Will Plastic Surgery Training be impaired by Medicare Cuts? YES!
Most patients know that Medicare provides insurance coverage to people who are 65 years of age or older. What most people do not realize is that the Medicare system also plays a critical role in subsidizing graduate medical education. In 2009, Medicare paid over $9 billion to U.S. teaching hospitals for resident training. These funds are roughly split with one third of them going toward direct funding for about 100,000 residency positions (across all specialties), and two thirds toward additional costs of patient care associated with the training of these physicians.
I am indeed a Board Certified Plastic Surgeon; but that title was only possible following four years in medical school, five years in a general surgery residency, one year in plastic surgery tissue engineering fellowship and another three years of plastic surgery training residency. All told, that was nine years of residency training. Nine well spent years of surgical education and experience which is necessary in a specialty as dynamic and complex as is plastic surgery. During every year of my residency training, my salary was subsidized by Medicare stipends to the residency programs and training hospitals. The same is true for every plastic surgeon, general surgeon, obstetrician, internist, orthopedic surgeon…and every other medical specialist, who has trained over the last several decades.
Unfortunately, the situation for our future physicians may not be quite the same. Currently, there is a cap on Medicare funding for graduate medical education which allows for about 100,000 residency positions. However, as our population grows, so too does the need for more physicians. Over the last twenty years, there has been an increase in the absolute number of medical schools and therefore an increase in the number of medical school graduates. The number of available residency positions has remained roughly stable overall. That means that not only are residency positions becoming more difficult to obtain, but that as we move forward there may simply be an inadequate number of them. It is estimated that by 2015, the number of medical school graduates from schools in the United States will actually surpass the number of graduate medical education (residency) positions. This may likely occur even with current amounts of Medicare funding. Imagine what will occur if Medicare actually makes cuts in funding, as is expected under the new upcoming healthcare legislation.
*photo in this blog post does not show an actual patient.