Sunday, March 11, 2012

Family Medicine: They Are Closing Us Down Coast to Coast

Across the nation, random attempts to close Departments of Family Medicine and Family Medicine residency training programs are continuing to bubble, fade, succeed, fail and surprise those who thought more Family Physicians are needed to "bend the cost curve" of healthcare.

It's all about the money, folks.  Family Physicians decrease emergency room visits, admissions and re-admissions to hospitals and over-all cost of health care. That loses money for several entities, but saves money for employers and patients (and governments, aka tax payers) .

Watch in your area to see where the cuts occur that decrease your access to Family Physicians.  You may be surprised.  I was.

I remember surprising moves over the years by the University of Iowa, Ohio State University, Penn State University, Duke University and numerous Community Hospitals that evicted, closed, reduced or merged Family Medicine Departments or Residency Training Programs.  Rumors about the University of Minnesota were the most recent example of University versus Family Medicine.

I trained in the Family Medicine Residency of the Department of Family and Community Medicine of the Milton S. Hershey Medical Center.  My training program was evicted years later and picked up by the Good Samaritan Hospital in Lebanon, PA which picked up an expanded Penn State relationship in the process.

Both flagship hospitals of the two surviving hospital networks in my area of Dayton, OH have closed their Family Medicine training centers within the last three years.  Who is training the Family Physicians needed to serve the Greater Dayton area?

I'm worried about the Future of Family Medicine and access to care for Americans as we are about to add 30 million people to the ranks of  "the insured".  I fear that they and millions of others will find that an urgent care center or emergency room is their Family Doctor.  The costs of care can only to continue to bankrupt America unless we get together about a better vision for health care.

Medicare is paying much of the costs for Family Medicine training via subsidies to training hospitals.  As this money is decreased with various government policies, the hospitals may lean toward training specialists who make more money while in training such as cardiology fellows who do procedures and order lots of expensive tests routinely.

Various legislative efforts are being initiated such as H.R. 3667 to find ways to continue the training of Family Physicians and other primary care physicians.  You may wish to read more about this bill and its background and sponsors by double clicking on the link below.  More later.

H.R. 3667

What have you heard about reductions in training Family Physicians and other primary care physicians?


  1. I'm glad that you are raising awareness of this troubling trend. There are rumbles where I am that the 3 FM residency programs in our system may be "condensed" into 2 in the next few years... I, sadly, would not be surprised to see it happen. How have we, as a specialty, failed to help others understand what FM is and why it's important? We cannot fix US Health Care without Family Medicine - but it seems someone forgot to tell all these profit-centered bureaucrats that.

  2. Family medicine has been declared dead many times in the past. In fact I dare say that every family physician who is practicing now was told at one time or another to be a different kind of specialist. "The prestige wasn't there. The money wasn't there. It wasn't sexy." Despite that, family physicians still exist and the AAFP is the largest most prominant specialty in the country. Our family physicians do it because we believe in what we do. It is done for love, duty, and caring. This cannot be vanquished. Trends in education, policies, politics come and go. The specialty will survive. We will find a way to teach the next generation.

  3. Thanks, Joe, for your passionate comment about the power of Family Medicine to survive. Mike Sevilla echoes your belief in his post on Family Medicine Rocks about barely saving a Family Medicine Residency program in Kern Medical Center in Bakersfield, CA last week.

    It may take heavy activism from us and our patients and the aware media to keep winning these victories "for the people".

    (Joe Jeu, MD has a great practice in Hilliard, OH that is still growing and succeeding and adjusting to tech advances and government mandates. A Family Medicine success story which , hopefully, has been told again and again)