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  • ACOEM Urges House and Senate Appropriations Subcommittees to Fully Fund NIOSH ERCs

    The following letter was sent on March 23, 2015, to the chairs and ranking members of both the House and Senate Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies.

    As the Labor HHS Appropriations Subcommittee considers funding priorities for Fiscal Year 2016, the American College of Occupational and Environmental Medicine (ACOEM) urges you to maintain the Fiscal Year 2015 level of funding for the National Institute for Occupational Safety and Health (NIOSH), including $27 million for the Education and Research Centers (ERCs).

    ACOEM is especially concerned that the President’s budget request for Fiscal Year 2016 eliminates almost all NIOSH funding for occupational medicine residency programs through elimination of the NIOSH funded Education and Research Centers (ERCs).

    We request the Subcommittee to reject the Administration’s proposal in this area and to urge NIOSH to look at options for increasing the number of occupational medicine (OM) residents supported by NIOSH through the ERCs and the training program grants (TPG).

    Occupational medicine physicians are trained in population health management, a critical skill for improving the effectiveness and cost of our health care system. OM physicians are central to harnessing all of the opportunities that employers can offer to improve the health of U.S. citizens. As we are all aware, healthy workers lead to a healthy economy.

    Occupational medicine physicians are a unique specialty. We are trained to increase the overall health of workers and their family in a variety of ways: through health and wellness programs; assuring workers are performing their jobs in a safe manner; and preventing long term disability when workers do receive injuries in the workplace.

    The impact of occupational medicine physicians is significant, reaching an average of 21,000 individuals versus an average of 1,600 for a primary care physician. The OM physician leverages his or her impact by decreasing long-term disability and unemployment and by increasing the overall health of workers, e.g. decreasing obesity, diabetes, etc.

    Unlike almost every other major medical specialty, occupational medicine does not receive residency-funding support from the Centers for Medicare and Medicaid Services. NIOSH is the primary source of federal funding for occupational medicine residency programs. The NIOSH ERCs and TPGs provide tuition and stipends to the majority of young physicians currently in occupational medicine residency programs.

    There is broad agreement that OM residency programs have been seriously underfunded for many years, resulting in a shortage of residency-trained OM physicians. In 2000, the Institute of Medicine noted the need for substantially more specialists with formal training in occupational medicine — a need that has taken on a new urgency today.

    According to the American Board of Preventive Medicine, the number of board-certified OM physicians has been in stark decline. Where 121 became board-certified in 2004, there were only 86 in 2013. Without an increase in residency positions, the long-term outlook for OM — based on these numbers — is bleak. Current projections show a loss of 1,655 OM Boarded physicians, due to retirement, over the next 10 years. Assuming that there would be 764 newly certified OM physicians over this period, the result would be a net workforce reduction of 891, or 33% of the current workforce of OM Boarded physicians (those under age 65).

    This trend downward comes at the same time that there is an increased demand for residency-trained OM physicians to manage health risks and improve the fundamental health of the workforce. America’s chronic disease crisis, combined with an aging workforce, requires new strategies to create healthier workplaces — strategies that OM physicians are uniquely trained to provide. Increasingly, employers are seeking the advice of workplace health specialists to help them move in this direction — recognizing that healthier workers are critical to their future.

    If you should have any questions or need additional information, please contact Patrick O’Connor, ACOEM’s Director of Government Affairs at 202/223-6222.

    Thank you for your consideration.


    Kathryn Mueller, MD, MPH, FACOEM