MISSION

Develop training and workforce solutions for the provision of quality primary care to underserved populations through support and transformation of primary care health workforce training partnerships.

Areas of focus:

  • FQHC-residency training partnerships
  • Consultation services
  • Health workforce research
  • Policy solutions for primary care training

CHALLENGE

Health centers and the specialty of family medicine share the vision of breaking down barriers to access so that every American has a patient-centered medical home. Unfortunately, in addition to their common values of service, health centers and residencies also share the burden of a health workforce crisis. As a result of decreased interest in primary care, the recent expansion in numbers of health centers and a chronic problem of recruitment and retention of health care providers to underserved areas, there is a shortage of Family Physicians within health centers. The current health workforce crisis threatens the safety net system and the vulnerable population it serves. The crisis in primary care and a lack of secure funding threaten the survival of family medicine residency programs. New models of training primary care physicians in health centers are necessary to assure adequate health workforce to staff our nation’s safety net clinics.

RESPONSE

Since 2007 the EHCI partners have worked together to address this issue. The Education Health Center Initiative has produced a foundation of qualitative and quantitative evaluation of residency training in health centers, forged a coalition of health center and residency representatives throughout a ten-state region, and has made significant contributions toward the model of training primary care physicians in the health care safety net. EHCI principals have published papers that demonstrate that training family physicians in health centers helps meet the health workforce needs of the underserved by enhancing the recruitment of family physicians to such centers. Specifically, the research has shown that physicians who are trained in health centers are twice as likely to work in underserved settings and four times more likely to work in health centers after completing their residency. However, qualitative assessments reveal that the affiliation between health centers and primary care residency programs is hindered by financial, administrative and governance barriers, evidenced by University of Washington Department of Family Medicine’s national survey of all Family Medicine Residencies in the US, which demonstrated that only 9% of residents are trained in federally-qualified health centers.

Considerable interest in the EHC model has been generated by the THCGME provisions in the Affordable Care Act, as well as the perception by many that this is an idea whose “time has come”. Because of the considerable complexity and barriers that accompany the creation of an Education Health Center, in 2011 EHCI began offering a full complement of consulting services which augment and customize the essentials that are presented in its toolkit.