by JULIE ROVNER
“We recognize we are recommending substantial change,” says health economist and former Medicare Administrator Gail Wilensky, co-chairwoman of the nonpartisan Institute of Medicine panel that produced the report. “We think it’s key to justifying the continued use of public funds.”
“The scale of government support for this phase of physician education is unlike that given to any other profession in the nation,” said the report, which was funded by a dozen foundations with the support of a bipartisan group of members of Congress.
Even though the system has operated this way for decades, there are few data on how those funds are spent and how well they contribute to the preparation of a medical workforce needed for the 21st century, the panel found.
Despite a growing public investment in graduate medical education, there are persistent problems. They include uneven geographic distribution of physicians, too many specialists and not enough primary care providers, and a lack of cultural diversity in the physician workforce, the report found.
Not only that, the authors note, “a variety of surveys indicate that recently trained physicians in some specialties cannot perform simple procedures often required in office-based practice and lack sufficient training and experience in care coordination, team-based care and quality improvement.”
The current Medicare medical education payment system would be phased out over 10 years. At the end of the phase-out, policymakers would reassess whether Medicare should continue to subsidize doctor training at all, and if so, to what extent.