The Next Phase of Title VII Funding for Training Primary Care Physicians for America’s Health Care Needs

Robert L. Phillips; Barbara J. Turner

doi:10.1370/afm.1367

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How Clear Does the Message Need To Be?
Perry A. Pugno

Published on: 26 March 2012
Who should be a Family Doctor?
Andrea T. Manyon

Published on: 24 March 2012

Published on: (26 March 2012)
Page navigation anchor for How Clear Does the Message Need To Be?
How Clear Does the Message Need To Be?
Perry A. Pugno, V.P. for Education
This nation needs a primary care base to its health care infrastructure. The Commonwealth Fund's 2012 report (1) that demonstrates how improved support for primary care will result in major cost savings to the Medicare program is only the most recent in a series of documented efforts to "prove" the value of primary care to the nation. But the pipeline of primary care physicians is leaking badly due to the pressures of t...
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This nation needs a primary care base to its health care infrastructure. The Commonwealth Fund's 2012 report (1) that demonstrates how improved support for primary care will result in major cost savings to the Medicare program is only the most recent in a series of documented efforts to "prove" the value of primary care to the nation. But the pipeline of primary care physicians is leaking badly due to the pressures of the national economic downturn, continuing challenges to health reform, and lackluster student interest in generalist careers. How can we improve those dynamics?
Drs. Phillips and Turner have done an excellent job of summarizing the case supporting enhanced Title VII funding as a solution strategy. However, since the 19880s we have been struggling every year to maintain funding for Title VII programs. Why that is the case has always been a mystery to me. But now, when the need is greatest, we are at the lowest levels of funding in three decades. How clear does the message need to be? The ACA, COGME, ACTPCMD, Macy Foundation and even MedPAC all agree:
* The US must establish a primary care base to achieve the triple aim of improved care, lower cost and better health for all Americans. * Medical education must shift the emphasis of training to a community focus. * Resident education in primary care must include clinical experience in a medical home setting. * Faculty development for working and teaching in the advanced medical home is an unmet need.
Title VII programs have proven themselves as successful strategies in all of those dimensions. The case made by Drs. Phillips and Turner is a compelling call to action for a proven, cost-effective strategy to advance primary care that involves substantially less political controversy than trying to change payment policies for clinical care and GME. It's about time our legislators started paying attention.
Perry A. Pugno, MD, MPH, FAAFP, FACPE Vice President, Education American Academy of Family Physicians Leawood, Kansas
References
1. Paying More for Primary Care: Can It Help Bend the Medicare Cost Curve?
Reschovsky JD, Gnosh A, Steward K, Chollet D.
Issue Brief. The Commonwealth Fund pub. 1585, Vol. 5, March 2012
Competing interests: None declared
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Competing Interests: None declared.
Published on: (24 March 2012)
Page navigation anchor for Who should be a Family Doctor?
Who should be a Family Doctor?
Andrea T. Manyon, Associate Dean for Student Affairs
The 2012 National Resident Matching Program (NRMP) statistics show a modest increase in the number of students entering Family Medicine residencies. But who should be a Family Doctor? The 2011 NRMP match data for Family Medicine show an average USMLE step I score of 213 and an average step 2 score of 225. These candidates are also recorded as having an average of 1.6 research products and 6.7 volunteer experiences. The...
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The 2012 National Resident Matching Program (NRMP) statistics show a modest increase in the number of students entering Family Medicine residencies. But who should be a Family Doctor? The 2011 NRMP match data for Family Medicine show an average USMLE step I score of 213 and an average step 2 score of 225. These candidates are also recorded as having an average of 1.6 research products and 6.7 volunteer experiences. These data points are not in excess of their peers. But who should be a Family Doctor?
This excellent article from Drs. Phillips and Turner challenge us to define the next phase of Title VII funding for the training of primary care physicians for America's health care needs. But who should be a Family Doctor? Who should be the physician in the rural community, the urban community caring for the neediest patients? These Family Physicians need to possess both a solid high level of knowledge and a commitment to altruism and even scholarship.
Medical students are looking to be challenged, to be recognized for excellence. As the discipline of Family Medicine will now and in the future see an increasing number of American medical graduates in their residency programs we are challenged to provide a higher level of academic rigor, scholarly pursuits and the expectation for service excellence and volunteerism for our candidates as well.
In this pursuit of academic rigor for the programs and courses we teach, expanding opportunities for scholarship and advancing care in new models we will recruit and attract students who can meet the challenge of becoming a Family Doctor.
Andrea T. Manyon, MD, FAAFP
1. https://www.aamc.org/newsroom/newsreleases/276900/120316.html 2. https://www.aamc.org/students/download/264588/data/chartingoutcomesmatch2011.pdf
Competing interests: None declared
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Competing Interests: None declared.