AAMC calls for increase in medical school enrollment
Concerned that America may experience a physician shortage in the next few decades, the AAMC recommended last week that enrollment in U.S. medical schools be increased 15 percent by 2015; this would result in an additional 2,500 M.D. graduates per year. The association also recommended the removal of the current restriction on the number of residency and fellowship positions funded by Medicare in order to ensure that the new U.S. medical school graduates can complete their graduate medical education.

A survey of medical school expansion plans, conducted by the AAMC's Center for Workforce Studies in late 2004, shows that many medical schools have already begun to increase their class sizes. Of the 118 allopathic schools that responded to the survey, 31 percent indicated that they were "definitely" or "probably" going to boost first-year enrollment over the next several years. The WSU School of Medicine currently is investigating ways to potentially increase enrollment. The Center for Workforce Studies will continue to monitor and analyze changes in the physician supply, and will sponsor the first annual Physician Workforce Research Conference, May 5 and 6, in Washington, D.C.

For more information, please visit http://www.aamc.org/newsroom/pressrel/2005/050222.htm.

VA releases report on contracts with medical schools
The Department of Veterans Affairs Office of the Inspector General recently released a report criticizing the way sole-source contracts are awarded by Veterans Health Administration medical centers to affiliated medical schools and practice groups. The report, "Evaluation of VHA Sole-Source Contracts With Medical Schools and Other Affiliated Institutions," addresses three primary issues: general contracting issues, contract pricing and conflict of interest and other legal issues. The report concludes, "some contracts were awarded to meet the needs of the affiliate, not the VA" and that "VA was overpaying the affiliates for services provided" at both the affiliate and at the VA. Jonathan Perlin, M.D., Ph.D., VA under secretary for health, concurred with the report's conclusions, noting, "VHA recognizes that flaws exist in contracting processes throughout the system and that effective accountability controls are lacking." Dr. Perlin convened a committee to review the report and develop a plan of corrective action; that plan is included in the report.

For more information, please visit http://www.va.gov/oig/52/reports/2005/VAOIG-05-01318-85.pdf.

NQF requests comments on patient satisfaction survey for hospitals
The National Quality Forum is seeking public review and comment on a patient satisfaction survey that will allow consumers to compare the care received at hospitals across the country. This standardized survey, called "HCAHPS," was developed by the Agency for Healthcare Research and Quality and CMS. The HCAHPS survey was then submitted to NQF to be considered for endorsement as a single, voluntary, national standard measure of patients' perspectives of their hospital care experiences. The resulting 27-item version of this questionnaire is now being offered for review and public comment. The deadline for public comments is March 18; the deadline for NQF member comments is March 23. The AAMC will be issuing comments on the survey. For more information, please visit http://www.qualityforum.org/webhcahpsALL02-18-05.pdf.

AHRQ issues annual reports on quality, disparities
The Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services, recently released two second annual reports: one on healthcare quality and the other on disparities in the American healthcare system. The "2004 National Healthcare Quality Report" found evidence of improving quality as well as specific areas in which major improvements can be made. Three key themes concluded from the report: 1) quality is improving in many areas, but change takes time; 2) the gap between the best possible care and actual care remains large; and 3) further improvement in health care is possible.

The 2004 "National Healthcare Disparities Report" indicates that there continue to be disparities related to race, ethnicity, and socioeconomic status in the American health care system. The report indicates, for example, that in one-half of the research indicators, Hispanics received lower quality of care than non-Hispanic whites; about 90 percent of the research indicators showed that Hispanics had worse access to care than non-Hispanic whites. Three key themes resulting from this report: 1) disparities are pervasive; 2) improvement is possible; and 3) gaps in information exist, especially for specific conditions and populations.

For more information, please visit http://www.qualitytools.ahrq.gov.