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Bill would spread out medical training slots

Adding sites a boost for WSU-Spokane program

WASHINGTON – Congress may try to ease a nationwide shortage of rural family doctors by “growing” more of them in places like Spokane through legislation introduced this week.

Members of Washington’s congressional delegation want to increase the number of doctors practicing in small towns and rural areas by changing the federal Graduate Medical Education program, which helps pay for medical residencies.

The pilot program would pay for training at community-based medical programs as well as hospitals.

“We don’t grow enough of our own doctors to meet the demand of the people,” said Dr. Anne Montgomery, a Spokane family physician and president-elect of the Washington Academy of Family Physicians.

There are already not enough family doctors across the country, and the problem is more acute in Eastern Washington and other rural areas, said Rep. Cathy McMorris Rodgers, R-Wash.

“That especially affects rural areas’ access to quality and affordable health care,” she said. In small communities without large hospitals, family physicians are the main sources of medical care. The shortage is expected to grow as more physicians reach retirement age.

Because doctors are more likely to practice near where they complete their residency, more residency positions at Spokane hospitals would mean more doctors in rural Eastern Washington.

McMorris Rodgers introduced the Primary Care Workforce Access Improvement Act this week in the House, and Sens. Maria Cantwell and Patty Murray, both D-Wash., have plans to bring a similar bill to the Senate.

The Graduate Medical Education program caps the number of medical residency slots available. Under the current program, there are 10 medical students per 100,000 people in Eastern Washington compared to 250 medical students per 100,000 on the West Side. If passed, the legislation would create a five-year pilot project to test new ways to distribute residency slots. More slots would be created to train primary care physicians, with preference given to programs that serve rural areas.

The program would not require additional funding but would pull a small amount of funding given to hospitals across the country for current residency slots. If all pilot program slots are filled, it would produce about 100 new rural family doctors at the end of five years, according to the Council of Academic Family Medicine.

Among the models the program wants to support are medical schools collaborating with a hospital. The Spokane Medical Education Program at Washington State University-Spokane could apply for the program under that model.

“We are far below where we need to be to be competitive with residency positions. If it’s successful, it helps us get started,” said WSU-Spokane Chancellor Brian Pitcher.

The Washington, Wyoming, Alaska, Montana, Idaho Family Medicine Residency Program in Spokane could go from training 10 doctors at a time to training 20 or 25, Montgomery said.

Jessica Holdman is a student in the University of Missouri Journalism School’s Washington, D.C., reporting program.