 'I think there's a huge role for nurse practitioners, physician assistants and nurse midwives as we face the primary-care shortage in this county,' said Anita Monoian, chief executive of Yakima Neighborhood Health Services." Read More…

Before Any Healthcare Reform, U.S. Doctor Supply is Already Strained
November 23, 2009 – Miami Herald
"It's a phrase people are loath to hear when they're looking for a new primary-care doctor: Not accepting new patients. Some parts of the country already lack an ample supply of general internists, pediatricians and family physicians, forcing patients to drive further or wait longer for care. If a comprehensive health reform bill passes and extends coverage to millions of uninsured Americans, many are asking if there will be enough primary-care doctors to handle the increased demand for medical services." Read More…

Making Health Care Better
November 3, 2009 - New York Times

Podcast: Paying Doctors
November 4, 2009 - National Public Radio

Med Schools Offer Doses of New Reality
November 10, 2009 – Washington Post
"Changes such as these are happening across the United States as graduate schools try to catch up with a dramatically changing medical landscape. They need to prepare students for a world where mainstream doctors adopt holistic or alternative techniques, where doctors' offices portray themselves as "medical homes" offering "patient-centered" care, where primary-care physicians are increasingly in demand -- and, of course, where the system of paying for health care is likely to undergo a major upheaval. Catering to these needs, medical experts say, could help future doctors offer preventive care first, reactionary second." Read More…

Tough to Find Doctors for Small Wash. Towns
October 11, 2009 – Seattle Times
Mero said it's his belief that the state and nation don't have a doctor shortage so much as a 'doctor distribution problem.' There's been a sharp decline in the number of medical school graduates who choose family medicine residencies, according to the American Academy of Family Physicians. It's hard to blame doctors for choosing from among the wide range of specialties, such as oncology or surgery, instead of family medicine." Read More…

Doctor Shortage Prompts Shift in Medical Education
October 11, 2009 – Denver Post
"In a shivery-cold room inside a three-story building on the prairie, brand-new medical students dressed in white lab coats cut into cadavers. These Rocky Vista University students are Colorado's future doctors, an upcoming class of medical trainees needed to stave off a national physician shortage, which the Council on Graduate Medical Education predicts will reach 85,000 in the next decade. Colorado's two medical schools began training a combined 322 aspiring physicians this fall, far less than what's needed to meet the looming shortage." Read More…

Health Bills Won't Fix Doctor Shortage
October 12, 2009 – Kaiser Health News
"Even as Congress moves to expand health insurance coverage to millions of Americans, it's doing little to ensure there will be enough primary care doctors to meet the expected surge in demand for treatment, experts say. The American Academy of Family Physicians predicts that the shortage of family doctors will reach 40,000 in the next 10 years, as medical schools send about half the needed number of graduates into primary care medicine." Read More…

Official Says Medical School Will Be Active in Community
DemocratHerald.com, September 3, 2009
"Students and faculty at the new College of Osteopathic Medicine of the Northwest will be active members of the community, according to Dirk Foley. The new medical school will be jointly run by Pomona-based Western University and Samaritan Health Services and is scheduled to open in 2011. Construction is under way at the campus site across from Samaritan Lebanon Community Hospital on Highway 20." Read More…

Medical Students Worry Health Care Reform Will Hurt Chances to Pay Back Student Loans
New York Daily News, September 6, 2009
"The doctors of the future are sick with worry - for their patients, for the nation and for their future bottom lines. As politicians in Washington haggle over health care, New York's strapped medical students are increasingly worried about their earning power - and crushing school debts - as the health care pie gets sliced anew." Read More…

Summer of Work Exposes Medical Students to System's Ills
New York Times, September 8, 2009
"This summer, medical students from the University of Washington took a long look under the hood of the health care system they are about to inherit, and many returned to campus last week with their eyes wide open and their idealism tempered. For 21 years, the University of Washington School of Medicine has dispatched its rising second-year students across the Northwest to provide primary care in rural or underserved areas. The monthlong program is elective, but a record number of students took part this year — 117 from a class of 216." Read More...

