Dozens of graduating medical students at SUNY Upstate have signed a pledge to treat more Medicaid patients once they become doctors in professional practice. Emily Commesso is one of them, and led the effort. She and some classmates liked the idea of having more doctors with skin in the game, and extended the pledge to all 150 in their graduating class.
"In 3 to 5 years, we'll be entering our first practices, signing our first contracts as attendings. That's when we'll really be making decisions, deciding which patients we're going to be serving. We're going have a voice at that table if we're partners in a practice trying to get up to that point."
Commesso says the pledge doesn’t commit signatories to a specific percentage or number of Medicaid patients due to wide variations among specialties, just that they acknowledge that they can help close the gap in access for the 20 percent of Americans who are part of the program. She acknowledges that Medicaid could dramatically change in the coming months and years, but their commitment still stands.
"I think it's important to be willing to serve that community, whatever that title becomes next year, 5 years from now, 10 years from now. It's not so important to focus on it as a Medicaid community, even though that's what we say in our pledge, it's more the idea of serving that underserved, and not discriminating against a population as physicians."
At the same time, Commesso says the MD candidates are also realistic about the possible impact of the promise on their own lives. Reimbursement rates for Medicaid are historically low.
"We do live in a real world, and there are financial obligations, so we cannot say every patient we serve is going to be in a financially underserved community, of Medicaid status. That was important to us to not make set-in-stone number promise."
In all, about 70 students earning their medical degrees signed on to the pledge.