Budget Cuts Could Lead to More Physician Shortages

This article was originally posted on HCPLive.com.

The American College of Physicians (ACP) told leaders of the House of Representatives last week that ACP understands the serious financial constraints on the federal budget at this time and supports bipartisan efforts to reduce funding for discretionary programs that do not achieve sufficient value.

But the ACP made it clear that it firmly believes that Congress must continue on a path towards reversing an unprecedented shortage of primary care physicians in this country, the organization said in a statement. If uncorrected, the primary care shortage will lead to higher healthcare spending, poorer outcomes, and long waits for appointments. ACP’s letter was in response to the Continuing Resolution (CR), H.R. 1, which was introduced in the House on Feb. 11.

“The United States is facing a growing shortage of physicians in key specialties, most notably in general internal medicine and family medicine -- the specialties that provide primary care to most adult and adolescent patients,” J. Fred Ralston Jr., president of ACP said in a three-page letter. “Research also shows that investments in primary care are essential to achieving a highly performing, efficient, and effective healthcare system: over 100 annotated research studies show that the availability of primary care physicians in a community is positively associated with better outcomes and lowers costs of care.” ACP’s letter was intended to provide initial constructive feedback on specific provisions of the CR.

Section 747 under Title VII, Training in Family Medicine, General Internal Medicine, General Pediatrics, and Physician Assistantship program is currently the only federal support for primary care training and education. Institutions are provided grants to plan, develop, or operate accredited professional training programs, including residency or internship programs in primary care specialties for medical students, interns, residents, or practicing physicians. This grant program has been the most important federal intervention to help build and maintain the primary care medical and dental training infrastructure in this country.

While the proposed reduction of $145 million in health professions funding is not prescriptive in targeting Title VII but included in a combined cut in total spending in health professions funding, ACP strongly urged House leaders to forego these reductions that will undoubtedly hinder efforts to improve the primary care workforce.

H.R. 1 also eliminates $141.925 million in discretionary funding for the National Health Service Corps (NHSC) while maintaining $290 million in mandatory funding for the program. This reduction in discretionary funding would eliminate over 2,365 health professionals from receiving funding. NHSC is widely recognized as a success on many fronts, resulting in improved access to health care for the growing numbers of underserved Americans, providing incentives for practitioners to enter primary care, reducing the financial burden that health professions education places on new practitioners, and ensuring access to health professions education for students from all backgrounds.

The CR cuts funding by $1 billion from fiscal year 2010 enacted levels, meaning already-established Community Health Centers will lose the capacity to serve 3.3 million current patients in the next few months and over 11 million patients over the next year.

“The federal government has several critically important programs that have a proven track record in helping to train and retain primary care physicians, especially in the growing number of underserved communities,” Dr. Ralston said. “Yet even with such programs, the U.S. will likely continue to face a shortage of primary care physicians for adults, as well as shortages in other critical physician specialties, but this shortage will be much more severe if programs to ensure an adequate physician workforce are underfunded.”