GME in Wisconsin
Around our state, July marks the arrival of a new class of first year family medicine residents. This year we welcome 100 new family medicine residents across Wisconsin, which represents strong growth since just 2015 when we had 78 incoming R1s. Some of this growth even comes from new programs (like the one I'm associated with at Community Memorial Hospital in Menomonee Falls). More broadly, we are starting to see the benefits of direct state support for residency slots in WI, and of WAFP-led initiatives like Act 128, the Primary Care and Psychiatry Shortage Grant Program which encourages graduates of WI residency programs for practicing in underserved areas of the state.
But even with these innovative supports and a solid increase in family medicine residents, it isn't enough to meet the future need for family doctors in Wisconsin. We need a radical reform of how graduate medical education (GME) is paid for. Why? Because continuing to do the same thing (funding GME through Medicare), and expecting different results (a more rational balance between generalist and specialist physicians) is the definition of insanity.
The good news is that we have a start on serious GME funding reform, which is known as the Teaching Health Center program. This program began in 2011 and is based on moving the locus of control, and of funding for residents, from hospitals to outpatient clinics—chiefly federally qualified health centers. Please see more details. The funding for this program—initially $230M—is barely a rounding error compared to federal Medicare-based funding for GME of $10B, but despite this and despite demonstrated success at training generalists to serve in underserved areas, the program's existence has been in near constant jeopardy in the federal budget.
What action can you take? Make connections with your legislators, both state and federal. At the state level, please respond to WAFP legislative action alerts. We need your help to influence legislators to continue to support vital state-based workforce initiatives like Act 128. At the federal level, your senators and representative need to hear from you about the Teaching Health Center program. The WAFP office can provide you with talking points and background info on this program. You can reach them at email@example.com or 262-512-0606.
Ken Schellhase, MD
The mission of WAFP is to promote excellence in health care and to improve the health of the people of Wisconsin through the advancement of the art and science of Family Medicine, the specialty of Family Medicine and the professional growth of Family Physicians.