Leaders of a family medicine group are warning federal lawmakers against cutting graduate medical education budgets and funding for primary-care residency programs in particular.

The Council of Academic Family Medicine, described as the "family of family medicine," deals mainly with medical education issues and includes the American Academy of Family Physicians, Association of Departments of Family Medicine, Association of Family Medicine Residency Directors, North American Primary Care Research Group and Society of Teachers of Family Medicine.

In a letter to Sens. Harry Reid (D-Nev.) and Mitch McConnell (R-Ky.) and Reps. John Boehner (R-Ohio) and Nancy Pelosi (D-Calif.), the group argued, "Continued financial support to primary-care training will enhance the production of a high-value workforce that will be able to restrain future healthcare costs." The council continued, "If any budget proposal is to restrain the growth in healthcare spending successfully, it must also support programs that build the family physician and primary-care workforce.”

If Congress must cut GME funding, it should be targeted and not across the board, the group argued, with reductions aimed first at programs that lead to a second certification, rather than at programs that finance basic training for all new doctors.

The letter stands in stark contrast to recent calls to increase Medicare funding of GME in order to avoid projected doctor shortages. According to a June 2010 Medicare Payment Advisory Commission report to Congress (PDF), Medicare spent an estimated $9.5 billion on physician residency programs—or more than $100,000 per resident—in 2009.

While the country's medical-school enrollment is experiencing steady growth, the number of residency programs Medicare supports has been essentially capped at 1996 levels since the passage of the Balanced Budget Act of 1997. According to the Accreditation Council for Graduate Medical Education, the organization that evaluates and accredits the country's 8,887 physician-training programs, there were 113,142 full- and part-time medical residents for the 2010-2011 academic year.

Congressional bills proposing to fund an expansion of 15,000 new residency positions have become almost an annual ritual. Another recent bill sought to boost rural residency programs.

The council, however, appears to remain undaunted by these failed attempts, and it argues that Medicare-funded physician-training programs can be used to lead payment reform, boost quality and lower overall costs.

"Medicare GME should take the lead in providing payment incentives for the development of new models of care that will improve health outcomes for Medicare beneficiaries at significantly reduced costs," its letter to Congressional leaders stated. "Medicare GME funding for primary-care physician training should be protected from deficit reduction so that the production of a robust primary-care workforce—one that has been shown to correlate well with lower Medicare costs and improved quality of care—is preserved and strengthened."