[Congressional Record Volume 143, Number 17 (Tuesday, February 11, 1997)]
[Extensions of Remarks]
[Pages E210-E211]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                  PRIMARY CARE PROTECTION ACT OF 1997

                                 ______
                                 

                     HON. LOUISE McINTOSH SLAUGHTER

                              of new york

                    in the house of representatives

                       Tuesday, February 11, 1997

  MS. SLAUGHTER. Mr. Speaker, I am proud to have the opportunity today 
to introduce the Primary Care Promotion Act of 1997. This thoughtful, 
constructive legislation would refocus and target the current Federal 
Government effort to reduce the number of medical specialists 
graduating from U.S. teaching hospitals.
  There is little debate today that our Nation is experiencing a 
shortage of primary care physicians and an oversupply of specialists. 
In 1995, there were almost 650,000 active physicians in the United 
States. Of those, about 384,000 were specialists, while only 241,000 
were primary care providers--a ratio of 1.6 specialists for every 
general practitioner.
  As a result of this situation, some government agencies are working 
to change policies that appear to encourage students or medical schools 
toward training specialists rather than family practitioners. Last 
year, the Health Care Financing Administration [HCFA] issued a 
regulation reducing graduate medical education [GME] reimbursement for 
combined residencies. The apparent purpose of this action was to reduce 
a perceived incentive for students to enter combined residencies, which 
usually train doctors for a medical specialty like child psychiatry. 
There are, however, a small number of combined residency programs that 
produce primary care physicians. My legislation would restore full GME 
reimbursement for residents enrolled in a combined residency program 
where both programs are for training in primary care, like internal 
medicine and pediatrics.
  This legislation has been carefully crafted to preserve HCFA's intent 
to reduce the number of specialists trained while increasing the ranks 
of family practitioners. The Primary Care Promotion Act has already 
been endorsed by: American Academy of Pediatrics, American Osteopathic 
Association, American College of Physicians, National Association of 
Children's Hospitals, Association of Professors of Medicine, American 
Society of Internal Medicine, Association of Program Directors in 
Internal Medicine, Medicine-Pediatrics Program Directors Association, 
American College of Osteopathic Pediatricians, Association of 
Osteopathic Directors and Medical Educators, Federated Council for 
Internal Medicine, which includes: American Board of Internal Medicine, 
American College of Physicians, American Society of Internal Medicine, 
Association of Professors of Medicine, Association of Program Directors 
in Internal Medicine, Association of Subspecialty Professors, and 
Society of General Internal Medicine.
  I am pleased that Representatives Rangel, McDermott, McNulty, and 
Kennedy of Rhode Island have already joined me as original cosponsors 
of this legislation. I look forward to working with them and the rest 
of my colleagues to pass this constructive, bipartisan initiative.

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