For Them, Reform Could Hit Close To Home
The Baltimore Sun, September 3, 2009
"With heated debates about reforming health care swirling across the country, professors from the University of Maryland's graduate schools told more than 200 students about how proposed changes might affect their future careers in medicine, dentistry, nursing, law, pharmacy and social work at a panel discussion Thursday night in downtown Baltimore. All the professors agreed that the U.S. health care system needs to be reformed." Read More…

Tumultuous Environment Makes a Health Care Compromise More Unlikely

The New York Times - August 9, 2009
"Spontaneous or contrived, the shouting, shoving and other shenanigans at lawmakers' town-hall-style meetings point to one probable outcome: the demise of bipartisan health care negotiations. Those negotiations have proceeded tortuously all summer, with centrists on the Senate Finance Committee maneuvering around obstacles erected by the Democratic left, the Republican right and the White House." Read More…

Community Health Centers Vital to Any Health Overhaul
McClatchy Tribune - August 14, 2009
"While the health care debate rages on Capitol Hill, the Walker-Jones Health Center in northeast Washington is just a mile away, one of about 1,200 federally qualified community health centers across the country that provide free and reduced-cost care to millions of Americans. These centers, which have seen their caseloads increase significantly with the growing number of uninsured Americans and the economic tumult of the recession, appear to be in line for a major rise in federal support and probably a corresponding crush in patients seeking treatment if a health care overhaul passes." Read More…

If Health Care Bill Passes, Nurse Practitioners Could be Key
Time Magazine - August 3, 2009
"Even without reform, experts on the health-care labor force estimate there is currently a 30% shortage in the ranks of primary-care physicians. Fewer than 10% of the 2008 graduating class of medical students opted for a career in primary care, with the rest choosing more lucrative specialties. But there is an existing group of providers that health reformers are hoping can help fill this gap: nurse practitioners." Read More…

Health Care Bipartisanship Falling Apart?
CBS News - July 9, 2009
"President Obama and Senate congressional leaders have insisted from the get-go that they wanted their efforts at health care reform to be bipartisan. However, as the clock winds down to their self-imposed deadline for reform, liberal and centrist Democrats alike seem to be tired of waiting for their Republican counterparts to get on board." Read More…

Obama Takes Health Care Campaign to Doctors
The Boston Globe - June 16, 2009
President Obama yesterday took the fight for a public healthcare option to a skeptical audience, telling the American Medical Association that a government plan that would compete with private insurers is 'not your enemy; it is your friend.' Addressing a key constituency whose rejection of Bill Clinton's healthcare plan helped crush it 15 years ago, Obama said he believes a public plan would 'put affordable healthcare within reach for millions of Americans.'" Read More…

Parma Health Ministry Free Clinic Turns Away Newly Uninsured Patients Away for Lack of Doctors
Plain Dealer Reporter - June 18, 2009
"Deborah Hannan dreads picking up the phone at Parma Health Ministry. Since March, the free clinic, which has only two volunteer primary care physicians who see patients in the evenings, has had to turn people away. Hannan fields about a half-dozen calls a day, mostly from the recently uninsured. All she can do is add their names to the ever-growing waiting list or refer them elsewhere." Read More…

Low Income Serving Doctors on Health Care Reform
National Public Radio - June 18, 2009
"Speaking at the American Medical Association's annual conference in Chicago this week, President Obama outlined his plan to reform the nation's health care system. The president's pitch was met with mixed reaction, particularly on the point of a public health insurance option. A group of physicians advocating for health care in low-income and minority communities explain how their communities could benefit from a public insurance plan." Read More…

Cape Nurse Practitioners Take on Primary Care
Cape Cod Times, June 22, 2009
Increasingly, patients on the Cape are receiving at least part of their primary care from nurse practitioners. A shrinking pool of primary-are physicians is driving the trend, said Dr. Ted Epperly of Boise, Idaho, president of the American Academy of Family Physicians. 'Primary care is in crisis. Nurse practitioners and physician assistants must be part of the solution. We see this as an expanded team approach.'" Read More…

