Georgia AFP Advocacy Leads to Increased Funding for Residency Programs

Score one for the Georgia AFP. Earlier this year, the Georgia legislature approved -- and the state's governor signed into law -- a funding increase for Georgia's family medicine residency programs after an intense lobbying campaign by the Georgia Academy.

Passed as a state budget line item, the measure increases funding for the state's 10 family medicine residency programs by $541,461 compared with the previous fiscal year's funding. Gov. Sonny Perdue signed the measure into law in mid-May, and the increase will take effect on July 1.

"This is going to help the residency programs become much more robust," said Fay Fulton Brown, M.H.S., executive director of the Georgia AFP. "We also believe it gives the programs an edge in recruiting top-notch medical students into the Georgia family medicine residency programs."

The state has 202 family medicine residency slots in 10 residency programs throughout the state, and, unlike many other states, Georgia provides direct funding for its programs. With the increase in funding, the amount of money allocated for each resident will jump from slightly more than $19,319 to $22,000 a year, Brown said. That funding, she added, goes directly to the programs, and they, in turn, use the funds to "enhance their programs however they want."

The Georgia AFP has been working to increase funding for the state's family medicine residency programs for the past three years, Brown explained. But in 2007, GAFP staff stepped up their advocacy efforts, meeting last summer with staff from the governor's office and various legislative offices to jump-start the process well before the legislature convened in January. During the legislative session, GAFP staff routinely met with lawmakers serving on key committees, such as budget and appropriations. They also handed out copies of a one-page flier to all legislators explaining the importance of the residency programs and why a funding increase was needed.

"This increase would be an investment in keeping a strong primary care physician network throughout the state," the flier said. "Research has shown that graduates tend to establish their practice within a 50-mile radius of where they completed their training."

The flier also pointed out that the family medicine residency programs are "held accountable" for the funding -- that is, the programs must have at least a 50 percent retention rate of trained family physicians who stay in Georgia or they "must return the capitation funds." Moreover, the federal government matches each resident's capitation funding through Medicaid, giving the state approximately $1.60 for every $1 expended in state capitation funds, the flier said.

In making its case, the Georgia AFP relied heavily on the residency "footprint" maps produced by the AAFP's Robert Graham Center in Washington as part of the interactive HealthLandscape Web site. By using the site's Primary Care Atlas map-making tool to show where residency graduates wind up practicing, GAFP staff were able to strengthen the case for increased funding for the residency programs.

"We were able to show the legislature that the funding they have been allocating over the years has gone directly back to family physicians who have trained in Georgia and tended to stay in Georgia," Brown explained.

In the Georgia General Assembly, Rep. Ben Harbin, chair of the House Appropriations Committee, championed the funding increase, making sure it got into the budget and stayed there and helping to ensure the measure eventually was adopted, Brown said.

But perhaps most importantly, Georgia AFP President Bruce LeClair, M.D., M.P.H., met with key lawmakers every Wednesday during the legislative session. LeClair, an associate professor of family medicine at the Medical College of Georgia in Augusta, was able to provide the legislators a first-hand account of the importance of the residency programs.

"You never know how much effect you have on people," said LeClair. "But there is the personal nature that we don't always realize with our legislators -- seeing them, talking with them rather than just (sending them) an e-mail or a letter."

"I would encourage all of the chapters to have conversations with the policy leaders in their state because I strongly believe state legislators understand the importance of family medicine in their local community," said Brown. "When you start talking about the future and having someone who can take care of them as they age and their children and their children's children, it really resonates with them."