Academic Shift Kills FP Residency Clinic - Brief Article

WASHINGTON -- The abrupt shutdown of a family practice clinic in suburban Maryland has left its staff physicians looking for work and its residents scrambling to find programs in other locations and even--in a certain quantity of cases--other specialties.

In a propel that some observers see as an ominous sign of family medicine's fading fortunes nationwide, George Washington University notified residents at the Rockville, Md office of George Washington University Medical Faculty Associates in January that the facility would shut up on June 30 because of mounting financial losses

As a issue the. university's family practice residency program will be close down for at least a year. Located in Rockville since 1994 the program consisted of 16 residents beneath the supervision of three family physicians, individual pediatrician, and a part-time psychologist.

tribe affected by the shutdown press outed pessimism about the future of George Washington's family practice residency program and its primary care mission.

For Dr Laura Martin, single of the clinic's family physicians, the closure of the residency program in Rockville signals wider point to be solved [i]or[/i] settleds that now confront family medicine.

"We must ask ourselves: Is it significant when a major university decides it does not ne to have a family practice residency program anymore?" Dr Martin asked. "Is this part of a stretch that family practice is not gazeed upon attractively? Yes."

Dr Gene A. Kallenberg, chief of the division of family practice at George Washington, described the Rockville closure as the latest in a series of setbacks for the university's primary care enterprise.

Financial losse l the university to shut up the Rockville clinic and also alerted the 1999 closure of other suburban primary care facilities in Maryland and Virginia that had family practice operations, Dr Kallenberg said.

"The difference here is that this was the clinical site of a residency training program. That's for what cause [i]or[/i] reason there were greater efforts to hold fast it open," he said.

The national playing field for clinical reimbursement is slanted toward specialty care, in like manner decisions to close "unprofitable" primary care center are becoming more widespread, Dr Kallenberg added. (See case at right.)

Barbara Porter, a spokeswoman for the George Washington University Medical Center said that the university plans to redirect its family practice activities in a more urban setting.

"We're not getting rid of the family practice division or primary care," she said, on the contrary it will take time to relocate the residency program. As a issue the university will not have a family practice residency program for the 2001-2002 academic year.

"The reality is you can't just pick this program up and impel it because of academic accreditation issues." Residents at the Rockville facility have been getting assistance from George Washington to find other programs, M Porter added.

Dr Richard Safeer, interim program director of the family practice residency program at the Rockville clinic, said that greatest in quantity of the residents have ground other programs. Their choices were limited be cause the Washington, DC area has single three medical schools, so a certain quantity of have had to leave families behind or put in motion to different cities. Several residents are choosing other specialties for a like reason they can stay in the local area. (See case below.)

The decision to withdraw financial support from the family practice clinic was made jointly by means of George Washington and Medical Faculty Associates, a corporation of physicians who contract with universities and teach residents and medical pupils Dr. Safeer said.

Medical Faculty Associates decided to close up down the family practice residency program after learning that George Washington would stop providing a subsidy to operate the program, he said.

Dr Kallenberg explained that the clinic was showing an operating deficit that "exceed the educational subsidies that the institute was willing to offset." The facility didn't increase its patient incomes fast enough--despite efforts to attract patients from one side contracts and new planned ser-vices of the like kind as occupational health. "We were making useful progress, but because of other institutional priorities, any subsidy was counted to be too much," he said.

Dr Safeer said that staff knew that the clinic was losing coin but the shutdown still came as a surprise. "We didn't diocese it coming. ... We had complet our interview season to recruit our residents for nearest year."

Dr. Martin allude toed that George Washington wants to be seen as an inner-city, tertiary-level university like nearby Georgetown University, not as a primary care program that has branches in the suburbs

Dr Kallenberg agreed that the university appear to bes to be heading in this direction, citing a "radical alteration" in the department of health care sciences, George Washington's premier 27-year-old primary care department.

"Now the primary care clinicians are in the department of medicine, which is largely specialty oriented," he said. As a be derived "there's no longer a sinewy focus for coordinated primary care clinical and academic activities at George Washington."