Aug 20, 2009
Any ideas on how healthcare reform will affect residency training programs?
Will programs that rely heavily on the uninsured populations at the county hospitals suffer as patients with newfound insurance coverage seek care from private docs and nicer private hospitals?
Or will extended coverage mean more money for these county hospitals and thus benefit residency programs?
A recent front page article in the Dallas Morning News prompts these questions as it described the potential effect of the new healthcare reform in turning Parkland, the Dallas county hospital and main training site for all UT Southwestern residencies, into Dallas' "hospital of last resort."


10+ Year Member
Nov 18, 2008
Nobody knows.

Medicaid will continue to pay less and less. Obama's health care reform includes increasing Medicaid payments to family practitioners for an office visit (that's a fact) and probably decreasing the same office visit for other physicians (probability). So a rheumatologist gets maybe $45 for an office visit and a family practice person gets maybe $70 for same office visit. Those Medicaid patients will increasingly have to go the the county hospital when private doctors, who go to another hospital, can no longer see them unless they want to face bankruptcy.

So residents will continue to have surgical cases on the Medicaid patients.

Those newly insured 31M Americans will get private insurance, subsidized by taxpayers. But some of them will just pay the fine as it will be cheaper than buying insurance. Others will find that deductibles and copays will keep them away from the doctor. Low deductible insurance plans will go away as they become labelled "Cadillac policies" and then be subject to taxes.