How are medical residencies funded? What happens when residents become parents? Lori Mihalich-Levin gives us the scoop on this episode of Leading with Health.
Lori Mihalich-Levin, JD, is a Partner in the health care practice at Dentons in their Washington, DC, office, where she practices Medicare regulatory law and represents academic medical centers and teaching hospitals. She is also the founder of Mindful Return, a program that 65 organizations offer to their new parent employees, to help them navigate the transition back to work after having a baby.
10:00 – LML: “There was a time when we really thought that managed care was going to reduce the need for doctors. At that point, Congress imposed these caps and said, basically, however many residents you hospitals were training in 1997, that’s how many we, Medicare, are going to pay for, for the rest of all time. So if you were training 700 residents back then and now you have 1400 residents, which is the case in some big academic medical centers and teaching hospitals, then it’s the hospital that’s basically subsidizing the remainder of those residency positions.”
12:30 – LML: “It’s really important to get in contact with and learn everything that they can from the hospital finance people about how to fill out the GME sections of the Medicare cost report and how the hospital is actually going to be paid for the residents that are training there.”
14:22 – LML: “I think from the medical educator perspective, there’s a lot of interest in knowing how the finances work. I think if you flip it around, there’s not always so much interest by the folks in the reimbursement department to share that information with others within the healthcare entities. So I’d say that sometimes there’s a push and pull, there’s a tension within an academic medical center around how much money is coming in the door and where it’s getting allocated and whose money is whose.”
19:50 – LML: “The research shows that the more men take parental leave, the better off the women’s careers wind up – and the more engaged (they are) in the children’s lives throughout their entire lives.”
22:35 – LML: “One thing that I find really troublesome is that there really isn’t a standard for the amount of time that a residency program will offer for parental leave. I think more and more places are offering maybe six weeks. And that is so fast. If you think about the state that the baby’s in after six weeks and just how ridiculously helpless they are. And another issue around being a resident on taking leave is that it can sort of push you off cycle. It can require you to have to extend your training period beyond the number of years that you had allocated and sort of play around with your ability to go into a fellowship if you wanted to do that the following year, because now, you know, you’ve got to stick around for a couple extra months.”
26:10 – LML: “I created a four-week online, cohort-based group support program for people who are transitioning back to work after parental leave, whether they’ve taken off two weeks or six months or a year or whatever.”
Leading with Health is hosted by Jennifer Michelle. Jennifer has a Master’s in Public Health and Epidemiology and is a certified EMT. As President of Michelle Marketing Strategies, Jennifer specializes in healthcare marketing. She is on a mission to create a healthcare system that actually cares about the patients and the providers.