The hospital network Providence Swedish will no longer train primary care doctors at three community health centers in the Seattle area after current residents graduate.
Hospital leaders informed the Carolyn Downs Family Medical Center, the International Community Health Services and the Seattle Indian Board of Health last week that Providence Swedish would completely phase out their training programs by 2029. Each health center hosts six family medicine residents and provides medical care to patients no matter their ability to pay.
Community health advocates worry that it may become harder to access medical care as fewer primary care providers train in the Puget Sound region. Doctors will also have fewer opportunities to work with underserved communities during their residencies.
Providence Swedish’s move to roll back its residency slots in the Seattle area is part of a larger effort to merge its family medicine residency programs at its First Hill and Cherry Hill campuses. Family medicine doctors focus on caring for patients of all ages.
In an emailed statement, Providence Swedish said it is making these changes to sustain its training program and that the residency programs’ current structure is “operating at a significant financial loss and under mounting pressures — challenges that health systems across the country are facing.”
The nonprofit hospital network will continue to partner with the King County Downtown Family Medical Center and the Sea Mar Medical Centers as training sites for its primary care residents.
This decision was based on a number of factors, such as “the need to select sites that could best support broad family medicine training,” which includes pediatrics, geriatrics and obstetrics, according to the network.
Providence Swedish doctors who are currently completing their three-year residencies at the three clinics will be able to finish their terms. But those physicians will not be replaced.
As the hospital network combines its First Hill and Cherry Hill family medicine residencies, it will ultimately eliminate 18 residency training slots. Currently, Providence Swedish trains 78 family medicine residents across the state. That will eventually drop to 60 residents. Providence Swedish’s rural training program, which will not be affected by these cuts.
This decision sparked an anonymous online petition earlier this year, signed by more than 1,500 healthcare workers and community members, that called on Providence Swedish to avoid cutting residency slots and maintain partnership with all of the community clinics. It warned that the move will make it difficult for thousands of patients to receive care in the future.
“Fewer residents means fewer clinic sessions, longer wait times, strain on clinic support services, and increased utilization on urgent care and ER services if patients seek care at all, the petition states,” the petition stated.
King County clinics weigh options
“We're able to train residents that are specifically interested in taking care of this population, the Asian-Pacific Islander population,” Gibbs said. “The fact that ICHS will no longer be part of a medical residency program will, over the long term, reduce the number of such young physicians that have an interest in that and [who] can receive training immersed in those cultures and languages and needs.”
ICHS residents care for around 2,000 patients, only a fraction of the approximately 36,000 patients its providers see every year, Gibbs said. ICHS has locations throughout King County, offering medical, dental and behavioral health services.
In the short term, Gibbs said the change will not have a major effect on how ICHS operates. The health center is now assessing whether there are other ways it can continue training primary care providers.
“One option is to affiliate with another residency program. A second option is to try to establish our own program by ourselves,” he said. “A third is to not do it and absorb these patients in other ways.”
Still, he worried that Providence Swedish pulling back on training primary care providers will make it hard for people to access basic medical care. Gibbs noted that after finishing the program, many ICHS residents have gone on to work full-time at the health center.
“Fewer primary care residency slots in the Puget Sound area is going to make access to primary care worse,” he said.
The Seattle Indian Health Board, or SIHB, is also assessing how it will move forward.
“While Providence Swedish’s decision to end our longstanding partnership is disappointing, we will find ways to continue operating our family medicine residency program in the future,” said Dr. Elizabeth Parks, the board’s chief health officer, in a news release.
SIHB largely serves on Native American and Alaska Native patients.
“More than half of our graduates go on to work in Native health, and 75% continue working in underserved communities,” she said. “By training providers who are committed to serving these populations long-term, our program helps close that gap and builds a more sustainable, trusted healthcare workforce for the communities that need it most.”
Seattle Roots Community Health, which operates the Carolyn Downs Family Medical Center released a statement from its CEO, Brandy Taylor. Carolyn Downs was founded by the Seattle Black Panther Party in 1970. The majority of its patients are Black and Hispanic, according to Providence Swedish.
“We are deeply saddened by this news,” Taylor said. “Swedish Cherry Hill Residency program has developed an incredible pipeline of family doctors, strengthening the community health workforce in Seattle and throughout the state.”
According to Taylor’s statement, there is not a “readily available path” for Seattle Roots to maintain training residents past 2029. However, she is asking state leaders to help the affected community health centers to preserve these residency slots.
“Washington cannot afford to lose opportunities that prepare and inspire the primary care providers our communities will depend on for years to come,” she said.
