On Implementing a National Graduate Medical Education Trust Fund (1997) / Chapter Skim
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Appendix C: Public Comment on Graduate Medical Education Issues
Appendix C: Public Comment on Graduate Medical Education Issues
Pages 65-74
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From page 65... ...
At the public hearing on January 29, 1997, the committee heard from the following organizations, selected for their breadth of perspectives: the American Medical Association; the American Hospital Association; the Association of American Medical Colleges; the Council on Graduate Medical Education; the American Osteopathic Association; the American Association of Health Plans; the National Association of Community Health Centers; the American Nurses Association; and the American Academy of Physician Assistants. This Appendix is meant to serve as a general overview of the major themes in positions and statements of the organizations responding to our request for input.
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From page 66... ...
These needs included the desire for physicians with more ambulatory training, and for a different work force makeup, including more non-physician professionals like advanced practice nurses, physician assistants, and graduate level psychologists, to better serve all patients in a team-approach integrated environment, particularly in rural and large urban areas. Despite the need for flexibility in the funding system and the desire for change, almost all of the responders commented on the need for a system that offered stability for programs so that they could continue to train individuals in a high-quality environment throughout the term of their training.
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From page 67... ...
The current GME funding system includes a positive weight for primary care residents, and this was generally supported. However, several of the organizations representing medical specialties stressed the importance of not weighting so much in one direction that future specialist shortages would be created.
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From page 68... ...
Still others submitted that medical schools best fit the educational purposes of GME and should be responsible for guiding postgraduate training and directing funding (Hanft, 19911. Currently, many teaching hospitals have agreements with various ambulatory sites to provide training to the hospitals' residents.
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From page 69... ...
stated at the public hearing before the committee: As we remove the funding for graduate medical education from the AAPCC, we will have a negative impact, especially on some areas, on the development and maintenance of cost and quality responsible health maintenance organizations and other managed care organizations. A new program should begin slowly enough, or take into account enough, that we don't use this opportunity to drive an unnecessary wedge between managed care organizations and those institutions which train physicians.
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From page 70... ...
OTHER ISSUES Nursing Graduate Medical Education There was a near-unanimous response on this issue from a variety of individuals. The consensus is that current GME funding for nursing which goes to non-graduate-level hospital-based diploma schools should be redirected to help fund the clinical training of advanced practice nurses, which is at the graduate level.
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From page 71... ...
Much research was offered to show that the increase in the number of residents over the past decade is caused in large part by a growing number of IMGs in GME programs. The original intent of world health efforts and the J-1 exchange programs, was to bring foreign medical graduates to the United States from nations that did not have the capacity to train their own doctors and then return them home to practice.
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From page 72... ...
LIST OF ORGANIZATIONS SURVEYED AND THAT SUBMITTED MATERIALS Academy of General Dentistry Accreditation Association for Ambulatory Health Care American Academy of Family Physicians American Academy of Nurse Practitioners American Academy of Nursing American Academy of Osteopathy American Academy of Pediatrics American Academy of Physical Medicine and Rehabilitation American Academy of Physician Assistants American Association of Clinical Endocrinologists American Association of Colleges of Nursing American Association of Colleges of Osteopathic Medicine American Association of Colleges of Pharmacy American Association of Colleges of Podiatric Medicine American Association of Dental Schools American Association of Health Plans American Association of Nurse Anesthetists American Association of Preferred Provider Organizations American Association of Retired Persons American Board of Nursing Specialties American College of Cardiology American College of Chest Physicians American College of Dentists American College of Health Care Administrators American College of Nurse-Midwives American College of Occupational and Environmental Medicine American College of Physicians American College of Preventive Medicine American College of Rheumatology American College of Surgeons
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From page 73... ...
. Association American Psychological Association American Public Health Association American Society of Clinical Pathologists American Society of Plastic and Reconstructive Surgeons Association for Health Services Research Association for Hospital Medical Education Association of Academic Health Centers Association of American Cancer Institutes Association of American Medical Colleges Association of Maternal and Child Health Programs Association of Minority Health Professions Schools Association of Physician Assistant Programs Association of Schools and Colleges of Optometry Association of Schools of Allied Health Professions 73 Children's Defense Fund Congress of Neurological Surgeons Council of American Kidney Societies Council on Podiatric Medical Education Deans of Medical Schools Federation of American Health Systems Federation of American Societies for Experimental Biology Federation of Pediatric Organizations Federation of Podiatric Boards Federation for Accessible Nursing Education and Licensure Harvard Pilgrim EIealthcare Health Insurance Association of America Individual Teaching Hospitals and Medical Centers Integrated Healthcare Association Joint Commission on Accreditation of Healthcare Organizations Managed Health Care Association Mathmatica Policy Research Mayo Foundation National Association of Children's Hospitals and Related Institutions, Inc.
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From page 74... ...
74 The American Association of Hospital Dentists Schools of Medicine Renal Physicians Association Schools of Nursing State Medicaid Directors' Association ON IMPLEMENTING A NATIONAL GME TRUST FUND The American Association of Neurological Surgeons The HMO Group Voluntary Hospitals of America Washington Business Group on Health
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