Crowley, Schumer Unveil New Legislation That Would Help Reverse Critical Doctor Shortage Threatening Area Hospitals

May 8, 2009 Issues: Health Care

“No health care reform effort will be complete or even adequate unless we address the shortage of doctors in this country," Sen. Schumer said. "If we are going to insure more Americans, we will certainly need more physicians to treat them. This legislation will provide a common-sense fix to the outdated cap on residency slots."

The best health insurance in the world isn’t worth much if you can’t get an appointment with a doctor,” said Congressman Joseph Crowley.  “With Congress on the cusp of reforming our health care system, Senator Schumer and I are calling attention to the fact that we must take steps to increase access to primary physicians.  Communities like the Bronx are suffering from serve physician shortages – putting health care basics such as regular check ups, advice on how to avoid chronic illness, and vaccinations, flu-shots and blood pressure screenings out of reach.  If we want to keep Americans healthy, we will make sure they have a primary care doctor who is not just one phone call away, but a brief bus or subway ride away.  I am proud to introduce this legislation with my colleague and friend Senator Schumer and look forward to working with him to increase awareness on this critical issue.”

 “The passage of this bill will have a tremendous impact on our ability to serve the healthcare needs of the people of the Bronx, a community affected by significant rates of disease and among the most medically underserved in the nation,” said Steven M. Safyer, President and CEO, Montefiore Medical Center. “While national healthcare reform is imminent, simply insuring everyone is not the entire solution. True reform is needed: we need to be innovative in how we deliver care and place more value on primary and preventive care and disease management.  At Montefiore, new doctors we train remain to provide vital, state-of-the-art care to the community, taking responsibility for its health.  Congressman Crowley and Senator Schumer clearly understand that increasing quality physicians in the workforce is critical to the health of the Bronx and the nation.”

“This critically important legislation comes not a moment too soon,” said Greater New York Hospital Association president Kenneth E. Raske. “With the United States at the doorstep of an alarming physician shortage, Congressman Crowley and Senator Schumer are working to ensure that New York’s teaching hospitals have the means and support to continue to train tomorrow’s doctors. I applaud them for their commitment to keeping New York the physician training capital of the world.”

Allen M. Spiegel, M.D., Dean of the Albert Einstein College of Medicine said, "I applaud Senator Schumer and Congressman Crowley for understanding the importance and taking action to expand residency training slots across the nation.  Assuring an adequate supply of highly-trained doctors will be a critical component of the move toward universal health care."

Congressman Eliot Engel said, “With the aging baby boomer population, our nation is facing a critical shortage of physicians.  As a senior member of the Health Subcommittee of the Energy and Commerce Committee, I am proud to join with my colleagues in introducing legislation to expand Medicare-supported residency slots, with an emphasis on primary care, training in community health centers, and other community-based training. As we work with President Obama on a comprehensive healthcare reform package, this proposal should be included as it will have a positive effect on our shortage of doctors in New York and nationwide."

The federal government traditionally has helped pay for physicians’ residencies, the final step in a doctor’s training.  But in 1997, federal law capped the number of Medicare-supported medical residents for hospitals.  Since 1997, the U.S. population has increased by more than 30 million – making the need for additional medical residents particularly acute.

Schumer and Crowley said teaching hospitals have the critically important mission of training the next generation of doctors, and New York’s teaching hospitals train more than 16,000 medical and surgical residents every year—fully 17% of all physicians trained in the United States. No other place in the world trains more doctors in more specialties, and three out of every four doctors practicing in New York also trained here.

Right now, there are 14,548 residents being trained at New York City area hospitals, 350 over the cap.

Schumer and Crowley’s legislation would increase by 15 percent the ranks of doctors-in-training by increasing the number of Medicare-supported hospital residency positions by 15,000, bringing the total to about 115,000. This would mean New York hospitals would be able to train 400 new residents and be able to apply for up to 5,000 additional slots.

In 1997, the Balanced Budget Act froze the number of residents that a hospital could claim Medicare payment for, based on the number of residents that each hospital employed in 1996. 

Between 1980 and 2005, the nation’s population grew by 70 million people—a 31 percent increase. By 2030, as baby boomers age, the number of Americans over age 65 will double from 35 million to 71 million. These changes will significantly increase the demand for physicians’ services.  In 2007, the Council on Graduate Medical Education recommended increasing Medicare-funded residency positions by at least 15% to meet growing demand.

In light of efforts to greatly expand health coverage as part of health reform efforts, this need is even more acute.  This legislation would meet that need by expanding Medicare-supported residency slots with a focus on primary care and community based training. These residents treat all patients of every age throughout the hospital.  It would also make changes to current rules that limit a hospital’s flexibility in training its residents in non-hospital settings, like community health centers.  Finally, it would allow residency slots in hospitals that close to be used by nearby teaching hospitals so that these slots were not lost upon a hospital closure, as currently is the case. 

Schumer and Crowley were joined by Dr. Steven Safyer, President and CEO of Montefiore Medical Center, Kenneth E. Raske, President of Greater New York Hospital Association (GNYHA), and Dr. Allen Spiegel, Dean of Einstein College of Medicine.