Nav: Home

Unique primary care residency program hangs in budget balance

May 04, 2017

PROVIDENCE, R.I. [Brown University] -- It's too soon for Shayla Durfey to know whether she'll apply for a Teaching Health Centers (THC) residency when she graduates from the Warren Alpert Medical School of Brown University in a few years -- but as she and two professors write online in JAMA, the unique opportunity won't still exist for her or other medical students without action from Congress.

Created under the Affordable Care Act (ACA), the $60 million THC program needs budget reauthorization by Sept. 30, 2017. The program currently funds 700 residents to serve as primary care providers at 59 community health centers, rural health clinics and Indian Health Centers in 28 states. The program helps to serve the outpatient medical needs of about 500,000 people, most of whom live below the poverty line and either have public insurance or none at all.

The nation also needs to train more primary care physicians, wrote Durfey, Dr. Eli Adashi, professor of medicine and former dean of medicine and biological sciences at Brown, and Dr. Paul George, associate professor of family medicine and assistant dean of medical education.

"There is a projected primary care shortage in the United States, especially with increased coverage and access under the ACA," said Durfey, a student in Brown's primary care and population medicine dual degree program. "This program addresses that shortage by training people in the highest need areas."

In the Viewpoint essay, the trio cites research showing that the program succeeds in inspiring more young physicians to stay in primary care practice (91 percent among THC residents compared to 23 percent for residents overall), to do so in underserved areas and community health clinics (76 percent compared to 26 percent) or in rural areas (21 percent vs. 5 percent).

To students like Durfey, THC also offers young doctors aspiring to primary care the prospect of training for the realities of primary care practice, she said. The program's residencies offer training in areas such as multidisciplinary leadership, primary care innovation and patient-centered medical homes. Many traditional residency programs are inpatient focused, even though that's not how most primary care is delivered, she said. But THC is unique in channeling residency funding directly to outpatient centers, rather than through inpatient-focused hospitals.

Whether any funding remains in 2018 will be up to Congress, even as it continues to debate the future of the Affordable Care Act.

"A permanent funding solution is essential to ensure the future of the THC [residency] program," the authors wrote. "The uncertain future of the ACA makes awareness and funding of successful primary care programs like this one critically important. Without such awareness, the THC program could be easily forgotten in the face of larger health system upheaval."
-end-


Brown University

Related Primary Care Articles:

A blueprint for building transgender health programs in primary care
Leading educators and clinical experts on transgender health care from Harvard, Fenway Health, and The Fenway Institute address access issues for transgender patients seeking care by providing a plan to integrate gender-affirming hormone therapy, surgical referrals, or wrap-around services into primary care.
Contacts with primary care physicians did not increase after the Affordable Care Act
At the same time the Affordable Care Act increased the number of insured Americans, analysis of health care industry data shows a continued decline in contact with primary care physician services.
Collaboration may improve access to HIV testing, primary care
Getting better access to testing and proper primary care for individuals vulnerable to HIV could be as simple as a telephone call or email among health providers.
Case management in primary care associated with positive outcomes
In a systematic review, researchers identified three characteristics of case management programs that consistently yielded positive results: case selection for frequent users with complex problems, high-intensity case management interventions and a multidisciplinary care plan.
A new approach to primary care: Advanced team care with in-room support
In this special report, the authors argue that the current primary care team paradigm is underpowered, in that most of the administrative responsibility still falls mainly on the physician.
How primary care physicians can make Astana work
The Astana Declaration, adopted by the World Health Organization in October 2018, acknowledges the importance of primary health care to achieve better health outcomes globally.
A structured approach to detecting and treating depression in primary care
A questionnaire-based management algorithm for major depressive disorder in primary care is feasible to implement, though attrition from treatment is high.
New tool measures primary care as a whole
There are a number of measures to assess aspects of primary care, but a new measure breaks new ground by combining experiences of patients, clinicians, and payers and allowing the most informed reporter -- the patient -- to assess vital primary care functions that are often missed.
Learning more about opioid prescribing in primary care
Chronic opioid prescribing in primary care varies significantly by patient and clinician characteristics, according to a new study.
Large federal program aimed at providing better health care underfunds primary care
Despite a mandate to help patients make better-informed health care decisions, a ten-year research program established under the Affordable Care Act has funded a relatively small number of studies that examine primary care, the setting where the majority of patients in the US receive treatment.
More Primary Care News and Primary Care Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Clint Smith
The killing of George Floyd by a police officer has sparked massive protests nationwide. This hour, writer and scholar Clint Smith reflects on this moment, through conversation, letters, and poetry.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Dispatch 6: Strange Times
Covid has disrupted the most basic routines of our days and nights. But in the middle of a conversation about how to fight the virus, we find a place impervious to the stalled plans and frenetic demands of the outside world. It's a very different kind of front line, where urgent work means moving slow, and time is marked out in tiny pre-planned steps. Then, on a walk through the woods, we consider how the tempo of our lives affects our minds and discover how the beats of biology shape our bodies. This episode was produced with help from Molly Webster and Tracie Hunte. Support Radiolab today at Radiolab.org/donate.