Letter: Congress Needs to Extend Support for the National Teaching Health Center Program

Greater Lawrence Family Health Center President and CEO John M. Silva told business leaders about the planned Haverhill Family Health Center early in 2020. (WHAV News file photograph.)

To the Editor:

On July 1, a new academic year unlike any other began for medical residents throughout the nation.  However, one of the positive stories to emerge from the current COVID-19 pandemic has been the role medical residents at the nation’s 56 Teaching Health Centers (THCs) played to combat the coronavirus, including screening and testing patients at community health care clinics and adapting telehealth for countless individuals with chronic diseases.

The heroic efforts of our residents at Greater Lawrence Family Health Center also validate the Teaching Health Center program, which Congress created over 10 years ago to help expand the primary care physician workforce in medically underserved areas. The outsized return in access to care and the increase in physicians demonstrate why policymakers must swiftly extend the program, which is due to expire on November 30, 2020. As noted below, this is particularly time-sensitive given the financial hardship faced by community health centers like ours due to the COVID-19 crisis.

America has a shortage of primary care physicians and dentists and needs medical residents like those at our Lawrence Family Medicine Residency. Residents throughout the country train for three to four years in community clinics before opening up their own practices or joining the health care workforce. Teaching Health Centers provide an alternative to traditional hospital-based graduate medical residency programs and are sponsored by community-based clinical organizations such as federally qualified health centers like ours, rural health clinics, or consortia of nonprofit health care organizations. So far, more than 1,100 THC graduates have completed their residency, and a substantial percentage have continued practicing in primary care and become doctors in underserved communities.

During the COVID-19 crisis, THC residents were essential as we pivoted quickly and adopted new ways to provide primary care like offering telemedicine services for our patients. In fact, at Greater Lawrence Family Health Center, we were one of the first Community Health Centers in the Commonwealth to fully operationalize our telehealth medicine services, and our residents were right there on the frontline helping to make it happen. They have been indispensable in the COVID-19 fight. Our residents at the Lawrence Family Medicine Residency were all on the frontlines here in our community. The residents, in fact, were called upon to staff the COVID-19 only floor at Lawrence General Hospital over the last four months during the height of this unforeseen pandemic. THC residents all across the country have been doing the same from state to state, community to community. We are proud of our Residency Program.

The Teaching Health Center program deserves a five-year extension and increased funding so that more medical students can benefit. Since 2015, despite broad bipartisan support for the program, Congress has only passed several short-term funding extensions for Teaching Health Center residencies. THCs and medical residents need long-term certainty and stability because sponsoring organizations (all nonprofits with low margins and significant local needs) are balancing uncertain federal funding and significant COVID-19 financial losses that threaten their stability.

The stellar performance of the nation’s THC medical residents during their COVID-19 baptism by fire should convince Congress to enact immediately the multi-year extension for the Teaching Health Center program. Our nation’s health care safety net is stronger today due to investments in the program. THC residents remain committed to working in medically-underserved communities struggling with the fallout of the COVID-19 epidemic. As legislators consider another COVID-19 emergency response bill this month, they should fully fund this excellent source of primary care physicians and dentists.

In addition, in the wake of the COVID-19 epidemic, Congress needs to recognize that community health centers that are also Teaching Health Centers, are closing sites and furloughing staff to remain open.  THCs have had to shift the way their programs operate over the past few months and still don’t have a sustainable funding path in sight. This adds to the urgency of the multi-year extension of the Teaching Health Center program and also suggests that Congress should identify additional ways to support centers like ours in the coming weeks.

John M. Silva is president and chief executive officer of Greater Lawrence Family Health Center.

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