In July of 2017, I introduced the bipartisan Training the Next Generation of Primary Care Doctors Act of 2017 to reauthorize the Teaching Health Center Graduate Medical Education (THCGME) Program for three years. This legislation will also allow for the expansion of new programs within existing centers or the creation of entirely new teaching health centers, while emphasizing the importance of establishing sustainable funding.
It’s estimated that we could have a nationwide shortage of more than 23,000 physicians by 2025. That’s unacceptable. In rural communities, the physician-to-patient ratio is even more stark. Only about 10% of physicians practice in these areas, even though almost a quarter of the population lives there. Compared to doctors who train in the traditional Medicare program, those trained at Teaching Health Centers are 82% more likely to practice primary care, 20% more likely to work in rural communities, and 55% more likely to work in underserved areas. This legislation will work to meet the needs of rural and underserved communities through access to a new generation of primary care medical professionals.
In June, I joined Providence Health, Empire Health Foundation, and Washington State University Spokane at the Spokane Teaching Health Clinic for a press conference to discuss the importance of this legislation to our community in Eastern Washington. You can watch the full press conference here:
On September 14, 2017, the Congresswoman joined her colleagues in the House Energy and Commerce Committee’s Subcommittee on Health for a hearing to discuss federal health care workforce programs that support the next generation of health care providers. As part of this discussion, committee members talked about the future of the Teaching Health Center and Graduate Medical Education (THCGME) program. You can watch her remarks here:
Recruiting and developing the next generation of medical providers in our community starts with securing the funding and building the facilities needed to attract more doctors to our area.
In 2015, I led the effort to secure a two year extension of the THC program, and a $40 million funding increase. Spokane is reaping the benefits of the program with an increase in medical residents, and a renewal will help our community gain access to the health care providers and services they truly need.
In September 2016, I co-introduced a bipartisan resolution to support a stable and sustainable funding source for the THCGME Program. The THCGME program is dedicated to training primary-care physicians and dentists in community-based settings to help fill shortages of primary-care clinicians across the country.
In April 2017, I sent a letter with 94 of my colleagues encouraging the reauthorization of the THCGME program, which is set to expire on September 30, 2017, and to set the program on a path for stable and sustainable funding to ensure its future, long-term viability.
Teaching Health Centers (THCs) were established to address the crisis-level shortage of primary care physicians, especially in rural and medically underserved communities. Since then, the program has grown from 63 residents to 742 residents spread across 59 THCs in 24 states. THCGME residents will provide more than one million primary care medical visits in 2017 to underserved communities. Regardless of this substantial growth, THCGME made up less than 0.5 percent of the annual federal outlay committed for training physicians in FY2016.
These residents are specifically training in specialties with the largest shortages nationally, including family medicine, general internal medicine, pediatrics, obstetrics and gynecology, psychiatry, and dentistry. Furthermore, when compared with traditional Medicare GME residents, residents who train at THCs are more likely to practice primary care (82 percent vs. 23 percent) and remain in underserved (55 percent vs. 26 percent) or rural (20 percent vs. 8 percent) communities.
It is clear that the well-designed THCGME program not only plays a vital role in training our next generation of primary care physicians, but helps bridge our nation’s physician shortfall.
“The Teaching Health Center GME program has demonstrated that addressing the shortage of primary care physicians, especially for traditionally underserved rural and urban areas, is not only essential but also achievable. The leadership of Representatives McMorris Rodgers and Tsongas in sponsoring the continued funding and potential expansion of this program is a critical action in assuring the continuing training for the 742 medical residents now engaged in programs across the country and in attracting new programs to this vital initiative. While this Nation spends more than $15 Billion on graduate medical education annually, the THCGME program is our only opportunity to target the output of physicians by specialty and locality. Those of us leading THCGME programs applaud the bipartisan leadership of our Congressional representatives and are committed to continuing to build the country’s desperately needed primary care workforce.” – Neil S. Calman MD, MMS, FAAFP, President, American Association of Teaching Health Centers and President and CEP, the Institute for Family Health
“The Training the Next Generation of Primary Care Doctors Act of 2017 will go a long way towards every community health center’s goal of providing access to comprehensive primary care for every individual in need. The National Association of Community Health Centers (NACHC) applauds Reps. McMorris Rodgers and Tsongas for introducing this legislation and for their firm commitment to bolstering the health center workforce.”
