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Rural Healthcare

The American Academy of Family Physicians (AAFP) recently joined hands with four other organizations in its attempt to expand the ranks of primary care physicians to where they are needed badly. The agency intends to make changes to the proposed CMS rule.

The group has submitted a letter to CMS that proposes to give more support for rural training. Apart from AAFP, it was signed by the Society of Teachers of Family Medicine, the Association of Departments of Family Medicine, the Association of Family Medicine Residency Directors, and the North American Primary Care Research Group.

According to the letter, “The production of primary care physicians, especially family physicians, is a key area where we believe CMS can and should do more to remove barriers to increased production. We hope CMS will provide special consideration for underserved rural areas under statutory authority given to CMS for that specific purpose. We are concerned that CMS, in its rulemaking, has not sufficiently considered its authority to encourage the production of rural physicians.”

It is a fact that number of medical residents who become rural physicians is very low at present. From 759 teaching institutions, only 4.8 percent of graduates chose to practice in rural areas in 2013. Most rural training programs do not receive enough federal funds for its residents either, which is one of the prime reasons for their lack of interest.

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Medical Residents

According to the current policy, residents who spend 2 years at a rural site and one year at an urban facility are considered as residents of the urban hospital for the first year. Policy puts limits on residency slots for hospitals that do not have an official teaching function.

Nevertheless, CMS discourages urban hospitals from opening new rural training track programs. Hospitals that want to begin a rural residency have the option of establishing the program in different specialties or open two or more separate sites of the same specialty. Else, the program will be ineligible for federal funding.

“We ask that CMS revise its definition of a teaching hospital,” the letter states. “If a hospital makes no claims for the training of residents in that hospital and is not the institutional sponsor of an accredited, or approved, graduate medical residency program, we ask that it not be considered a teaching hospital and, therefore, have no cap.”

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