The government spends about $15 billion every year on physician training programs that a panel of highly respected medical experts says may not actually be producing quality doctors.
The Institute of Medicine (IOM) issued a report this week concluding that the current system is failing and must be reformed.
"A variety of surveys indicate that recently trained physicians in some specialties cannot perform simple procedures often required in office-based practice and lack sufficient training and experience in care coordination, team-based care and quality improvement,” the report said.
The federal government doles out about $11 billion–mostly through the Medicare program. Meanwhile, states pay about $4 billion annually through Medicaid to train doctors, Kaiser noted.
And though the government is investing so much money to train these doctors, there is very little data on how the funding is used and how effective the system actually is. The panel said the government doesn’t even know who is being trained or if the programs are producing competent doctors.
"The scale of government support for this phase of physician education is unlike that given to any other profession in the nation," the panel said in the report.
The report also details some other serious problems with the program, including the way the physicians are distributed among practices. For instance, there are too many specialists and not enough primary care providers. The report also said there is a lack of cultural diversity among physicians, which reflects the profession as a whole.
The panel proposes overhauling the program by shifting it to a performance-based system. Such a change would have to be made by Congress. Though tweaking Medicare would not likely be an easy endeavor on Capitol Hill.
"We recognize we are recommending substantial change," health economist and former Medicare Administrator Gail Wilensky, co-chairwoman of the panel that authored the report. "We think it's key to justifying the continued use of public funds."
This isn’t the first time the government has struggled to measure its programs’ effectiveness.
Earlier this year, the Institute of Medicine also flagged the government’s $3 billion PTSD treatment programs, which it said might not actually be working to help soldiers and veterans.
At the time, the IOM recommended that the Defense and Veterans Affairs Departments develop an integrated system to track PTSD treatments and progress so they can determine if the programs actually work.
It is unclear whether either agency has taken up this recommendation.
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