[Congressional Record Volume 157, Number 87 (Thursday, June 16, 2011)]
[Extensions of Remarks]
[Page E1124]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 IN SUPPORT OF EXPANDING THE PRIMARY CARE WORKFORCE AND OPPOSING H.R. 
                                  1216

                                 ______
                                 

                           HON. KATHY CASTOR

                               of florida

                    in the house of representatives

                        Thursday, June 16, 2011

  Ms. CASTOR of Florida. Mr. Speaker, I rise today to acknowledge the 
importance of the primary care workforce and support provisions 
included in the Affordable Care Act to expand the number of primary 
care physicians, especially in my home state of Florida.
   One of the smartest things we can do in health care today is to 
bolster primary care and family medicine. Your primary care doctor is 
your family doctor; the one you and your family see for checkups, and 
the doctor who is most likely to understand your health care needs. It 
is widely understood that if we are going to be more efficient in 
America with our health care dollars, we need to focus on prevention 
and boost the number of primary care doctors. There is a great demand 
for primary care physicians across the country and training new doctors 
in a community teaching setting is vital.
   Training doctors is an especially critical issue in my home state of 
Florida. We have a significant doctor shortage. Florida has great 
medical schools and are turning out quality medical school graduates, 
but that is not enough because we do not have a sufficient number of 
residency slots. Florida is short nearly 3,000 new GME positions to 
meet current physician demand. Florida is the third most populous 
state, but ranks 44th in the nation in terms of the number of residency 
positions under Medicare. Those numbers reflect a brewing crisis 
situation. Not only does Florida have the largest and fastest growing 
percentage of citizens over 65, we have a rapidly aging physician 
population--25 percent of Florida's physicians are over 65. We need to 
do everything possible to train new primary care doctors all across the 
country, but especially in Florida. H.R. 1216 will take us backwards 
and that is why I strongly oppose its passage.
   Before we take up legislation to terminate an initiative that 
encourages the training of new doctors in primary care, family medicine 
and internal medicine, please understand our country's need for 
physicians who are most effective for our families. I urge my 
colleagues to support a robust primary care workforce. We need to work 
together to develop modern methods to train primary care physicians--
and the Teaching Health Centers GME program, which my colleagues on the 
other side of the aisle seek to eliminate, is an innovative new model 
to help train more primary care physicians and encourage them to 
practice in communities. Physicians who train in a community setting 
have a better understanding of the needs of the communities they serve. 
Many organizations--like MedPAC and the Council on Graduate Medical 
Education--have called for a community-based GME program, so why do 
Republicans want to eliminate these opportunities before they start? 
Residency rotation through rural and outpatient locations provide great 
training opportunities for physician residents; and it encourages the 
resident to practice in out-patient or rural communities.
   If we do not work together to find common sense solutions for our 
primary care workforce, America will be short of the doctors we need to 
serve in our communities and our families and neighbors will suffer the 
consequences. This is why I voted against H.R. 1216 and why I strongly 
oppose any attempt to eliminate innovated methods for training our 
future primary care workforce.

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