“The Council of Academic Family Medicine was involved with the creation of the Teaching Health Center (THC) program statute and has supported the continuation of this vital program. We applaud the efforts of Reps. McMorris Rodgers and Tsongas in introducing legislation to reauthorize and support the sustainability of this critical primary care workforce program.” – Mary Hall, MD, Chair, Council of Academic Family Medicine
“Our nation is in the middle of a devastating shortage of primary care providers, including ob-gyns. In fact, half of all US counties have no ob-gyns at all, leaving women with severely limited access to obstetric and gynecologic care,” says Haywood Brown, M.D., President, The American Congress of Obstetricians and Gynecologists. “We commend Congresswoman McMorris Rodgers for recognizing and taking practical steps to address this urgent need, and improve access to quality health care for women in rural and underserved areas.”
“The innovative Teaching Health Center Graduate Medical Education Program, which trains medical residents in primary care community-based settings, has a strong track record of improving the distribution of physicians in underserved areas across the country. We thank Representatives McMorris Rodgers and Tsongas for their bipartisan leadership in sponsoring the Training the Next Generation of Primary Care Doctors Act of 2017. We urge Congress to prioritize support for this critical legislation that works to ensure a robust primary care physician workforce in communities most in need.” – Stephen C. Shannon, DO, MPH, President and CEO of AACOM
“Pacific Northwest University of Health Sciences commends Representative McMorris Rodgers for her notable leadership in envisioning new and innovative mechanisms of funding for critical community-based medical residency programs that will benefit not only the state of Washington, but underserved patient populations across the country,” – Keith Watson, DO, President, Pacific Northwest University of Health Sciences
“The communities on the front-lines in the fight against chronic disease rely on Community Health Centers and Rural Health Clinics to deliver quality care at a lower cost. And there’s no better place than this setting to train the primary care professionals that America needs. This legislation is essential to sustaining the current capacity of the Teaching Health Center Graduate Medical Education Program and NCHC is pleased to support it.” – John Rother, President and CEO, National Coalition on Health Care
“This important legislation will enable Greater Lawrence Family Health Center and its Lawrence Family Medicine Residency Program to continue the great work it has done over the last 23 years. Educating our primary care workforce in low income, underserved communities like Lawrence has proven to be a winning combination in training our nation’s most needed clinicians in the areas of community and family medicine. The Lawrence Family Medicine Program has trained 175 family physicians, and more than 79% of whom continue to work in underserved communities and 55% have continued to work in community health centers across the country. Speaking for the first community health center-sponsored residency program in the country, I commend the efforts of Representatives McMorris Rodgers and Tsongas in introducing this legislation. Their continued efforts to support sustainable funding for this program are critical to the long-term survival of the THC program.” – Joseph Gravel, MD, Chair of Family Medicine & Community Health/ Chief Medical Officer of the Greater Lawrence Family Health Center
“The Teaching Health Center program is a proven program that trains doctors to practice holistic primary care for rural and underserved populations. By training physicians in underserved communities, they learn the skills and gain the experience and confidence that allow them to successfully serve rural communities for the long term when they finish their residency.” – National Rural Health Association
“The Teaching Health Centers Graduate Medical Education (THCGME) program is an essential component of our collective effort to meet the country’s primary care needs in rural and underserved communities. The goals of the program align naturally with the training and practice of osteopathic medicine, and the majority of the 59 teaching health centers are AOA-accredited or are dually-accredited (DO/MD) programs. Since the program’s inception, nearly 800 osteopathic resident physicians have been trained through the THCGME program, with many staying in the communities where they trained. The American Osteopathic Association applauds Representatives McMorris Rodgers and Tsongas for sponsoring this important bipartisan legislation to ensure the THCGME program continues putting physicians in communities where they are most needed.” – Mark A. Baker, DO, President, American Osteopathic Association
Organizations that support my work on the THCGME program: