Federal Cap on GME Funding Jeopardizes Timely Patient Care
Early and appropriate treatment by a rheumatologist is critical to prevent permanent disability and avoid costly procedures, but the estimated 5,600 active board-certified rheumatologists cannot meet the demand of the estimated 91 million Americans living with rheumatic disease. This gap between the number of rheumatic disease patients and the number of rheumatologists is growing in both the adult and juvenile populations. Currently, there are nearly 300,000 American children suffering from juvenile arthritis, yet there are fewer than 400 board-certified pediatric rheumatologists in the United States.

Unfortunately, The Balanced Budget Act of 1997 imposed caps on the number of residents for which each teaching hospital is eligible to receive Medicare direct graduate medical education (DGME) and indirect medical education (IME) payments. These caps have remained in place and have generally only been adjusted as a result of certain limited and one-time programs despite the growing medical workforce shortage. The Resident Physician Shortage Reduction Act (H.R. 1763/S. 348) would increase the number of residency positions eligible for this support by 15,000 slots over five years and requires that at least 50% of the additional 3,000 slots added each fiscal year be directed to a shortage specialty residency program as identified by HRSA, like rheumatology.

The workforce shortage is compounded in rural communities by the concentration of these professionals in our most populated areas leaving, for example, nearly 75% of juvenile arthritis patients to be treated by either pediatricians, who have not received the extra training to most effectively treat rheumatic diseases, or by adult rheumatologists, who may not be familiar with the diagnosis and management of pediatric-specific rheumatologic conditions or pediatric growth and development. To this end, the Resident Physician Shortage Reduction Act would give special consideration to hospitals emphasizing training in community-based settings, operating training programs in a rural area, or a program with an integrated rural track. 

Please ask your legislators to support The Resident Physician Shortage Reduction Act (H.R. 1763/S. 348) to lift these devastating caps and add much-needed residency slots for our specialty. 
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