Source: United States House of Representatives – Congresswoman Carol Miller (R-WV)
Washington, D.C. – Today, Congresswoman Carol Miller (R-WV) participated in a Ways and Means Health subcommittee hearing on the current and worsening health care workforce shortage in America and Medicare’s role in financing the training of physicians through graduate medical education (GME) payments. A video and full transcript of the Congresswoman’s remarks can be found below.
Congresswoman Miller began by discussing the importance of rural healthcare in her home state of West Virginia. She then questioned a witness, Dr. Emily Hawes, Pharm.D., Professor, Department of Family Medicine at University of North Carolina School, on what Congress can do to improve access to healthcare in rural communities.
I grew up in Columbus, Ohio. When I left it, I think there were 600,000 people. The Ohio State, lots and lots of physicians, wonderful education. I moved to West Virginia. I love my home state of West Virginia. I’ve been there over 50 years. I moved to a town of approximately 85,000 that is now approximately 47,000 people because bad policies can have bad results. And I’ve seen a huge turnaround in the last couple of years to our state.
But it’s rural healthcare, I can’t scream it loudly enough, how important rural healthcare is to my state and many states. When you look at the number of people that have spoken from Missouri and Oklahoma, and, except for my partner over here who is from a big city. We have less than 2% of residency programs in rural communities, and more than 90% of the residents today have never even practiced in a rural setting.
Dr. Hawes, thank you for highlighting the Rural Residency Planning and Development Program, also known as RRPD, in your testimony. This program is essential to hospitals in West Virginia, and I am proud to have introduced the Rural Residency Planning and Development Act. My bill formally authorizes the RRPD program, which helps rural hospitals cover the upfront costs of developing new residency programs because without rural training pipelines, we cannot solve rural physician shortages.
My question for you, Dr. Hawes, is given that rural hospitals face unique barriers, what additional policy changes beyond RRPD are needed to ensure rural communities can not only start residency programs, but sustain them long term and successfully retain physicians after training?” asked Congresswoman Miller.
“Thank you, Representative Miller, and I want to thank you and your team for the wonderful data requests and emails that you’ve sent over the years. We want to be helpful with information, and so I offer that to all of you, too, as you’re evaluating policies.
I also want to highlight just a story that that has impacted me from your district. Marshall started a Point Pleasant Psychiatry program and it, just, it speaks to the impact of these programs. So they noticed that the psychiatry patients were coming from Point Pleasant. And so they said, ‘let’s go out to Point Pleasant and start a residency in a county with no psychiatrists.’
And what they’re doing is they’re using telemedicine and a partnership with Marshall that is enabling them. They up-fitted an emergency room that has two telemedicine-like triage sections. And then also they created a new rural health clinic as a result of that psychiatry residency. And their residents are starting a cancer support group from just one of the benefits and spillover effects. So one of the things that just specifically about your district and a policy that would help is just supporting telemedicine and tele-precepting, especially for psychiatry programs,” responded Dr. Hawes.
Congresswoman Miller concluded by discussing her bill, the Fair Access in Residency Act, before questioning Dr. Thomas Mohr, D.O., Dean, Sam Houston State University College of Osteopathic Medicine, on the role Doctors of Osteopathic Medicine play in closing the nation’s physicians shortage.
“Thank you so much. I’m pleased to see that the Osteopathic Medical Schools are represented here today. As our country grapples with worsening physician shortages, we’ve got to eliminate the unnecessary barriers that prevent highly qualified Osteopathic medical students from accessing residency opportunities.
For a rural state like my own, we cannot afford artificial barriers to physician distribution, particularly when Doctors of Osteopathic Medicine play such a vital role in primary care, which is why I introduced the Fair Access to Residency Act.
Doctor Mohr, from your perspective, what role do Doctors of Osteopathic Medicine play in helping close the nation’s physician shortage, particularly in communities that are rural?” asked Congresswoman Miller.
“Thank you for that question, and thank you for your support of the FAIR Act.
My job as Dean is not just to educate and train medical students so that they can graduate and pass the board examinations, but also to assist in their residency placement. Osteopathic physicians are essential to meeting rural and underserved workforce needs, and by percentage, our students do tend to go more into rural and underserved programs.
However, according to the National Residency Match Program data, 29% of residency program directors currently state that they never or seldom interview D.O. candidates, while nearly three quarters, 73%, of GME programs that do consider DO’s mandate that they take the MD licensure exam, where we take the COMLEX-USA licensure exam.
This causes our students to have to take two examinations, which are costly and expensive and stressful and unnecessary because every state, every medical board in the nation recognizes the COMLEX-USA. And so I think we need to understand that to be fair and to help to support Osteopathic Physicians who are more likely to go into rural, community-based and underserved areas, that we have to have a little bit more transparency when it comes to acceptance. And that’s what the FAIR Act, as you know, does. It suggests that there be reporting of both DO and our MD colleague applicants,” responded Dr. Mohr.
