Topeka A rural Kansas physician asked a legislative panel today to delay considering a bill that would penalize the Kansas University Medical Center unless more of its students enter family practice.
"While we appreciate the spirit and the intent of the legislation, we ask you at this point to place it on the back burner," said Dr. Roger Tobias, president of the Kansas Academy of Family Physicians.
Tobias, who practices in Lyons and is a 1976 graduate of KUMC in Kansas City, Kan., said the KAFP wants to come up with 12 more suggestions to deal with the shortage of primary-care physicians in rural areas.
The bill was introduced by the Joint Committee on Health Care Decisions for the 1990s at the request of Rep. Fred Gatlin, R-Atwood.
It would require KUMC to graduate at least 5 percent more primary-care physicians in the 1996 fiscal year than the 1995 fiscal year, or suffer a 10 percent cut in funding.
FOR EACH year following 1996, the number of graduates that have either selected or entered a primary-care postgraduate residency training program must be at least 5 percent greater than the previous year, according to the bill.
Gatlin, who spoke this morning before the Senate Public Health and Welfare Committee, said the bill is similar to what the Minnesota Legislature did in 1970 to spur action to solve its own shortage of rural doctors.
He said the result was a program that has provided an acceptable ratio of primary-care physicians in all of Minnesota's 87 counties for the first time in that state's history.
"The more I studied this, the more I realized we had a basic problem in medical schools, including the KU Medical Center," Gatlin said. "I also discovered that while the shortage of primary-care physicians is most acute in the rural areas of Kansas, we have a chronic and an increasingly acute shortage throughout Kansas, including many, if not all urban areas."
GATLIN SAID he was certain that with positive action by the medical center that the penalties would never be applied.
In 1991, 45 of the 193 KUMC graduates 23 percent of graduates went into family practice residencies. From 1976-1991, 19 percent of all KUMC graduates entered family practice.
Tobias said the KAFP has backed off its earlier support of the bill, for now, after meeting recently with KUMC officials.
"There is no way to guarantee that an across-the-board reduction in operating funds at the medical school would not impact family or general primary-care training programs as much or even more than other departments in the medical school," Tobias said.
For example, civil service employees and tenured faculty can't have their pay reduced, he said.
"So the individuals and departments that would most likely feel the pinch are the same ones whose departments need to increase in size and numbers to meet the goals of the bill," Tobias said. "So we would be shooting ourselves in the foot."
HE SAID the KAFP has met with KUMC officials in the past week and "we feel the wheels are turning and we would wish to improve things. We would rather work with the school than against it."
He said the KAFP will continue to meet with KUMC officials and will return later in the session with a list of suggestions for solving the shortage of rural doctors.
The committee plans to hear more testimony on the bill Wednesday. KUMC officials are expected to testify against the bill.