One way to ensure that patients in underserved communities have access to family physicians is to adequately fund the nation's teaching health center program. That's the primary finding in a policy brief(www.jabfm.org) published in the March-April issue of the Journal of the American Board of Family Medicine.
Researchers confirmed a trend that shows family medicine residents who trained in THC residency programs were much more likely than non-THC graduates to pursue practice in a safety-net setting after completing residency.
In the brief, titled "Practice Intentions of Family Physicians Trained in Teaching Health Centers: The Value of Community-Based Training," researchers focused on data collected from family medicine residents who graduated in 2014 through 2016 and who completed a questionnaire from the American Board of Family Medicine -- a requirement when graduates register for the ABFM certification exam.
"Across the three years, an average of 35.6% of THC residents reported intent to work in a safety-net setting versus 18.7% of non-THC residents," wrote the authors.
"These findings suggests that the THC program is producing a cohort of family physicians likely to increase access to primary care services for vulnerable communities," they added.
Researchers reported that 9,579 family medicine residents graduated during the three-year span. Of those residents,
- 64.5% of the 9,256 who graduated from non-THC settings revealed their practice plans for the future and
- 66.9% of the 323 residents who graduated from THC settings did so.
Even though the number of THC-trained family medicine residents was small compared to the number of their non-THC trained colleagues -- 51 THC-trained versus 1,815 non-THC trained in 2014, 79 versus 2,058 in 2015 and 86 versus 2,093 in 2016 -- THC-trained residents were almost twice as likely to look for a job in a safety-net setting.
Speak Out for Teaching Health Centers
Urge your senators to support S. 304, the Training the Next Generation of Primary Care Doctors Act, which would update the Teaching Health Center Graduate Medical Education program for five years, authorize funding for existing residency programs, and support expansion into rural and underserved communities. Use the Academy's Speak Out tool to make your voice heard(www.votervoice.net) on this critically important issue.
The researchers defined safety-net settings as federally qualified health centers, rural health clinics, public health clinics, institutional clinics and clinics that were part of the Indian Health Service.
Policy brief authors lamented the fact that the THC program is small and on precarious ground when it comes to funding -- a double whammy that "leaves it perilously close to disappearing without a sustainable policy strategy for its long-term existence."
Authors noted that the THC graduate medical education program provides funding for residency positions that focus on community-based training, and in turn, help balance health care workforce needs. Currently, 700 medical residents fill these positions in 57 FQHC programs across the country.
Corresponding author Andrew Bazemore, M.D., M.P.H., director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, summarized for AAFP News the importance of THC funding and the role the program serves in producing family physicians who are able and willing to care for patients in underserved areas across the country.
"The THC graduate medical education program has proven to be -- despite unstable funding since its inception -- a vital source of community-based primary care providers for the nation's most vulnerable patients and populations," said Bazemore. "The residency program directors continue to report that these training positions cannot continue without a renewal of funding from Congress."
Furthermore, he added, "The program's long-term viability and the continuing production of safety-net physicians remain in jeopardy absent broader graduate medical education reform."
Related AAFP News Coverage
Leader Voices Blog: Spread the Word: Teaching Health Centers Deserve Support
More From AAFP
Teaching Health Centers are Integral to Future Access to Care
American Association of Teaching Health Centers(aathc.org)