Studies Show that Decentralizing Graduate Medical Education Training Would Improve Access to Health Care

FOR IMMEDIATE RELEASE: Monday, Feb. 2, 2015

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Megan Moriarty 
Public Relations Strategist
(800) 274-2237, Ext. 5223
mmoriarty@aafp.org

WASHINGTON — Millions of people in the United States live too far from a doctor’s office or clinic to get needed preventive, acute and chronic disease management care. 

Two studies published this week support a common theme — the importance of decentralizing graduate medical education training, particularly for primary care, from the academic and large teaching center settings to more community-based training sites such as Teaching Health Centers. 

The key to helping ensure that people in medically underserved areas have access to care is training primary care physicians in those communities. Knowing that many family physicians train at Teaching Health Centers in underserved communities and will then practice in close proximity to their training sites, the extension of the Teaching Health Center program becomes an increasingly important policy. 

“Teaching Health Center GME Funding Instability Threatens Program Viability,” a one-page research summary published yesterday in American Family Physician, concludes that Congressional failure to continue funding the Teaching Health Center Graduate Medical Education program beyond 2015 could jeopardize a successful program that trains hundreds of primary care physicians and dentists who serve patients with limited access to health care. Without Congressional action, funding ends when the current appropriation ends in 2015.

Researchers Kathleen Klink, MD, FAAFP, and Elizabeth Brown, MD, surveyed the leadership of the currently funded 60 THCs to learn the impact that funding loss would have on their programs.

“The THCGME program supports a key national health priority,” said Klink, medical director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care. “Without the graduate medical education funding for these programs, we’ll undermine the progress we’ve made so far and seriously undercut future growth of primary care physician training programs that focus on caring for underserved Americans.

“That’s important, because research shows that graduates of these residency programs are much more likely to stay in underserved areas to practice. Research supports the supposition that new doctors practice in or near the same communities where they completed their training.”

One such study was also published today, which found that more than half of newly minted family physicians practice within 100 miles of where they completed their graduate medical education, nearly half practice within 50 miles of their residency training site, and one in five practice within five miles of their residency location.

“Family Medicine Graduate Proximity to Their Site of Training: Policy Options for Improving the Distribution of Primary Care Access,” a study published in today’s Family Medicine Journal, was produced by Blake Fagan, MD, and his Graham Center colleagues.

“We’ve demonstrated that training family physicians in areas of highest need is the best way to place family physicians in those areas,” said Fagan. 

“When we examined the relationship between where physicians train and where they ultimately practice, we discovered that more than half of family physicians will practice within 100 miles of their training site. This study reminds us how important training site location is to distribution of the physician workforce,” said Andrew Bazemore, MD, Director of the Robert Graham Center.

“Previous work has clearly shown that training in safety net sites — Community Health Centers, Rural Health Clinics and Critical Access Hospitals, specifically — is strongly associated with increased physician practice in those shortage locations,” said Bazemore. “The survey of Teaching Health Centers shows us that efforts to train more physicians in underserved areas may no longer exist without continued funding.”

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About the Robert Graham Center

The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.

Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.