IOM report calls for sweeping changes to medical education

A new report from the Institute of Medicine calls for sweeping changes to the way $15 billion in federal funds are spent annually on training physicians (Source: “Report Touches Off Fight Over Future Of Doctor Training Program,” Kaiser Health News, July 30, 2014).

Released Tuesday, the report for the Institute of Medicine called for more accountability for the funds, two-thirds of which are provided by Medicare. It also called for an end to providing the money directly to the teaching hospitals and to dramatically alter the way the funds are paid.

 The funding in question is for graduate medical education, the post-medical school training of interns and residents required before doctors can be licensed to practice in any state. 

“We recognize we are causing some disruption,” said Gail Wilensky, a health economist who, along with former CMS chief Donald Berwick, co-chaired the panel that produced the report. “But we think we are doing so in a thoughtful and careful way,” including phasing in the payment changes over 10 years.

The report was met with criticism by the American Hospital Association, the American Medical Association and the Association of American Medical Colleges.

“While the current system is far from perfect, the IOM’s proposed wholesale dismantling of our nation’s graduate medical education system will have significant negative impact on the future of health care,” said AAMC President and CEO Darrell Kirsh. “By proposing as much as a 35 percent reduction in payments to teaching hospitals, the IOM’s recommendations will slash funding for vital care and services available almost exclusively at teaching hospitals, including Level 1 trauma centers, pediatric intensive care units, burn centers, and access to clinical trials.”