What changes are needed to better align GME policy to meet the surgical health needs of the US population? Projection of future supply of surgeons for 12 ACGME surgical specialties Cartographic analyses showing geographic distribution of surgery services Synthesis of lessons learned from state-based initiatives to expand GME training
Current policy context What’s a shortage? Trends in supply and distribution Where do NC physicians come from? Why do we care where physicians trained? Who counts as primary care? If we need more people, who do we need? Health workforce planning in NC
GME is hot topic (and not just for policy wonks) North Carolina versus the United States — how do we compare? Residents trained in North Carolina – retention, specialty choice and distribution AHEC’s contribution to residency training in NC GME costs and funding Time to change the GME training paradigm?
Trends, Challenges and Opportunities Setting the policy context Trends in supply and distribution Demographic and practice characteristics Projections and implications
Health system is transforming; existing workers take on new roles There are imbalances in the geographic location, specialty and practice settings of health professionals New and existing workforce will shift from acute to ambulatory,community- and home-based settings Career ladders missing, have broken rungs
Where do we get data on NPs in North Carolina? How many NPs are there and where are they? What are NPs’ demographic, education and practice characteristics?
Presentation Overview Background on NC HPDS Licensed Practical Nurses Registered Nurses Nurse Practitioner Specialty Definitions Certified Nurse Midwifery data presented at NC General Assembly
Lessons Learned from State Initiatives May 21, 2014: CMMI SIM Team Webinar Why Study States? • Most discussion has been national, our study examines state initiatives • In absence of substantive federal policy change, states are “policy laboratories” for GME innovation We sought to: understand successes and failures of state innovations identify innovative ideas about… Read more »
It’s Complicated: Quantifying the Magnitude, Timing and Effect of Branching and Switching during Graduate Medical Education May 1, 2014: AAMC Health Workforce Research Conference Presentation This presentation was originally given at the AAMC Health Workforce Conference 1st May 2014 using Tableau® (www.tableausoftware.com) Due to data use agreements it is not possible to distribute the Tableau… Read more »
A North Carolina Case Study May 1, 2014: AAMC Health Workforce Research Conference Overview • NC Pharmacist Supply • NC Pharmacist Demand • New and Emerging Roles for Pharmacists
February 26, 2014: Joint Legislative Oversight Committee on Health and Human Services Subcommittee on Midwives Presentation Overview Where do we get the data? How many physicians provide deliveries in NC and how has that number change over time? Do we have more or fewer CNMs relative to the nation? Where do they practice? How many… Read more »
January 21, 2014: NC Legislative Review Committee on Health Care Provider Practice Sustainability and Training/Additional Transparency Presentation overview Where do we get data on NC providers? How many health providers are enough? Benchmarking: North Carolina to United States (US data are shaky) Monitoring trends: are we worse or better off than in the past? (NC… Read more »
January 21, 2014: NC Legislative Review Committee on Health Care Provider Practice Sustainability and Training/Additional Transparency Presentation overview What I covered in December, agenda for today Supply of optometrists – how many is enough? Benchmark to national ratios Monitor trends over time Distribution of optometrists – are they where we need them? Rural versus urban… Read more »
Lessons Learned from State Initiatives September 25, 2013: National Health Policy Forum Presentation Overview Our interviews paint a picture of states having much to risk and much to gain, but missing out on important opportunities to reform GME. 10 Lessons Learned Recommendations for Model State Legislation
February 20, 2013: NC Hospital CEOs and AHEC Directors Meeting Presentation Overview GME is hot topic (and not just for policy wonks) North Carolina versus the United States — how do we compare? Residents trained in North Carolina — retention, specialty choice and distribution AHEC’s contribution to residency training in NC GME costs and funding… Read more »