Residency Shortage
Hospital Corporation of America
is leading the charge for a timely solution to the Residency Shortage
nationwide. “Nationally, HCA
is one of the largest GME providers, with more than 203 programs….Currently
2,750 residents and fellows are participating and that number is expected to
grow to 5,500 by 2020”.(1) This would
mean an additional 70 residency programs.
Perhaps other hospital corporations will follow HCA ’s
example. The slow moving bureaucracies
of Medicare Funding, the ACGME (Accreditation Council of Graduate Medical
Education), and state licensure laws have precluded a timely solution in the
public sector.
Here is what is going on in Florida ,
where HCA says, “The physician shortage is
especially critical in Florida ”. An IHS Global study found that Florida
faces a shortage of about 7,000 physician specialists by 2025. The Teaching Hospital Council and Safety Net
Hospital Alliance report said, “We are not, to put it bluntly, training enough
physicians….Without more physicians, Florida
will have a tough time providing quality health care to our growing, aging and
increasingly diverse population.” You
may recall from a prior blog that in 2015 Florida
began a “GME Start-up Bonus Program” which funded $100,000 for each new
residency “slot” in shortage specialties.
I would assume that HCA is taking
advantage of these bonuses to help fund their new residency slots. In Florida ,
HCA says,”Currently 336 residents …are
training at one of our seven teaching hospitals, with plans to expand to more
than 550 residents by the 2018-2019 academic year.”
The other 49 states seem to be approaching these Residency
and Doctor Shortages in many different ways.
I see the private sector approach working very nicely in Florida ,
and would encourage other states to offer similar incentives to the hospital
corporations operating in their states.
However, I would still mention that until the Residency Shortage is
solved, each state give preference to its own citizen applicants for residency,
as well as those unfortunate doctors who have not matched in prior years. Upon completion of residency, many doctors
opt to practice in the state of their training.
Why should a state offer incentives for new residency slots, only to
have these trained doctors leave their state when finished?