A new report by the Institute of Medicine, issued Tuesday, called for an overhaul of federal financing of physician training and residency programs. The report questioned the idea that the United States needs to increase the number of physicians it trains, but said that there is a need for much more accountability. "Current financing -- provided largely through Medicare -- requires little accountability, allocates funds independent of workforce needs or educational outcomes, and offers insufficient opportunities to train physicians in the health care settings used by most Americans," said a summary of the report.
The Association of American Medical Colleges, which has been leading a campaign to expand the training of physicians, was quick to object to the report. "[T}he IOM’s proposal to radically overhaul graduate medical education (GME) and make major cuts to patient care would threaten the world’s best training programs for health professionals and jeopardize patients, particularly those who are the most medically vulnerable," a statement from the association said. "The committee’s proposals assume that in the coming decades, our health care workforce would require no expansion of the highly specialized services or physicians equipped to meet the needs of a growing and aging population, with ever greater need for both primary and specialty health care. By proposing as much as a 35 percent reduction in payments to teaching hospitals, the IOM’s recommendations will slash funding for vital care and services available almost exclusively at teaching hospitals."