Family Medicine urges Congress to invest adequately in our nation’s primary care physician workforce. Provide at least $38.9 million in FY2017 for the Title VII Health Professions Primary Care Training and Enhancement Grants administered by the Health Resources and Services Administration (HRSA.)
The Primary Care Training and Enhancement (PCTE) grants authorized by Title VII, Section 747 of the Public Health Service Act are important to support the education and training of family physicians. It is the only federal program that specifically supports primary care training and the professional development of primary care faculty and is essential to support the family physician workforce. The PCTE strengthens medical education for physicians and physician assistants to improve the quantity, quality, distribution, and diversity of the primary care workforce. Without additional funding, there will not be any new grant competitions for four more years.
Primary Care Demand Expected to Rise
A study in the Annals of Family Medicine projects that the rising number of primary care office visits for the expanding, aging, and increasingly insured population will require an additional 33,000 practicing primary care physicians by 2035. Another study in the same journal noted meeting the increased demand for primary care physicians would require a major investment in training. The article explicitly called for the expansion of Title VII, Section 747 to improve access to primary care. But we already face shortages in specific settings. A March 2016 report of the National Association of Community Health Centers found that more than two-thirds of health centers are actively recruiting for at least one family physician.
The federal Advisory Committee on Training in Primary Care Medicine and Dentistry noted that the funds “available through Title VII, Part C, sections 747 and 748 have decreased significantly over the past 10 years, and are currently inadequate to support the system changes.” The committee recommended restoring funding to inflation-adjusted FY 2003 levels plus an additional $25 million per year over the next five years beginning in FY 2017 to permit annual competitive grant cycles for primary care training grants.
For decades, these competitive grants to medical schools and residency programs have helped increase the number of physicians who select primary care specialties and who go on to work in underserved areas. A 2014 study which looked at the effect of a PCTE grant addressing faculty development needs found that targeted federal funding can bring about changes that contribute to an up-to-date, responsive primary care workforce.