The training of clinicians in the US has operated under a largely unchanged system for decades, and our nation’s physicians are among the most educated professionals in the world. Still, a report by a panel from the Institute of Medicine is calling for substantial financial change to the $15 billion system, in order to better meet the growing and evolving medical needs of Americans.
WVPE reports nearly 75 percent—$11 billion, to be exact—of the financial backing for physician training comes from federal funding, and state Medicaid programs make up the remaining $4 billion. According to the report, the level of government funding is unlike that given to any other profession. The nonpartisan panel sought insight into how these funds are spent and how they contribute to the preparation of today’s clinical workforce, but found few data.
The study did find, however, data suggesting “recently trained physicians in some specialties cannot perform simple procedures often required in office-based practice, and lack sufficient training and experience in care coordination, team-based care, and quality improvement.” Other persistent issues included in the report were uneven geographic distribution of physicians and too few primary care providers.
”We recognize we are recommending substantial change,” says health economist and former Medicare Administrator Gail Wilensky, co-chairwoman of the nonpartisan Institute of Medicine panel that produced the report. ”We think it’s key to justifying the continued use of public funds.”
Over the course of 10 years, the panel is hoping to see a shift toward a performance-based system, with the current funding system replaced with a more evenly distributed payment structure. Specifically, the new plan would see a declining share paid toward direct subsidies and teaching programs, and an increasing share toward the funding of physician training in “priority disciplines and geographic areas.”