AAFP Praises Legislation Addressing THCGME, Rural Workforce

The Doctors of Community Act (H.R. 3671, S. 1958), said the AAFP and seven other medical and health care groups in a June 2 letter, is “landmark legislation” that would permanently extend funding for the Teaching Health Center Graduate Medical Education program and ensure availability of sustainable funding to “help increase access for rural and urban medically underserved Americans by training and producing primary care physicians to serve these populations for the future.”

The bill’s proposed THCGME expansion — which would follow the American Rescue Plan Act’s investment of $330 million in the program and a recent three-year extension — would be permanent, fulfilling a long-standing AAFP policy goal. The Academy has for years advocated that the THCMGE program is crucial to the training of new primary care physicians and bolstering the physician workforce.

The DOC Act would “allow teaching health centers to manage their residency programs more efficiently and grow the number of residents in training from the current 769 to more than 3,000 by the time it is fully implemented,” said the letter. It also would ensure that each state has at least one THC; today, there are THCs in just half the country.

The letter was sent to the legislation’s co-sponsors, Sen. Patty Murray, D-Wash., and Rep. Frank Pallone, D-N.J. The Academy’s co-signatories included the American Association of Teaching Health Centers, the National Association of Community Health Centers, the American College of Obstetricians and Gynecologists, and the American Osteopathic Association.

In a separate June 2 letter, the Academy expressed strong support for the reintroduced Rural Physician Workforce Production Act of 2021 (S. 1893), which would direct new federal support to rural residency training, alleviating physician shortages in those communities and answering another AAFP priority.

S. 1893 would remove caps for rural training and provide new financial incentives for rural hospitals, including critical access and sole community facilities, to provide training opportunities in communities facing PC shortages. The incentives also would apply to urban hospitals in order to grow the population of residents on “rural training tracks.”

“Although evidence indicates that one of the most promising ways to recruit physicians to practice in rural areas is through rural experiences during their residency training,” the letter said, “numerous incentives in the Medicare program discourage hospitals from providing such opportunities — including in communities that desperately need new physicians.”

Rural Americans face greater socioeconomic barriers than their average urban counterparts, and their communities are marked by higher rates of poor health outcomes, including higher rates of all five leading causes of death. While 20% percent of Americans are rural residents, only 12% of primary care physicians practice in these areas, the Academy wrote.

The letter was sent to that legislation’s co-sponsors, Sens. Jon Tester, D-Mont., and John Barrasso, M.D., R-Wyo., and signed by AAFP Board Chair Gary LeRoy, M.D., of Dayton, Ohio.