COMMENTARY: A smart solution to Delaware’s health care workforce shortage

Delaware’s General Assembly is facing a challenging week ahead with growing pressure to make difficult budget cuts. We recognize that tough decisions must be made and that funding reductions seem inevitable. However, eliminating funding for vitally important health care programs cannot be an acceptable solution to the puzzle of how to balance Delaware’s budget.

Recently, the General Assembly’s Joint Finance Committee proposed to eliminate all programmatic funding for the Delaware Institute for Medical Education and Research and the Delaware Institute for Dental Education and Research. Eliminating funding for this program would be highly inadvisable and shortsighted.

The purpose of the DIMER and DIDER programs is twofold — to help medical- and dental-school students from Delaware repay their student loans, and to reserve medical- and dental-school spaces for Delaware residents. These programs provide strong encouragement to medical and dental students to return to Delaware to practice their professions.

Lopita Lopez

Lopita Lopez

The Association of American Medical Colleges recently predicted that the nation faces a shortage of over 60,000 physicians within the next 10 years. Delaware is already feeling this workforce shortage. The Affordable Care Act has helped expand the insured population; physicians have been leaving the workforce in response to increasing administrative demands and a rapidly changing health care environment; and new “concierge” practices in Delaware have resulted in some primary care practices in Delaware reducing the number of patients they serve.

If Delaware does not effectively plan for this increasing workforce shortage, the impact on patients will be profound; Delawareans will have less access to health care, especially primary care, and will receive potentially lower-quality care if Delaware is not able to recruit and retain top-notch health care professionals.

The DIMER and DIDER programs are a smart solution to Delaware’s medical and dental provider workforce problems. There are no medical or dental schools in Delaware, but because of these programs, Delawareans currently have access to a total of 30 admission slots at the Sidney Kimmel Medical College of Jefferson University, the Philadelphia College of Osteopathic Medicine, and the Kornberg School of Dentistry of Temple University.

Without this funding, the current admission spots could disappear, making it more difficult for Delawareans to access medical and dental schools in the region. Financially, these programs make sense — the state funding allocated to these programs is matched dollar-for-dollar by the federal government, and the funding reduces the pressure for Delaware to create and pay for its own medical and dental schools.

The impact of this decision would likely be greatest on our most vulnerable populations. If this proposal becomes a reality, it would hurt Delaware’s community health centers, such as Westside Family Healthcare, that rely on the program to help them recruit doctors and dentists.

Westside Family Healthcare has been providing equal access to quality health care, regardless of ability to pay, since 1988. Westside’s six health centers are located in federally designated health professional shortage areas. Each day, we’re faced with the challenge of balancing our limited medical and dental provider capacity with the growing demand for our services. Every year, we count on the DIMER and DIDER programs. These programs help us recruit and retain talented doctors and dentists who want to pursue careers in community health.

Tom Stephens

Tom Stephens

Collectively, Delaware’s community health centers cared for nearly 42,000 Delawareans in 2014; most of these patients live in communities of high need and barely make ends meet. Reducing the ability to compete for quality physicians and dentists will hinder the ability of community health centers to meet the health care needs of these most vulnerable patients.

Demand for services from community health centers has continued to grow each year. Inability to meet the demand would lead to the worsening of chronic medical conditions such as diabetes and asthma and to increased health care costs when patients must seek expensive care at the hospital emergency department rather than obtaining effective care at Delaware’s community health centers.

We urge the members of the Joint Finance Committee to reject the proposal to eliminate the DIMER and DIDER programs. The future of our health care delivery system and community health centers depends on this funding. The health of underserved communities in Delaware depends on this funding. This is a decision that Delaware simply cannot afford to make.

EDITOR’S NOTE: Lolita A. Lopez, Fellow of the American College of Healthcare Executives, is the president and CEO of Westside Family Healthcare, a non-profit community health system with a mission to provide equal access to quality health care, regardless of ability to pay.

Tom Stephens, M.D., Dr. Stephens is a family medicine physician and the chief medical officer of Westside Family Healthcare.

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