4 Key Moments: Listening to on Advancing the Subsequent Technology of America’s Health Care Workforce

WASHINGTON, D.C. – There stays a vital want for extra doctor coaching and medical residencies positioned in rural communities throughout the nation, witnesses shared at a Ways and Means Health Subcommittee listening to analyzing Medicare’s Graduate Medical Education (GME) program and different progressive methods to coach America’s well being care workforce with a give attention to serving rural and underserved communities. America will face a complete scarcity of 187,000 physicians by 2037, with rural areas experiencing shortages of 60 p.c and concrete areas of simply 10 p.c. In addition, many rural hospitals are under-resourced and battle to open and run their very own residency applications. At the identical time, way of life interventions that incorporate diet and train for power illness administration and expertise might be higher leveraged to assist the subsequent era of physicians. 

Missouri Rural Hospital Shares Challenges Of Getting More Residency Training and Practicing Physicians Into Rural Areas

Rural hospitals usually battle to begin a residency program due to an absence of sources, workers, and affected person quantity. Consequently, solely 2 p.c of residencies are in rural areas. Lower reimbursement charges, as much as $70,000 much less per resident, for sure rural hospitals in comparison with the usual hospital reimbursement additional exacerbate the difficulty. A Missouri rural hospital detailed the monetary challenges they face in beginning a household drugs and obstetrics residency program to answer local people wants. 

Chairman Jason Smith (MO-08): “Mr. Shenefield, could you please share how Phelps Health is developing its family medicine residency program, the hurdles, financial and otherwise, you have faced in that process, and how the Medicare program can make it easier for hospitals in rural communities to innovate in the manner that you have?”

Jason Shenefield, Missouri hospital administrator: “We’ve talked about doing a residency program for a few years prior to knowing that this funding was out there. The challenge was how do we pay for getting it going? The need really comes from creating more access. There are not enough primary care providers in our community, and we really felt that the best way to create more access is developing a residency program, specifically family practice with obstetrics. It just seems to fit a few of our different needs in our community… 

“Being able to update our per resident amount when starting a new residency program, that is a concern. We estimate that it’ll be close to about $100,000 loss per resident based off of our current estimates. I think those are some of the big things that we see. We are unique: we are just big enough that we can take this on. I think smaller hospitals would struggle, but I think if some of these issues are fixed, I think that they could overcome that as well.”

Rep. Greg Murphy (NC-03): “We added additional slots [to the Graduate Medical Education program]. But despite congressional intent, a lot of these did not reach rural areas. They went to places where they were not supposed to go. How do we make that moving forward so that that does not happen?”

Dr. Emily Hawes, North Carolina rural medical pharmacist: “The section 126 that you’re referring to points to the fact that rural hospitals who want to expand their training should be able to and 10 percent of them were supposed to go to geographic rural areas. There were relatively low numbers of eligible rural hospitals, which is something to consider. The prioritization of the slot distribution by Health Profession Shortage Areas [HPSA] actually disincentivized some of the rural hospitals with low or no HPSA scores from even applying…. If they’re training in rural areas, they need slots to be able to expand.”

Innovative Technology: A “Great Equalizer” For Rural Medicine

New expertise, like A.I. and wearable gadgets, may assist shut the well being hole in rural areas and alleviate burnout incessantly skilled by physicians, particularly these working towards in rural communities. Technology can assist overcome the lengthy distances and workforce shortages pervasive in rural well being care.  

Rep. Kevin Hern (OK-01): “I frequently hear from physicians back home about burnout and the massive administrative and clinical burdens they face. It is my hope that the new technology will help ease these burdens they feel when practicing medicine…Dr. Mohr, how are residency training programs keeping pace with the technology sector in making sure both residents and the physicians training them know how to use these newest health technologies? Can you confirm residents in both rural and urban settings are receiving equal training in these advanced systems?”

Dr. Thomas Mohr, Dean, Sam Houston State University College of Osteopathic Medicine: “Are we keeping up with technology? We’re trying, but I wouldn’t say that we’re keeping up. It’s moving too fast right now. It’s moving too fast for all of us, but that’s something that we need to put energy and effort into. At Sam Houston State University, we’ve created a Medical A.I. Institute to help us to do research, but also to figure out how best to utilize medical technology, A.I., large learning models, and independent wearable technology into the health care of folks that are out there. Now this could be the great equalizer for rural areas, because this actually could be a way that we can bring those types of technologies out to support rural areas, to decrease some of that terrible administrative burden, which absolutely leads to burnout.”

Lifestyle Medicine Matches Actual Delivery of Care in Rural Communities

Lifestyle drugs is vital to serving to Americans dwell more healthy lives by schooling and diet, train, sleep, power illness prevention, and different contributors to raised well being. One witness famous that rural areas are sometimes adept at offering way of life drugs at places apart from a medical workplace, which opens the door for brand new populations to obtain preventive care. 

Rep. Blake Moore (UT-01): “Much of the actual treatment for chronic disease happens outside a doctor’s office and in community settings. Can you discuss the ways that lifestyle medicine meets patients where they are and how this improves their health outcomes?” 

Dr. Jennifer Trilk, Director of Lifestyle Medicine, University of South Carolina School of Medicine: “We opened our doors in 2012 to be able to serve the community where they live, work, pray, and play. The idea of bringing lifestyle medicine into primary care, and then also into Greenville County, Oconee County and our existing counties, it is a way that we can serve patients needs and then also have providers and residents who graduate from our program and go into rural areas….In rural areas, we want to be able to access health care, but we also can use our community organizations, like the YMCAs, senior centers to have the physicians working with the patients in their care.”