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Extra Funding Lets NJ Hospitals Open Slots in Hard-to-Fill Specialties

Early results of state survey track where and how hospitals are putting additional $30 million to work.

New Jersey hospitals are expanding their medical residency programs in hard-to-fill specialties as a result of extra state funding, according to early results of a survey conducted by the New Jersey Council on Teaching Hospitals. The state requested the survey after it granted hospitals an additional $30 million last year.

“I am very pleased with what we are seeing with primary care expansion,” according to Deborah Briggs, president of the council. The teaching hospitals have to get approval for new residency slots from their accreditation organizations, which takes time, so the new slots will come on stream with the next class of resident that begins July 1, 2012.

Thus far, more than 100 new residency slots have been opened up in the following high-need areas: family medicine, 27; general internal medicine, 40, general surgery, 15; obstetrics/gynecology, 11, and pediatrics, 8. Hospitals have also added residency slots in various other specialties, including orthopedics, 5, and emergency medicine, 6.

Primary care physicians are particularly important to New Jersey, since the state already faces a shortfall of doctors pursuing this specialty.

Briggs said Health Commissioner Mary E. O’Dowd reached out to the council last summer to collaborate on a study to document how the state funds were being used, and if they were benefitting the state and the physician workforce.

O’Dowd had wanted all the data in hand before she began testifying on her department’s 2013 budget, which started Wednesday with her appearance before the Assembly Budget Committee. O’Dowd told the committee that she was “dismayed” that all the teaching hospitals have yet to respond to the survey, which she said will help the state determine if funding of residency program is producing doctors who can fill critical shortages.

“It is a matter of concern that some areas of the state are underserved by the medical profession,” she said. “There may be ways that we can reform the way we provide funding.”

To date the council has gotten responses from 23 of the 36 hospitals, or multihospital health care systems, that operate residency programs, said Briggs. She is expecting all of the hospitals to respond, and the results are being updated on the council’s websites as new reports come in.

Briggs said the delay resulted from the several months it took to finalize a survey form, which was sent to the teaching hospitals in early March. “We keep nudging them, and hopefully Commissioner O’Dowd's comments that she really wants 100 percent participation will be heard,” Briggs said.

The state’s $30 million increase brought total funding of graduate medical education to $90 million in the current fiscal year, and Gov. Chris Christie is proposing the same level of funding in fiscal 2013.

The report provides a detailed snapshot of the state’s residency programs, which in June will graduate 823 physicians in 39 specialties, including psychiatry, pediatrics, geriatrics, cardiology, pathology, and sports medicine. The survey asks for information on the number of patient visits provided by faculty and residents of teaching hospitals, and the hospitals are reporting on their efforts to serve under-insured or uninsured patients, including by partnering with other health care providers. More hospitals have launched efforts to keep physicians in New Jersey once they complete their residency. The report shows that six hospitals have programs to help physicians repay their student loans, up from three in 2010, and 13 are helping physicians start a medical office, up from six in 2010.

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