community-medicine

Kaplan GA. Ann NY Acad Sci 1999, 896:117-199

Most residency training is paid for by Medicare through the sponsoring hospital. HRSA Title VII provides money specifically to support programs who train physicians that leave training and practice among underserved populations. The previous administration had eliminated the program despite evidence of great success. There is $400,000,000 in the stimulus package for this year for this program. Additionally, the renewal will be put before Congress this year as well. Below are the key aspects of “Health Professions and Primary Care Reinvestment Act” which were H.R. 7302 and S. 3708 but will be renumbered in the 111th Congress.

In addition to the traditional emphasis in Family Medicine training, the following is included in the language of the bill for the “pre-doc” (programs that offer training to medical students) and residency grants:

·        to plan, develop, and operate an interdisciplinary training program that includes at least 1 of the following which demonstrates a team approach to care and may demonstrate a patient-centered medical home model:

o   A program designed to teach trainees the skills to provide interdisciplinary patient care through collaboration among various professionals, including those trained in geriatrics, physician assistants, nurse practitioners, pharmacists, or social workers.

o   A program developed in collaboration with dental students or residency training programs to improve integration and access to dental care.

o   A program developed in collaboration with psychologists and other behavioral and mental health professionals to integrate mental and behavioral health and primary health care

 

For the programs to develop primary care departments, the emphasis will be on: 

 

·     innovative approaches to clinical teaching using models of primary care, such as the patient centered medical home, team management of chronic disease, and interdisciplinary integrated models of health care that incorporate transitions in health care settings and integration physical and mental health provision.

·     Generating the capacity to do Community Health Needs Assessment-

 

Lastly, they will create a new entity, the Primary Care Training Institutes, whose purpose is

 

·      To prepare and train primary care providers by enhancing and coordinating multiple aims within academic health centers in order to lead to improving patient care delivered to health disparity populations and reduce health disparities;

·      To enhance the status of primary care within undergraduate and graduate medical education through influencing priorities in practice, education, and research;

·     To develop innovative approaches to primary care education and scholarship by transforming and integrating health care systems through interdisciplinary, team-based, and collaborative models that may demonstrate improved quality or lower costs;

·     To create economies of scale through academic and community collaborations by enabling academic infrastructure support for multiple community programs.

 

This money is needed to improve our training and make it more targeted towards what will imporve health, not just attack illness. Let’s all work to put this program back on track.

 

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