No Relief: Shortages Keep Older Docs on the Job
MSNBC, June 24, 2009
"At age 81, Dr. Kenneth H. Spady admits he's finally ready to retire. Almost. But Spady can't hang up his stethoscope just yet. After more than two years of trying, and several close recruiting calls, there's still no one to take his place in this rural community 100 miles north of Seattle, where the nation's shortage of primary care doctors has landed squarely at Spady's office door." Read More…

Diagnosis: A Shortage of Doctors
Lancaster Online - June 7, 2009
"The relative dearth of doctors nationwide has drawn the attention of Obama administration officials, who say they are particularly concerned about a shortage of primary care providers, the main source of health care for most Americans. Earlier this decade, talk of a doctor shortage was dismissed by trial lawyers and others as a ploy intended to boost malpractice reform. And state officials say there is no across-the-board shortage of doctors in Pennsylvania, though there is a growing need for more primary care physicians. In rural areas in particular, they say, both primary care doctors and specialists are in very short supply." Read More…

Rural Minnesota Clinics, Hospitals Struggle for New Doctors
Grand Forks Herald - May 10, 2009
"A growing shortage of rural physicians is taking its toll, and patients are feeling the crunch: Longer waits for non-emergency appointments. More care delegated to mid-level practitioners. Primary care physicians refusing to take on new patients. A number of factors have contributed to the shortage: Fewer medical students opting for primary care, challenges with reimbursement, the rising cost of medical school, and the lifestyle goals of a new generation of physicians." Read More…

Doctor Shortage in Rural Minnesota Reaches Crisis
Minnesota Public Radio - May 18, 2009
"Rural Minnesota has 13 percent of the state's population, but only 5 percent of all Minnesota physicians practice there, according to the Minnesota Hospital Association. With a wave of doctors nearing retirement, things are likely to get worse. For patients, the shortage means longer waits to get medical attention. The most critical need is for doctors who practice family medicine." Read More…

Shortage of Doctors Proves Obstacle to Obama Goal
New York Times - April 26, 2009
"Obama administration officials, alarmed at doctor shortages, are looking for ways to increase the supply of physicians to meet the needs of an aging population and millions of uninsured people who would gain coverage under legislation championed by the president. The officials said they were particularly concerned about shortages of primary care providers who are the main source of health care for most Americans." Read More...

Availability, Not Access, is Main Health Care Issue
Norwich Bulletin - April 18, 2009
"There is no denying our health care system is broken and needs to be fixed. Health care costs continue to rise while access to quality care diminishes. But health care reform is a complicated and complex issue, and many of the proposals being discussed on the state and national levels fall short of addressing the root causes of the problem. Numerous studies conducted during the last decade have all reached the same conclusion: In population centers where there is a higher proportion of specialists than generalists, health care is more expensive — and the mortality rate is higher. As a result of limited access to general practitioners, hospital emergency rooms and community health care centers become primary care providers — and they're overwhelmed, thus increasing the cost of health care delivery for all." Read More…

To Universal Care, via Massachusetts?
New York Times - April 4, 2009
"It is relatively easy to wish for social justice, pass a law and say it is so. But unless one understands the original problem, the wish will quickly fade under the pressure of reality. So it is with health care for all in Massachusetts. The state, like the rest of the country, lacks the keystone of any medical system: adequate primary care. And without good primary care, the coordination of care, preventive care and care of the chronically ill all become problematic." Read More…

Doctor Shortage Looms In Wisconsin: Demand For Primary Care Doctors May Go Up By 65 Percent By 2030
Madison News - April 6, 2009
"The Wisconsin Council on Medical Education and Workforce said the greatest need is for doctors specializing in family practice, internal medicine, and hospitalists. In other words, doctors serving as primary-care physicians. The report also predicts that demand for primary-care doctors will increase by 33 percent by the year 2020 and as much as 65 percent by the year 2030." Read More…

