Health care experts are calling for more transparency in how tax dollars are being spent on physician residency programs. North Carolina ranks 5th in the nation in the amount of graduate medical education (GME) funding it receives, yet the state is an overall net importer of doctors.

“I’m going to make the argument and pitch here that simply investing in more bodies is not going to address the issue. We have to fundamentally change the way we do things,” says Dr. Erin Fraher, Director of the Program on Health Workforce Research and Policy at the University of North Carolina. Fraher presented data last week on the state’s physician workforce to lawmakers who sit on the graduate medical education (GME) subcommittee.

North Carolina retains 43 percent of its physicians, and just three percent who graduated from residency programs between 2008 and 2011 are practicing in rural communities.

While the bulk of North Carolina GME funds are distributed out of Washington, $90 million is paid for by Medicaid, the state-federal health insurer for low-income patients. These funds help teaching hospitals cover resident salaries, benefits, and additional costs related to their physician training programs. For state taxpayers to get a better return on their investment, Fraher recommends that lawmakers target Medicaid GME monies at teaching hospitals that are keeping doctors in-state.

You can view her full presentation here.