AOA urges doc training outside teaching hospitals

If the American Osteopathic Association has its way, you could soon be recruiting medical residents not only from teaching hospitals but also from community health centers, walk-in clinics, and managed care organizations.

At a February 28 news conference in Washington, DC, the American Osteopathic Association (AOA) said entities other than hospitals should be eligible to receive federal funds for training doctors if they are incurring training costs. The professional medical organization wants to take physician training out of ivory tower teaching hospitals and into the community to meet growing demands for non-specialists and staunch the oversupply of medical specialists.

Train physicians where they will be needed

"The oversupply of physicians and the resultant imbalance in the generalist-to-specialist physician ratio has the potential to pose some serious access problems in regions across the country," saidLarry Wickless, DO, vice chairman, AOA Council on Federal Health Programs.

Because current policy permits physician training funds to be directed solely to teaching hospitals and financially rewards those hospitals that increase the numbers of physicians they train, Wickless argued that there is a disincentive for physicians to train in the settings they will more likely encounter when they enter a practice. If this policy is not changed, he said, the medical community cannot respond quickly to physician oversupply because of the long interval between medical school and completion of graduate medical education training.

Training consortia

The AOA recommends creating educational consortia composed of physician offices, community health centers, medical schools, and teaching hospitals to better coordinate physician training. Such consortia will become the central structure of all approved osteopathic training programs by July 1999.

By defining such consortia as eligible to receive training funds, Congress would remove the current incentive for teaching hospitals to add residents, a necessary step toward reducing the oversupply of physicians, the AOA says. t