Stephen C. Shannon, DO, MPH

AACOM Focuses Policy Priorities on Student Loan Debt and Physician Workforce

Congress has departed for its August district work period, leaving an enormous legislative agenda yet to be tackled. AACOM is urging legislators, upon their return, to address the many critical policy issues impacting the nation’s osteopathic medical schools and their students. AACOM’s top legislative priorities for the fall include: working toward ensuring that medical education is affordable and helping to alleviate the student debt burden; increasing medical residency positions and advocating for these positions to be aligned with national health care needs; and supporting primary care training and workforce programs, which aim to support future osteopathic physicians and the patients they serve.

Given the political realities with Congress, these priorities may seem lofty. However, I would argue that these priorities are necessary to advance the country’s health care system. Taking action on important legislation, such as reauthorizing The Higher Education Act (federal legislation that authorizes most federal student assistance programs and expires in 2013) will be vital to addressing the many complex issues involved with student loan debt and could offer opportunities to address reform in a collaborative and pro-active manner.

Helping future physicians better afford their education through fixed low-interest rate loans addresses both the impending physician workforce shortage and patient access to quality health care. Furthermore, increasing federal funding for scholarship and loan repayment programs, such as the National Health Care Service Corps (NHSC), produces physicians who serve patients in urban and rural underserved communities where better patient access to care is critical. In 2012, osteopathic medical students (who comprise 20 percent of all United States DO and MD medical students), received 35 percent of all NHSC scholarship awards. Additionally, exploring programs that would defer payment while medical residents are completing the required training to become licensed physicians is a necessary component of a comprehensive solution to medical student debt. The continued investment in medical education and support for sustainable, long-term solutions to the growing student debt crisis will not only benefit patient care, but also the nation’s health care system as a whole.

The impending physician workforce shortage is threatening health care delivery services and the patients who depend on these services. Osteopathic medical schools are continuing to increase their class sizes, graduating more students now than ever before. The current number of graduate medical education (GME) positions, or medical residency slots, funded by the Centers for Medicare & Medicaid Services will not be sufficient to accommodate the number of medical school graduates seeking residency positions, thus not adequately addressing the current and projected primary care workforce shortages.

Furthermore, in the Council on Graduate Medical Education’s "Twentieth Report: Advancing Primary Care," the Council recommends strategically increasing the number of new primary care GME positions and programs to accommodate the increased production of medical school graduates and respond to the need for a workforce composed of at least 40 percent primary care physicians. With projections of physician shortages already highlighting a widening gap between the availability of health care and the needs of the nation’s growing aging population and expanding patient population, AACOM encourages Congress to support the sustainable expansion of GME positions through various legislation currently introduced in Congress, such as the "Training Tomorrow’s Doctors Today Act" and "The Resident Physician Shortage Reduction Act of 2013" in both the House and the SenateFurthermore, support for the continuation of the Health Resources and Services Administration’s (HRSA) Teaching Health Center GME Program is vital to ensuring that community-based primary care residency programs continue to grow.

AACOM will continue to work with Congress and the Administration to strengthen our presence in the national dialogue on health care as well as advocate for policies that benefit osteopathic medical schools and their students and, ultimately, the patients they will serve. It is imperative that you, as a member of the osteopathic medical education community, lend your voice to the debate by responding to AACOM Action Alerts and other calls to action. There is much work to be accomplished when Congress reconvenes in September and with your continued collaboration and advocacy, we are able to move closer to achieving our legislative priorities.

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July / August 2013
Vol. 7, No. 7 / 8