Testimony by David Wright, MD
House Appropriations Committee, Article III
Monday, Feb. 16, 2015
Mr. Chairman and committee members, my name is David Wright, MD. I am a family physician in Austin and director of a family medicine clerkship program for medical students. In coming before you today, I am representing the 48,000 members of the Texas Medical Association.
Our members are concerned about the ability for physicians to train in our state.
The state’s support for medical student and GME funding is critically important to ensuring this. You are aware, medical school enrollments are expanding and our # of graduates will increase substantially at the end of the decade. This is not surprising. Texas has seen steep population increases for some time, but medical school enrollments stayed the same. This is now an effort to catch up.
It is estimated that it costs well over $100,000 a year to train a resident; and about l/3 of residency positions in the state are not eligible for Medicare GME funding. For years, there has been very little state funding available to hospitals to create new GME positions. About half of our graduates leave the state for GME each year.
We continue to have a serious physician shortage. Those shortages touch the majority of specialties and they impede access to care. The new expansion grant programs authorized by the last legislature are a big step toward expanding our GME capacity and we are grateful for the legislative commitment toward building our physician workforce. Having the additional $14.25 million is good for the state. The $65,000 per-resident amount authorized for these programs is significant. These programs also acknowledge the partnership between medical schools and teaching hospitals in training a resident.
With so many new programs, there has been some confusion. We would support tying the funding to the state’s most acute workforce needs and encourage simplification.
TMA strongly supports the $60 million in SB 2 for expansions to reach the target 1.1 ratio of entry training positions per Texas graduate. This will help toward breaking the current GME bottleneck that our graduates face in finding a residency position.
We hope there will be an opportunity to increase funding for the family medicine residency program and restore funding for the primary care preceptorship programs in order to catch-up with the state’s primary care needs. We also need to produce more psychiatrists and child psychiatrists. Additional dollars for GME formula funding is important.
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