Molly Gilbert: Cuts to residency program likely to lead to more primary care shortages in the future

By Molly Gilbert

Primary care is essential to meeting foundational health care needs and it’s absence means those needs are not being met. Studies have repeatedly shown that the concentration of primary care providers in a community is related to better health outcomes for the people who live there.

Shortages in primary care providers continue to delay access to health care in our community. Current wait times to establish care with a new primary care provider in Spokane may take several weeks to several months.

That will only get worse, as the spots available for residents in the Family Medicine Residency Spokane go from 10 to 4. That program has been serving our community for 53 years and is responsible for educating 40% of the family medicine physicians serving Spokane – including me.

Family medicine physicians are primary care providers, along with internists, pediatricians and others. Primary care is often the initial point of contact for individuals seeking health care and encompasses a wide range of services including diagnosis and treatment of common illnesses (colds, flu and infections), chronic care management (diabetes, asthma, high blood pressure), preventive care (cancer screening, vaccinations and lifestyle counseling), as well as referral and coordination of specialty care. Primary care emphasizes a long term relationship fostering open communication and shared decision making.

By 2030, the United States is projected to have a shortage of greater than 120,000 physicians. Washington state is projected to be short more than 6,000 physicians with primary care alone projected to be short 1,695 physicians. And, 32.7% of physicians in Washington state are within retirement age right now, which could further negatively impact the significant shortage of primary care providers with further delays in access to care.

Recent reductions in the number of Family Medicine Residency Spokane resident physicians training in Spokane from 10 to 4 resident physicians per year will significantly impact our community’s health in the future. Current Family Medicine resident and faculty physicians see outpatients at the Spokane Teaching Health Clinic, a vital access point for many, including our most vulnerable community members.

Family Medicine Residency Spokane is a flagship training program affiliated with the University of Washington and the first primary care residency established in Spokane.

Family Medicine Residency Spokane is in crisis because of loss of faculty and loss of funding from Providence Sacred Heart Medical Center.

The potential loss of Family Medicine Residency Spokane as a training pipeline for our local medical school students will negatively influence the number of family medicine physicians providing primary care in the future. It has been shown that resident physicians tend to stay in the community in which they trained, with even higher retention if they attended medical school in the same community. That is how this girl from Minnesota ended up practicing family medicine in Spokane for almost 30 years!

Currently, Family Medicine Residency Spokane is in need of physician faculty and financial support to increase the number of resident physicians in training back to the full complement of 10 resident physicians training per year. Graduate medical education funding for resident physician training programs is complex and we will be reaching out to community leaders and organizations for partnership to support this effort.

Please be on the look out for future opportunities to support Family Medicine Residency Spokane. If you are a family medicine physician interested in employment or volunteer opportunities at FMRS, please contact Diane Borgwardt, program co-ordinator at Family Medicine Residency Spokane at diane.borgwardt@providence.org.

Molly Gilbert is a family medicine physician in Spokane. She is president of the Inland Academy of Family Physicians and a clinical associate professor of family medicine and the University of Washington School of Medicine.