Doctor Shortages Hit Maryland
Frederick News Post - April 5, 2009
"The Maryland Hospital Association commissioned a study on the doctor shortage last year, the most rigorous ever performed in the area, according to association spokeswoman Nancy Fiedler. After adjusting for part-time and full-time status and the amount of time dedicated to seeing patients, the study found Maryland has the equivalent of 178 active physicians per 100,000 residents. The U.S. average is 212 per 100,000. Using guidelines from several sources, including the National Ambulatory Medical Care Survey and the Graduate Medical Education National Advisory Council, the study found that Western Maryland has a shortage in primary care and 19 of 28 identified specialties. The study predicts this shortage will expand to 21 specialties by 2015." Read More…

To Universal Care, via Massachusetts?
New York Times - April 4, 2009
"It is relatively easy to wish for social justice, pass a law and say it is so. But unless one understands the original problem, the wish will quickly fade under the pressure of reality. So it is with health care for all in Massachusetts. The state, like the rest of the country, lacks the keystone of any medical system: adequate primary care. And without good primary care, the coordination of care, preventive care and care of the chronically ill all become problematic." Read More…

Editorial: Defer Medical School Debt
Grand Rapids Press Editorial - April 3, 2009
"Congress should make ensuring an adequate supply of physicians to meet the nation's health care needs a priority. Primary and specialty care doctors are already in short supply. Lawmakers ought to support a House bill that reinstates a program that allows medical residents to defer loan payments without interest. Making it harder for students to pay back their huge debt can be a deterrent and that isn't in the nation's best interest." Read More…

Medical School Accepting Fewer Students in the Fall
Salt Lake Community College Globe - April 2, 2009
"Instead of increasing enrollment at the U School of Medicine to offset the state's growing physician shortage, the number of students will decrease by 20 percent in the fall. The medical school proposed increasing class size last year, but when the Centers for Medicaid and Medicare Services, a part of the U.S. Department of Health and Human Services, discontinued a $10 million grant to the school last fall, the U was forced to cut back." Read More…

Doctors Across New York Awards Announced
New York State Governor's Office - March 23, 2009
"Today, the Governor's office announced the recipients of the Doctors Across New York awards. A total of 126 physician practice support awards were granted, which totaled more than $11.1 million, with 78 (62%) of those going to 50 hospitals. Eighty-three physician loan repayment awards were made, of which 55 (66%) went to 36 hospitals. Many of the hospitals received multiple awards. HANYS is pleased that so many of the awards went to hospitals across the state." Read more…

Boom Amid Bust: Med. Schools Grow as Economy Tanks
Associated Press - March 12, 2009
"You wouldn't know there was an economic crisis the way the medical school business is booming these days. Responding to warnings of a looming doctor shortage, existing schools are increasing enrollment, and new ones are opening or under development from El Paso in West Texas to Kalamazoo in western Michigan." Read More…

Archive »Featured Items

Beware of the Siren Song of New GME: Graduate Medical Education and Health Care Reform
June 15, 2009 – Fitzhugh Mullan, MD and Elizabeth Wiley, JD MPH, Health Affairs Blog
"Federal support for graduate medical education (GME) training positions has been capped for more than a decade and it is no secret that the country's teaching hospitals are restive. They want 'more cap.' A number of bills have been introduced in the House and Senate proposing an increase in the Medicare funded GME cap by fifteen percent, or roughly 15,000 positions. These proposals are an alluring Siren song but they will not be good for health care reform or for the country. What could be wrong with more residents?" Read More...

The Case for Teaching Health Centers
July 2009 – Medical Education Futures Study
"In order to achieve the quality, access, and affordability, we must invest in the development of a robust primary care physician workforce -- particularly as an aging population and expanded health care coverage increase the demand for services. Developing residency programs within community-based ambulatory primary care settings such as health centers, with the appropriate infrastructure investment, will immediately bolster the primary care workforce. Residents provide patient care services and the opportunity to teach promotes recruitment and retention for existing staff."
To download a copy of this brief, click here.

Medical Education Futures Study

George Washington University School of Public Health and Health Services

Josiah Macy Jr. Foundation