Academic Medical Centers

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SurfingDoctor

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Medical education just got a rude awakening. Who cares about the NIH or federal funds you ask? Medical and Graduate School admins, that's who. The trickle down effects will be enormous...

You thought the MATCH was a concern before....
oh-boy-dismay.gif


If you don't think so... you know nothing about medical centers nor medical education. Even if you do MATCH... prepare for some unemployment.

Thank your local Senator/President/Tech Bro. If you're not pissed... you should be.
 
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I’m in a rural FQHC right now that just got all of their grants frozen……

What’s ironic is that, based on stereotype anyway, probably 90% of our patient population bigoted for Trump

Edit: voted, not bigoted
 
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Medical education just got a rude awakening. Who cares about the NIH or federal funds you ask? Medical and Graduate School admins, that's who. The trickle down effects will be enormous...

You thought the MATCH was a concern before....
oh-boy-dismay.gif


If you don't think so... you know nothing about medical centers nor medical education. Even if you do MATCH... prepare for some unemployment.

Thank your local Senator/President/Tech Bro. If you're not pissed... you should be.
I'm curious, how do you think these budget slashes will affect the match, or residency programs? I understand a lot of funding for residency programs comes from the federal budget (medicare/medicaid funds). Does this mean that some residency programs may shut down? Which programs might those be? Perhaps ones that are historically unfilled?
 
I'm curious, how do you think these budget slashes will affect the match, or residency programs? I understand a lot of funding for residency programs comes from the federal budget (medicare/medicaid funds). Does this mean that some residency programs may shut down? Which programs might those be? Perhaps ones that are historically unfilled?
Oh, we are in uncharted territory. Your guess is as good as mine.

I would be surprised if Medicare got cut, the senior citizens would never stand for that. Medicaid and VA money is more targetable because voters don't really care about kids and veterans.

The real panic is in federal grants. They are essentially on hold indefinitely. Why it may seem like "who cares?", the directs and indirects contribute hugely to medical centers' paylines. In most places, it's all one big pot of money. So if you have net loss income that is not rectifiable, you got to make cuts elsewhere and rearrange the money. I still would be surprised if you see a lot of cuts to the actual number of spots because GME labor is cheap labor (they could always just cut the salary and fringes of trainees), but there may not be jobs when you graduate if the medical centers are still financially reeling from having to tap into reserves. I mean, the centers will have to RIF people and then protect the positions/salaries of others, which will disrupt clinical expansion and infrastructure.

I can tell you everyone (hospital CEOs, deans of schools, etc.) are sh-tting the biggest bricks that I've ever seen in my career.
 
I agree no one knows what will happen. Trump is unlikely to cut the Medicare that seniors see -- their benefits, or their out of pocket costs, etc. But I could imagine Trump cutting all GME funding. Or 340b. Or DSH payments. All of these things keep hospitals afloat. There was also talk of revoking non-profit status for hospitals. Any of these would be devastating to bottom lines. Should any come to fruition, it's anyone's guess how hospitals will make ends meet.
 
I agree no one knows what will happen. Trump is unlikely to cut the Medicare that seniors see -- their benefits, or their out of pocket costs, etc. But I could imagine Trump cutting all GME funding. Or 340b. Or DSH payments. All of these things keep hospitals afloat. There was also talk of revoking non-profit status for hospitals. Any of these would be devastating to bottom lines. Should any come to fruition, it's anyone's guess how hospitals will make ends meet.
I think we’ve seen enough “unlikely” things pass in the last month <spoiler, many people knew they were very likely> that I think we should stop prognosticating about what the current administration will and won’t do.

My question to everyone is simply, does a group in power consolidate power in the executive branch this way if they ever plan for their opponents to be in power again?
 
I'm not entirely sure, but I will doubt that any proposals endorsed by the AMA and AAMC on increasing support for more residency slots from Medicaid/Medicare will be passed. It's more likely cuts will affect residency training indirectly, but that's me thinking worst case.

Here's the history about how residency slots are funded.


For certain there will be disproportionate impact on primary care, women/gender-inclusive care, and efforts for documenting or addressing health equity such as health fairs for minorities.


I think you should worry more about what your residency experience is going to be like. If you feel overworked, underpaid, and understaffed now, let's see what happens... especially as venture cap expands into running hospital systems.
 
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Just so you know how much your representatives care about you…
View attachment 399366
The responding address was “[email protected]

They hope you all suck it…
That's why you should sign up for the lobby days at the hill organized by all your professional organizations. Go attend local town halls and see who shows up. If you get shouted down, so be it. They're wearing airpods like everyone else.
 
That's why you should sign up for the lobby days at the hill organized by all your professional organizations. Go attend local town halls and see who shows up. If you get shouted down, so be it. They're wearing airpods like everyone else.
I was being a little facetious. They do care, so long as it gets them votes.

Science, healthcare… that used to get votes. It still might actually, but it’s less clear as the “silent majority” are as aimless and feckless as a drunken polar bear on a slab of melting ice.
 
I was being a little facetious. They do care, so long as it gets them votes.

Science, healthcare… that used to get votes. It still might actually, but it’s less clear as the “silent majority” are aa aimless as a drunken polar bear on a slab of melting ice.
Fair. 🙂 But we've entered the world where science, education, and healthcare have become political. The middle-moderate is being primaried away.
 
That's why you should sign up for the lobby days at the hill organized by all your professional organizations. Go attend local town halls and see who shows up. If you get shouted down, so be it. They're wearing airpods like everyone else.
I want to echo this as well. Folks don't understand how critical lobbying is in the US.

When I was a med student, almost all of us were part of the AMA. Mostly because it was really cheap (maybe free?) and they gave free swag.

Many attendings complained about the AMA being too focused on social justice issues. I think the AMA focused on it to get students/residents to sign up, but they weren't doing a good job of explaining to private practice attendings what they were doing for them.

Regardless of how any of us feel about the AMA's stance on some issues, they're also the only large national lobbying force we have as physicians. So if constant Medicare reimbursement cut threats, lack of indexing reimbursement to inflation, patient access to care, GME funding, etc., bother you, the only realistic way most of us have to make any sort of difference is to support our national lobbying groups. This is largely the AMA, with our specialty groups being a long distant second (they have very little power compared to the AMA).

Support your state medical association as well--ours does quite a bit for us in CA.

Sadly, as self-employed docs/physician-owned practices wither away more and more, the AMA and our state medical associations will lose members and thus power, likely resulting in yet more of us leaving such practices (despite patients get better care from independent physicians).

So stem the tide. Join the AMA, your state medical association, and your national specialty association. Yes they're all expensive, but it's worth it for our professional autonomy, patient care, and our bottom line.

We've already given up so much bargaining power at the table. We're one of the most respected professions in the country (look up the latest Gallup polls), but we're trading it in. Patients now usually feel more local to their corporate healthcare brand than their primary doc for said healthcare corporation. If we want to drive the conversation around healthcare in the country and be the most respected voice, we have a lot more clout speaking as a professional organization representing physicians who have taken the Hippocratic oath (patients really do respect that) compared to a nameless corporation that cares more about the bottom line.
 
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