Change through disruption (check)
Change through creating policy (check)
Change through educating the media, legislators, and the public (pending)
All of the above are the reasons for continuing efforts to ensure that medical schools are held accountable for the primary care workforce numbers it publicizes and promotes to medical students, federal/state/local legislators, and the public. All of the aforementioned stakeholders deserve the right to know how many of its medical school and residency graduates ACTUALLY practice primary care.
We have used this blog to call out medical schools that lie to the media and ultimately lie to themselves. These blogs have served as references for a number of articles in the media to help explain what "the Dean's Lie" actually is. Over the past year, a number of media outlets have caught on to and have called out medical schools that, despite being shown the data, continue to publicize primary care percentages that cannot be proven until at least 3-5 years after graduation from medical school.
An article by Medical Economics ("How Medical Schools consistently cover up their primary care failures") focuses on an interview with Primary Care Progress CEO and primary care change agent, Dr. Andrew Morris-Singer. The article does an exceptional job in trying to relay this information to the media. By utilizing the media for these numbers, they may be more likely to show how many of the "primary care institutions" are actually performing at the bottom of all medical schools in the entire country. In fact, this is already being evaluated in our internal medicine residency programs by the Graham Center and resulted in several media pieces, including the "20 worst" residency programs for contributing to the primary care workforce.
Now that our efforts are finally starting to show promise, it is now important to continue this momentum and accumulate organizational support. Since medical schools and residencies refuse to face the truth and provide the correct data proving their inability to produce primary care physicians, we must now do the work ourselves in finding this objective data and distributing it via multiple large-scale organizations to legislators and the public.
The opportunity to provide guidance and create policy outlining the specifics of this initiative presented itself this past weekend at the 2013 American Academy of Family Physicians (AAFP) National Conference of Family Medicine Residents and Medical Students. The Resident Congress provided a forum to present a resolution that, upon approval by the Resident Congress, a specific action and policy could be put into place to task an organization that represents over 110,000 Family Medicine physician, resident, and medical student members with advocating and collaborating with others in amplifying these efforts.
The following resolution was submitted and approved by the AAFP Resident Congress:
RESOLUTION NO. R1-407
Rebuilding Trust In and Accountability for Primary Care Workforce Production Reporting
WHEREAS, The United States (U.S.) educational system is currently doing a woefully inadequate job of producing enough primary care physicians to satisfy future demand, and
WHEREAS, medical school deans and residency programs consistently cover up their primary care failures, regularly exaggerating the number of medical school students and residents they report graduating into “primary care residencies” and practicing in “primary care fields,” also known as “The Dean’s Lie,” and
WHEREAS, publicizing misleading data of primary care workforce production gives the taxpaying community and politicians a false sense that the primary care workforce shortage is being fixed, and
WHEREAS, after factoring in the specialization rate of pediatrics (66%), internal medicine (80-98%), and other “primary care” residencies (e.g. IM/Peds, etc.), a much lower number of medical students actually end up practicing primary care, and
WHEREAS, medical schools utilize other non-primary care specialties when reporting their primary care production numbers (e.g. obstetrics and gynecology), and
WHEREAS, the institutions touted at producing primary care physicians have recently been found to be among the worst at producing primary care workforce when looking at graduating classes from five years prior, and
WHEREAS, it costs $500,000 of taxpayer dollars to train the average resident and as part of the Affordable Care Act, provisional funding will be given to “primary care” residencies including internal medicine, pediatrics, etc., now, therefore, be it
RESOLVED, That the American Academy of Family Physicians (AAFP) advocate for accurate reporting by medical schools and residencies of primary care workforce production measuring the type of practice five years following medical school graduation, and be it further
RESOLVED, That the American Academy of Family Physicians (AAFP) explore the feasibility of working with other organizations and news outlets to collaborate in advocacy for more accurate reporting of primary care workforce production to politicians and the public.
Things are about to get very interesting....
Highlight on interesting comments: