Another View Of Podiatric Residency Funding

In regard to last month’s “Letters” section (see “A Closer Look At Federal Funding For Residencies,” page 14, November), teaching hospitals that have intern and residency training programs and that also treat Medicare patients are currently being reimbursed by the Centers For Medicare And Medicaid Services (CMS) for direct and indirect expenses. The direct expenses would cover such financial items as intern/resident salaries, health insurance, meals, malpractice insurance and educational expenses. This is usually the smaller of the amounts received by the hospital administration. The indirect amount is the larger amount and is based on a complex formula that involves DRGs and Medicare discharges from the given institution. However, the fact remains that each teaching institution, whether it is university-based or community-based, does receive a specific gross amount of GME dollars that is divided by the number of house staff or FTE (full-time employee/intern/residents). That gross number (capped amount + podiatric and dental residents) is divided by the FTE number. That total amount is the direct and indirect CMS and graduate medical education (GME) funding per intern/resident. It is valuable knowledge to know what that figure is and, as a member of the Council of Teaching Hospitals (COTH), each podiatric residency director is provided with that confidential information. Granted, as we all know, that dollar amount does not all go to the interns and residents. A large amount goes toward the running of the hospital and clinics, etc. My personal opinion is that podiatric residency directors who are armed with the financial GME dollar information and have formulated an educational budget for their podiatric residents are in a better position to negotiate with their Director of Medical Education (DME) or hospital financial administrators. One important thing to keep in mind is that the hospital gets the same amount of GME dollars for their podiatric residents as they do for family practice, internal medicine, surgical or orthopedic residents. With the power of specific GME funding knowledge, one can approach the financial powers-that-be with more confidence and request equal funding for their residents’ training. — Marshall G. Solomon, DPM Chair, Council Of Teaching Hospitals Director of Podiatric Medical Education Botsford General Hospital Farmington Hills, MI

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