By Charlie Martinez

ATHENS, Ohio (3.6.12) A contingent of students from the Ohio University Heritage College of Osteopathic Medicine (OU-HCOM) plan to lend their voices – and presence – to a problem facing medicine today: too few post-graduate residency positions in the nation’s hospitals compared to the number of physicians who earn medical degrees each year.

On March 8, 41 OU-HCOM students will join other osteopathic medical students and physicians on Capitol Hill in Washington, D.C., as participants in the 13^th Annual D.O. Day on Capitol Hill.

“This is not your average eighth grade field trip to Washington D.C.,” said Peter Bell, D.O., a CORE assistant dean and professor of emergency medicine.

Many of the OU-HCOM students making the trip will meet with their own congressman or congressmans’ staff to voice their concern over the current health care system.  OU-HCOM students representing 11 Ohio congressional districts in southeastern, central and northeastern Ohio will make such visits.

Bell believes that medical students can really make a difference when speaking with representatives in Washington. “Personal stories are great, and the senators listen, especially when coming from doctors. They think that doctors are the “wise men” of society and the will remember those stories when it comes time to vote,” he said.

One major issue the American Osteopathic Association (AOA) plans to focus on this year is the shortage of graduate medical education positions. Currently, fourth year medical school are matched into residency programs at hospitals and practices across the country. But the Balanced Budget Act of 1997 created a cap for the number of residency slots for which a hospital or practice could receive government funding. Consequently, the legislation created a situation where there are too many medical school graduates for the residency spots available.

Congress is considering a bill, the Resident Physician Shortage Reduction Act (S 1627), that may add nearly 15,000 residency positions in a variety of specialties, especially primary care physicians.

“I hope to be able to share with them how many of my classmates changed their medical specialties due to the low number of spots available in specific fields, such as emergency medicine and pediatrics,” said Andy Little, OMS IV, who will enter an emergency medicine residency at OhioHealth’s Doctors Hospital in Columbus this summer after graduating. “With the ever growing number of medical student graduates, we will soon not have enough training spots to accommodate the number of physicians graduating from medical school, which we are doing to fulfill the current and future shortage of physicians.”

Little plans to meet with Ohio Rep. Jim Renacci and Sen. Rob Portman, who he met with during last year’s D.O. Day on the Hill. While meeting with the Ohio lawmakers, Little said he will focus on the shortage of emergency medicine post-graduate training positions, and especially the need to increase such slots in rural and community hospitals.

“I will share with them how most of the current osteopathic emergency medicine programs are located in non-academic community hospital settings, and that with funding we could continue to increase our number of graduates who will be more likely to practice in community hospitals,” Little said.

Other OU-HCOM students will discuss the same topic with their own representatives in the nation’s capital. “Right now we are facing a potential controversy with residency spots,” said Cassandra Adams, OMS II, and president of the OU-HCOM chapter of the Student Osteopathic Medical Association (SOMA) who is organizing the trip.

Adams plans to meet with lawmakers from her home state, Indiana, including Rep. Larry Buchshon, who also happens to be a physician, and Indiana Sens. Richard Lugar and Dan Coates. “Now is a good time to go tell Congress about our concerns,” she said.

“As medical students, we sometimes feel like we don’t have a say,” Adams said. “But actually, going to the Hill and meeting with representatives gives us a voice. We do have a say in the future of our field.”

Another important topic that will be discussed is the growing concern over the Sustained Growth Rate (SGR) used to calculate the physicians’ payment for patients with Medicare. The SGR is a formula used to calculate inflated costs of healthcare, but because of new medical technologies and a growing elderly population, the SGR is calculating inefficient numbers, Bell said.

In 1997, Congress approved a plan to reimburse physicians for treating Medicare patients using the SGR formula.  The SGR formula determines the amount physicians are reimbursed based on inflation and other factors. However, beginning in 2001, the formula began calculating cuts to physicians’ reimbursements. Each year since, Congress has voted to delay implement SGR.

According to Bell, if the SGR were to be continued, current calculations would result in a 27 percent cut in what physicians are now paid by Medicare. Many D.O.s are pushing for SGR to be repealed this year and make sure that one of the largest and most influential health care programs will not continue to be funded on an ad hoc basis.

“Health care reform is the single-most important issue facing the nation today. It's important for physicians to be actively involved in the debate as advocates for their patients and the future of osteopathic medicine.” said Jon Wills, Ohio Osteopathic Association executive director.

“Students, in particular, need to be informed and engaged, since they will be practicing in an entirely reshaped system, based on patient safety, payment reform, quality outcomes, and electronic health data interchange,” Wills said.  

D.O. Day on the Hill began in 1999 as a forum for those involved in osteopathic medicine to have their voices heard in Washington. The (AOA) organized a rally and encouraged doctors across the nation to lobby for the future of osteopathic medicine. OU-HCOM began participating in the event in 2000.