On Sep. 16, Rep. John P. Sarbanes (D-Maryland) introduced a bill into the U.S. Congress called the Primary Care Physician Reentry Act, which, according to a press release from Rep. Sarbanes’s office, “aims to help ameliorate the nation’s primary care physician shortage by providing training and financial assistance to doctors returning to medical practice in exchange for their service as a public health provider.”
As the press release further noted, “This legislation would establish a grant program for medical schools, hospitals and non-profit organizations to create or expand their physician reentry programs which give physicians a streamlined process for credentialing and continuing medical education to return to medical practice after an absence. Funding could also be used to assist with credentialing fees, loan repayments and salaries. In return for this assistance, these physicians would serve at community health centers, VA medical centers or school-based health centers to help fill the shortage of primary care doctors. Participating physicians would be able to practice on a full- or part-time basis and would be covered under the Federal Tort Claims Act, which provides physicians with medical liability protection.”
Sarbanes, prior to his entering Congress in January 2007, where he represents Maryland’s Third District, had worked for some years as an attorney, spending his professional legal career at the law firm of Venable LLP in Baltimore from 1989 to 2006, where he was chair of the firm’s healthcare practice from 2000 to 2006.
Shortly after the introduction of the bill into Congress, Rep. Sarbanes spoke with HCI Editor-in-Chief Mark Hagland regarding his intentions for the bill, and his perspectives on the current and growing primary care physician shortage within the U.S. healthcare system. Below are excerpts from that interview.
Can you explain your intentions in drafting this bill?
I got to Congress in 2007; we very soon began to pave the way for the Affordable Care Act (ACA). I was able by my second term to get a position on two committees, the Energy and Commerce Committee, the principal committee I serve on today; and I was on the Health Subcommittee of that committee, and that’s where a lot of the ACA really came together legislatively. And there were obviously many different elements in that reform. A lot of the discussion was around the insurance coverage element of the legislation. But I got very interested early on in the workforce element, the supply side of this, the notion that if we’re going to cover another 30-35 million insured people, we need to figure out how to keep up supplying the demand for caregivers and providers. And we knew about the shortages. And my background in healthcare made me interested in how providers step forward and deliver care, and what changes make sense, and in particular, if we’re going to turn our healthcare system more in the direction of prevention and primary care, what are the implications for workforce needs?
Rep. John P. Sarbanes
So I became very interested in all those issues, and became interested in what we need to do to create and improve pipelines for workforce supply. And I wanted to look at some non-traditional pipelines; thus, this idea of creating a retiree cohort—what could we do to encourage them to come back into the practice of primary care? And from time to time, I came across people who had fashioned pilot reentry programs. And I wanted to do something more systematic here. So the Primary Care Physician Reentry Act would fund 10 programs that would be qualified medical institutions—medical schools, hospitals, and non-profit organizations—to provide expedited training for these physicians. It’s kind of a form of continuing medical education, but one focused on how these practitioners can be deployed into one of three arenas—school-based health centers, community health clinics, and VA medical centers. So one of the things we want to learn by doing this as a demonstration project is to learn what works in helping individuals get back into a level of clinical proficiency that you need for them to reenter the field.
So this corps would then be trained and redeployed back into the healthcare system. And I’m very committed to the idea of improving care delivery in these VA medical centers, community health clinics, and school-based health centers. And all you have to do is to look at the recent scandal at the VA, much of which had to do with clinician shortages, to see why this was needed. And one of the critical components of our proposal is that their malpractice insurance would be covered under the Federal Tort Claims Act. That’s the coverage you can get at federally qualified health centers; it basically means the physician does not have to pay out of pocket for malpractice insurance. And we would extend that beyond the VA setting to school-based health centers and community health clinics. So we’d be making it as easy as possible for retired physicians to get back into the healthcare system.
When was the bill first introduced?
We introduced it in the last Congress; our most recent reintroduction in this session was last week. There are certain organizations that will not endorse your bill until it’s been field and introduced. Those that have already endorsed it include the American Academy of Pediatrics, the American Association of Colleges of Osteopathic Medicine, the Federation of State Medical Boards, the American Osteopathic Association and the School-Based Health Alliance. Those organizations already signed onto the bill through their endorsements will be quite helpful in building sponsorship for this legislation.