the American Association of Colleges of Osteopathic Medicine

This analysis was prepared by Venable, LLP, on behalf of AACOM.

This hearing took place on May 12.

Speakers:

Dr. Valerie Montgomery Rice, President and CEO, Morehouse School of Medicine

Dr. Jeannette E. South-Paul, Executive Vice President and Provost, Meharry Medical College

Dr. Hugh E. Mighty, Senior Vice President for Health Affairs, Howard University

Dr. David M. Carlisle, President and CEO, Charles R. Drew University

Dr. David J. Skorton, President and CEO, Association of American Medical Colleges

Sonya Randolph, Student, Morehouse School of Medicine

Jamil Joyner, Student, Morehouse School of Medicine

Samuel Cook, Resident, Morehouse School of Medicine

Chairman Bernie Sanders (I-VT) criticized the American healthcare system, calling it “broken” and “unsustainable.” He cited several startling statistics. 85 million Americans are under or uninsured. On average, a person spends $13,000 a year on healthcare, twice as much per capita as any other nation in the world. Moreover, 500,000 people a year go bankrupt from medical expenses.
Chairman Sanders was distraught about the lack of diversity in the healthcare field. 13% of the U.S. population is Black, but Black Americans only comprise 5% of the total physician workforce. He expressed his commitment to expanding the healthcare professional workforce and increasing its diversity. While Chairman Sanders indicated he could not make any concrete promises due to the political climate in Washington, he expressed a deep commitment to working to build a diverse physician workforce to help alleviate these disparities.
Dr. Montgomery Rice highlighted the incredible work historically black colleges and universities (HBCUs) and minority serving institutions do to build a talented and diverse healthcare professional pipeline. Morehouse School of Medicine and other HBCUs are consistently ranked as the top medical schools for their social missions. Physicians that graduate from HBCUs disproportionately serve people of color and patients living in medically underserved communities. Unfortunately, HBCU medical schools do not have the same financial resources, academic affiliations, and endowments that other medical schools benefit from. Additionally, HBCUs often do not receive adequate resources from the federal government. Only a fraction of residency slots created by the Graduate Medical Education (GME) program in Medicare go to teaching hospitals and health centers affiliated with HBCUs. Dr. Montgomery Rice and Dr. Mighty called for Congress to include specific provisions in the GME program to give a meaningful portion of residency slots to HBCU affiliated health centers and teaching hospitals.
Morehouse School of Medicine received a seed grant from CommonSpirit Health to open five additional medical campuses across the country and 10 graduate medical education programs. Each program will have no less than two specialties, with at least one of the specialties being primary care to address the chronic workforce shortages in that specific field.
According to Dr. South-Paul, more than a third of Americans identify as underrepresented minorities, yet underrepresented minorities make up fewer than 7% of physicians and fewer than 5% of academic medical faculty. To solve this problem, Dr. South-Paul urged Congress to implement several policy changes. She called on Congress to provide $5 billion for improving research and development infrastructure at HBCUs and other minority serving institutions. She also called on Congress to increase funding for pipeline programs like summer education enrichment, mentorship programs, and scholarships to expose students to healthcare at an early age. Furthermore, Dr. South-Paul recommended that Congress update regulations to FQHCs to allow academic institutions such as HBCUs to sponsor interprofessional workforce training opportunities for students in physical, oral, and behavioral health. Last, Dr. South-Paul recommended that Congress facilitate building a pipeline for in-demand disciplines such as primary care, behavioral health, and maternal health.
Black women in the U.S. are three times more likely to die in pregnancy, childbirth, and post-partum than white women, a gap that persists despite income and education levels. Ms. Randolph spoke to the challenges people of color face when receiving medical care. She noted that people of color’s concerns are often dismissed or ignored, leading to adverse health outcomes, and fueling racial disparities in healthcare. Studies show that when Black patients are treated by Black doctors, they are more satisfied with their healthcare, more likely to have received the preventive care they needed in the past year, and more likely to agree to recommend preventive care. The need for a more diverse physician workforce cannot be understated. Unfortunately, students from disadvantaged backgrounds who aspire to be physicians are more likely than their peers to drop their aspirations before the 12th grade. Barriers to entry need to be addressed to encourage more students to become doctors.
Dr. South-Paul, Dr. Mighty, Dr. Montgomery Rice, and Dr. Skorton support the Resident Physician Shortage Reduction Act (H.R. 2389) introduced by Rep. Terri Sewell (R-AL-7), which would add 14,000 new GME slots that give special consideration to HBCUs and other minority serving institutions.
Dr. Mighty mentioned that the HRSA Title VII and VIII workforce diversity programs are currently funded at less than they were in FY 2005. Increasing funding for these programs would allow more schools to build meaningful diversity training programs and pipelines. Dr. Skorton wants to double the amount of funding for these programs.
By 2034, the U.S. is expected to experience a shortage of 124,000 physicians, and the problem is predicted to be more pronounced amongst physicians of color. HBCUs comprise less than 3% of all M.D. granting institutions but produce more than 50% of all Black medical graduates. Dr. Skorton expressed grave concern around two pending SCOTUS cases that would limit race as an admissions factor in medical schools. An adverse ruling would be detrimental to HBCUs and would likely make the problem of workforce diversity much worse. In states where the use of race conscious admissions has been banned, there has been a 37% reduction in the diversity of classes.
Dr. Skorton called on Congress to pass the Expanding Medical Education Act. Dr. Skorton also called for Congress to resolve the backlog of green card applications and make use of J-1 Waivers to allow international physicians and nurses to practice in the U.S.
Virtually every person at the roundtable called on Congress to take action on the student loan debt crisis. The high cost of medical and nursing school serves as a massive barrier for aspiring physicians and nurses, especially those from disadvantaged backgrounds. Several audience members who graduated from medical and nursing school over a decade ago spoke about how they are still struggling to pay off their student loans. One woman was even part of faculty at a nursing school. Chairman Sanders would like to see student loan debt forgiven.

Watch the full hearing here.