EPtalk by Dr. Jayne 4/3/25
I finally have some solid data from the recent residency match, as administered by the National Resident Matching Program.
For those who might not be familiar, this is where medical students indicate where they want to do their residency training; training programs indicate who they want to fill their allocated number of training slots; and an algorithm tries to bring them all together. This year’s match had 52,409 applicants, for which only 47,208 submitted a final rank order list. The candidates were competing for 43,237 positions. At noon Eastern time on match day, all the applicants learn where they’re going to be for the next three to seven years.
Different medical schools handle the big reveal in different ways, with some handing out sealed envelopes for class members to open privately. Others throw blowout match day celebrations complete with “walk-up” music like you might see at a major league baseball game, followed by live reveals as candidates open their notices. The latter can be a difficult environment for those who didn’t get their top choices, but everyone still acts thrilled regardless.
Those who didn’t match were notified earlier in the week and have the opportunity to compete in The Supplemental Offer and Acceptance Program (SOAP), commonly referred to as “the scramble,” where unfilled slots are offered and candidates have only two hours to accept a potential offer. If you saw a graduating medical student with their phone glued to their body March 17-20, chances are they were part of the scramble.
It’s a brutal process for those who have been through it, although some of my classmates who had top scores were largely unfazed. The final match data can be telling as far as what students think about a particular specialty, and following the worst parts of the COVID-19 pandemic we saw a significant drop in matches to emergency medicine as students saw what that specialty had become. After experiencing an 81.8% fill rate in 2023, emergency medicine rebounded to 95.5% in 2024 and landed at 97.9% for 2025.
Primary care specialties ended up with a 93.5% fill rate, even with an increase of 877 in the positions available. Family medicine matches fell from 87.8% to 85.0%, which means that we will continue to have shortages in that specialty for years to come. Unless healthcare payment policies change (and workloads shift), we’ll continue to see a decline as students choose specialties with higher compensation and better work-life balance.
I had dinner with some friends last week, and one of them was showing off her Oura ring. She and her husband bought matching rings in an effort to use data to determine who was more disruptive during sleep. The company has been working to improve its sleep tracking algorithm, and although it’s better than competitor devices, it’s still not as accurate as formal polysomnography. Although it will probably be good enough to force one of the parties to consider seeking medical help, it’s not classified as a medical device, nor is it approved to diagnose, treat, or monitor health conditions. If you think your bed partner has apnea or another serious condition, it is best to see a licensed professional.
In another discussion, a friend asked me about this article on Gather Health, which aims to provide primary care services with a focus on keeping older patients out of the emergency department. Founded by an emergency physician who was tired of seeing patients seeking care in high-cost facilities when it could be better managed elsewhere, over 2,500 patients are enrolled, with the majority being covered by Medicare and Medicaid. The company has raised $17 million in funding and hopes to break even in 2025. The company pairs office-based care with home health, remote patient monitoring, and social opportunities to improve patient outcomes.
The article mentions revenue forecasts of $44 million this year. It hopes to expand from four to 17 sites in Massachusetts. Of course, when venture capital is involved, there’s an expectation that the services will yield a profit, and it would be interesting to learn more about how much money they think they can make on something like this. I’m not against people making a profit, but it’s the extreme focus on profitability that I’ve seen create a lot of issues in healthcare delivery organizations. Nearly every physician gathering that I attend features at least one horror story related to private equity or venture funding of care delivery organizations.
Caring for complex elderly patients is expensive and challenging. The company’s founder also served as chief operating officer of VillageMD, so it will be interesting to see what he does differently with this endeavor. From the patient perspective, I wish the company well and will be interested to see how it performs over the next few years.
The Open Payments program is a national system that creates transparency around payments made to physicians from drug companies, device manufacturers, and other regulated entities. Each spring, data is released so that physicians can review what is associated with their name and potentially dispute anything unexpected. It’s been many years since I attended so much as a drug company lunch, so I was surprised to see a significant amount of money posted against my name for the recent reporting period.
I’m glad I reviewed it, because the entry was from a company I don’t associate with and was tagged with a nebulous “food and beverage” category for a single event in the first few months of 2024. I’ve opened a dispute about the entry and hopefully it will be resolved quickly and with a minimum of extra work on my part. If you’re a provider subject to reporting, it might not be a bad idea to take a look at your account. Even if I’m unable to resolve it, my understanding is that my record will be flagged as “disputed,” which is good because I hate to break my record of perfect zeros.
Mark your calendar for the next DEA National Prescription Drug Take Back Day on Saturday, April 26. Communities will be holding collection events, often at local police departments or other health facilities. Unwanted and expired medications are a health hazard and also pose risks to the environment when people dispose of them incorrectly. Fortunately, my local law enforcement agency has a box that’s available for drop off around the clock, and I made good use of it when a relative passed away, leaving behind a cache of pain medications with a street value in the thousands of dollars. The program has collected 19 million pounds of medications over the years, which is pretty impressive.
Email Dr. Jayne.
Cant you sue the F&B company for fraud if they said they paid you money but never did?