There are also 24 residency review committees which are responsible for accrediting the residency programs within their respective specialties that are sponsored by US teaching hospitals. Teaching hospitals hire the number of residents they need to care for their inpatient population. Yet the mix of health professionals to fill the staffing needs of teaching hospitals does not necessarily create the production of the types of providers that will be needed by the population. The bulk of expenses for residency training are covered by revenues from patient care, with the US government being by far the largest single payer through the Medicare program. Medicare reimburses each hospital based on number of residents in training at the institution and the number of days of inpatient care provided to Medicare patients.
Residents offer reliable, valuable, inexpensive labor to help a hospital operate.
Additionally, generating research residents in specialties can increase an institution's reimbursement for patient care by increasing the use of technology and the number of inpatient days. It is likely that the US currently has too many physicians and perhaps even enough physicians practicing primary care. The real issue is that we have a maldistribution of physicians. The demands of the current market for more primary care physicians is being met through a variety of channels. Training programs, states and the federal government have been involved with encouraging more graduating medical students to choose primary care practice and to practice in underserved areas.