Good Morning. It is an honor to be here this morning. My name is Dr. Humayun Chaudhry. I am the President of the American College of Osteopathic Internists. The ACOI is a membership organization dedicated to the highest standards of education, patient care and research in contemporary internal medicine based upon osteopathic concepts. I am also the Commissioner of Health Services for Suffolk County.

Thank you for holding this important town hall meeting. I attended P.S. 199, Andries Hudde Junior High School and Midwood High School. I have spent my professional career in New York, as a medical student, intern, resident, attending physician, residency program director and medical school department chair and assistant dean, and now as Health Commissioner. Having grown up here, training in the Bronx and on Long Island, and serving as the Commissioner and as the President of the ACOI, I have dedicated my life to improving the availability of quality health care.

While I only have a few minutes, there are a few key points that I want to address. Reformation of the health care system should be viewed as an osteopathic physician views his patient: look at the interaction between all of the systems and structures and not just the symptoms. An increase in the availability of health care coverage will require an increase in the number of physicians to provide the care. As such, no one part of the health care delivery system is cordoned off from any other part of the system. This must be kept in mind moving forward.

There is without a doubt a need to increase the availability of health care services for all Americans. The most recent estimate by the U.S. Census Bureau is that there are over 45.7 million Americans without health insurance coverage. This results in people not receiving care when they need it most. When care is finally sought, it is often at a time when the condition has worsened and the cost of care has grown. Improving access to preventive care and earlier treatment will reduce overall costs and improve long-term patient health.

The patient-centered medical home should be part of the health care reform package advanced by Congress. This comprehensive approach to providing health care will expand primary care services to children, youth and adults. Use of the medical home concept will address many of the reform principles advanced by President Obama and highlighted by many of the speakers here today. Through the coordination of care, the patient-centered medical home model promotes prevention and wellness; improves patient safety and the quality of care; and, through the attainment of greater efficiencies, advances efforts to obtain long-term fiscal stability. The patient-centered medical home should be included in any health care reform package advanced by Congress.

As I stated earlier, a change in one part of the health care delivery system will impact other areas of the system. Specifically, more patients will require additional physicians. We are already facing a physician shortage in the future. Expanded access to care, although empathetically a good thing, will compound the problem. This must be recognized and addressed. Any reform package considered by Congress should include provisions to improve the affordability and availability of medical education and training.

It is estimated that a medical student now graduates with over $150,000 in medical school debt. This certainly impacts career choices and has the potential to drive physicians away from less lucrative areas of medicine such as primary care. As our population ages and more people have access to health care coverage, the need for additional primary care physicians will continue to grow. Efforts must be made to make primary care a viable career choice.

In addition to improving the affordability of a medical education, efforts must be made to increase the number of residency training slots available under the Medicare program. I encourage you to consider co-sponsoring the “Resident Physician Shortage Reduction Act of 2009 (H.R. 2251). Your co-sponsorship of this bill would signal your support for expanding the number of available training slots in primary care and general surgery. Inclusion of this bill or similar provisions in a health care reform package advanced by Congress would address a key component of the health care reform debate.

As Congress moves forward with its efforts to reform the health care delivery system, caution must be exercised to avoid any un-intended consequences. There has been a great deal of discussion as of late regarding a “public plan” option to provide health care coverage. As physicians, we have had some concerns with the manner in which currently existing “public plans” have worked. As you know, reimbursement under the Medicare program has become an annual headache. While we understand budgets are tight, the realities of practice are that overhead costs must be met in order to keep the doors of practices open. The ACOI supports efforts to expand coverage and understands that controlling costs through increased quality and efficiency is essential. Any public plan option is certain to include measures to accomplish these goals. We simply ask that careful consideration be given to the impact of the adoption of these measures on patients and physicians.

In summary, two questions should be asked when considering any health care reform proposal: 1.) Will this proposal increase health care coverage and access to quality health care services?; 2.) Will this proposal increase the number of available physicians to provide the expanded care resulting from the new coverage?

Again, thank you for holding this important town hall meeting and thank you for the opportunity to be here today. The ACOI and its members stand ready to assist you and other members of Congress in any way possible. I welcome your questions and comments.