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Academic Medicine: A Key Partner in Strengthening the Primary Care Infrastructure Via Teaching Health Centers

Rieselbach, Richard E. MD; Crouse, Byron J. MD; Neuhausen, Katherine MD, MPH; Nasca, Thomas J. MD; Frohna, John G. MD, MPH

doi: 10.1097/ACM.0000000000000035

In the United States, a worsening shortage of primary care physicians, along with structural deficiencies in their training, threaten the primary care system that is essential to ensuring access to high-quality, cost-effective health care. Community health centers (CHCs) are an underused resource that could facilitate rapid expansion of the primary care workforce and simultaneously prepare trainees for 21st-century practice. The Teaching Health Center Graduate Medical Education (THCGME) program, currently funded by the Affordable Care Act, uses CHCs as training sites for primary-care-focused graduate medical education (GME).

The authors propose that the goals of the THCGME program could be amplified by fostering partnerships between CHCs and teaching hospitals (academic medical centers [AMCs]). AMCs would encourage their primary care residency programs to expand by establishing teaching health center (THC) tracks. Modifications to the current THCGME model, facilitated by formal CHC and academic medicine partnerships (CHAMPs), would address the primary care physician shortage, produce physicians prepared for 21st-century practice, expose trainees to interprofessional education in a multidisciplinary environment, and facilitate the rapid expansion of CHC capacity.

To succeed, CHAMP THCs require a comprehensive consortium agreement designed to ensure equity between the community and academic partners; conforming with this agreement will provide the high-quality GME necessary to ensure residency accreditation. CHAMP THCs also require a federal mechanism to ensure stable, long-term funding. CHAMP THCs would develop in select CHCs that desire a partnership with AMCs and have capacity for providing a community-based setting for both GME and health services research.

Dr. Rieselbach is professor emeritus of medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Dr. Crouse is professor of family medicine, associate dean, Rural and Community Health, and director, Wisconsin Academy of Rural Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.

Dr. Neuhausen is director, Delivery System Reform, Office of Health Innovation, and clinical assistant professor, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia.

Dr. Nasca is chief executive officer, Accreditation Council for Graduate Medical Education, Chicago, Illinois, and professor of medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.

Dr. Frohna is professor of pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, and program director, American Family Children’s Hospital Pediatric Residency, Madison, Wisconsin.

Funding/Support: None.

Other disclosures: None.

Disclaimer: Dr. Rieselbach and Dr. Nasca are past presidents of the Association of Program Directors in Internal Medicine. This proposal does not necessarily reflect the position of the foregoing organization.

Ethical approval: Not applicable.

Correspondence should be addressed to Dr. Rieselbach, Department of Internal Medicine, University of Wisconsin School of Medicine and Public Health, Health Sciences Learning Center, 750 Highland Ave., Madison, WI 53705; telephone: (608) 263-2552; e-mail:

© 2013 by the Association of American Medical Colleges