Bill Overview
Title: Increasing Competition for Medical Residency Act
Description: This bill repeals the antitrust exemption for graduate medical resident matching programs.
Sponsors: Rep. Spartz, Victoria [R-IN-5]
Target Audience
Population: Current and future medical residents and applicants to residency programs as well as potential patients impacted by redistribution of healthcare professionals
Estimated Size: 194000
- Repealing the antitrust exemption for medical residency matching programs may increase competition among hospitals and medical institutions to attract residents.
- Current medical residents and future medical students apply through the resident matching programs, so they will be directly affected by this change.
- The quality and distribution of healthcare could shift as institutions adjust their residency offerings.
- By possibly altering where doctors end up working, local patient populations could be impacted by shifts in healthcare availability.
Reasoning
- The policy's primary impact will be on medical residents and applicants for residency programs. This group is directly involved with the matching programs and will see immediate changes.
- The budget constraints mean that changes will need to be efficient, affecting existing systems without requiring massive capital expenditure.
- A significant portion of the impact will likely be on the competition among institutions, which could lead to changes in residency slots and potentially how attractive different hospitals become to graduates.
- Consider the perspective of hospitals and the healthcare system, which may adjust their recruitment processes or residency offerings to attract top candidates.
- Indirect effects on healthcare quality and availability could manifest if certain regions attract more doctors than others due to increased competition. This would be a longer-term effect felt by local patient populations.
Simulated Interviews
Surgical Resident (Boston, MA)
Age: 28 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- I'm concerned that increased competition might pressure hospitals to focus on offers rather than training quality.
- This change could make residency programs less predictable, potentially benefiting those willing to negotiate better terms.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 7 |
| Year 2 | 6 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 6 | 7 |
Medical Student (Austin, TX)
Age: 26 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- I hope this change increases opportunities in underserved areas, but I'm wary of how it might destabilize my match prospects.
- If more programs open up in rural areas, it could align with my career goals.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 7 | 6 |
Healthcare Administrator (San Francisco, CA)
Age: 35 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- The repeal may drive us to improve our residency offerings, but funding is always a concern.
- It might be possible to attract more diverse talent if we're allowed to tailor offers more directly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
General Practice Resident (New York, NY)
Age: 31 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- Contract negotiations become crucial, and added stress might affect our focus on training.
- I think it might open pathways but only if hospitals are prepared to handle the added competition.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 6 |
Recent Medical Graduate (Miami, FL)
Age: 24 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- The change could level the playing field or make it even more competitive, I'm unsure how it will turn out.
- As a recent graduate, any additional competition feels daunting.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 5 |
Family Physician (Rural Kansas)
Age: 40 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- Rural areas might benefit from increased competition if more programs are willing to offer incentives to work here.
- It has potential, but I'm afraid it might make little difference if programs still favor urban areas.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 4 | 4 |
| Year 3 | 4 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 4 | 4 |
Medical School Dean (Chicago, IL)
Age: 50 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 6/20
Statement of Opinion:
- It's challenging to predict how this will affect match rates and student satisfaction.
- We might need more resources to educate students on negotiation and competitive application strategies.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Cardiology Fellow (Los Angeles, CA)
Age: 29 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- Increased competition could mean better conditions but also higher stress in securing favorable terms.
- Many fellows might feel uncertain about post-training opportunities under this change.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 6 | 7 |
| Year 5 | 6 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 6 | 7 |
Patient Advocate (Seattle, WA)
Age: 47 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- I worry about potential disruptions to healthcare delivery if residents face too much movement or instability.
- The policy change might push hospitals to focus too much on attracting residents instead of patient care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 5 | 6 |
Hospital CFO (Atlanta, GA)
Age: 55 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- It's vital that we find a cost-efficient way to remain competitive without degrading the quality of our residency programs.
- This new dynamic could shift how we allocate resources for resident training.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Cost Estimates
Year 1: $50000000 (Low: $30000000, High: $70000000)
Year 2: $52000000 (Low: $31000000, High: $72000000)
Year 3: $53500000 (Low: $32000000, High: $74000000)
Year 5: $56500000 (Low: $34000000, High: $77000000)
Year 10: $62000000 (Low: $38000000, High: $84000000)
Year 100: $100000000 (Low: $60000000, High: $130000000)
Key Considerations
- The transition away from a centralized matching system may initially disrupt the placement process, affecting both hospitals and residents.
- Long-term impacts on healthcare quality and distribution are uncertain as institutions adjust to new competitive dynamics.
- Antitrust law changes could attract legal challenges adding potential costs or delays.