A unique partnership is helping Spokane solve a critical problem that has troubled midsize cities for decades: a severe shortage of slots for medical residents (newly graduated medical doctors who must complete at least three additional years of graduate medical education, known as GME).
Communities that don’t have sufficient numbers of residency slots don’t attract physicians because medical students tend to begin their careers near their residency assignments.
To appreciate the significance of the problem, consider our state’s numbers: Washington has approximately 1,600 medical residency slots, with more than 1,500 of those in Western Washington. Only 74 are in Spokane. As well, our region has long suffered from a shortage of primary care physicians, which has become critical this year due to the convergence of the Affordable Care Act, retiring baby boomer physicians, an aging population, and the need for more physicians at Veterans Affairs hospitals.
We are pleased to share that over the next five years, the number of medical residency slots in Spokane could potentially grow by as much as 62 percent thanks to a consortium of partners that applied for and received funding through a new program supporting “teaching health centers.”
The first round of funding approved in December by the federal Health Resources and Services Administration will support six residents – three in family medicine and three in internal medicine – who begin their residencies July 1. If this funding source is continued, the number of residents in Spokane could grow by 39, reaching 119 at the end of 2019.
This potential growth is the result of a 7-month-old consortium called the Spokane Teaching Health Center, comprising the Empire Health Foundation, Providence Health Care and Washington State University Spokane. The STHC was formed in an effort to secure positions for much-needed resident physicians, and to increase health care access throughout the region. The funds were made available within the Affordable Care Act.
Spokane leaders have worked for years to increase residency slots as a way to ensure that physicians choose to stay here once they complete the last portion of their medical education. The efforts of Greater Spokane Incorporated, and in particular former Chief Executive Officer Rich Hadley, helped to educate the community on the issue and inspired us, in part, to pursue this new funding.
The consortium and its nine-member board of directors is also taking over sponsorship of the longtime Providence-based residency programs. Because the traditional funding stream for residencies is most often linked to medical schools and university hospitals, it is very unusual for a consortium like ours to oversee medical residencies, and it is a distinction for the Spokane region.
To qualify for the federal funding, the new residencies must be community-based. It is exciting to note that each of the partners is doing their part to make this work. Because funding for the program is due to expire at the end of the federal fiscal year, community stakeholders are working with the federal delegation to continue, as well as increase, existing residency funding.
If no new money is appropriated, Empire Health Foundation has agreed to pay the expenses for the existing residents, allowing the six doctors to finish their training. The foundation is providing flexible startup funds, at least $175,000 on top of the public funds, to launch the consortium and invest in the leadership of this important community asset. We’re grateful to EHF because this allows us to make a full commitment to the first group of new doctors. However, the federal funding is absolutely critical to growing the number of residencies.
Providence Health Care’s four decades of sponsoring, and partially funding, medical education gives the consortium the expertise necessary to make this project a success. For now, the new residents will be based at Providence Health Care’s residency clinic in the Fifth & Browne Medical Center Building, which provides free and low-cost health care.
WSU Spokane has agreed to fund the faculty and, in September, the WSU board of regents will consider whether to allow the university to sell $15.2 million in general revenue bonds to finance the construction of a two-story, 42,000-square-foot clinic on the Spokane campus.
The facility would also serve as a teaching space for health sciences students from WSU, Eastern Washington University and the University of Washington who share the WSU Spokane campus. They would work with the medical residents in interprofessional teams to serve the community.
As the premier health care center between Seattle and Minneapolis, and a true beacon of collaboration, Spokane has the capacity to do even more to increase access to health care. This consortium is a step in that direction.
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