Tuesday, February 4, 2014

Arkansas State University finds demand for an osteopathic med school

Posted By and on Tue, Feb 4, 2014 at 3:12 PM

click to enlarge Chancellor Rahn: If there aren't enough residency positions, more programs, like the osteopathy school ASU is contemplating, won't help doctor shortages.
  • Chancellor Rahn: If there aren't enough residency positions, more programs, like the osteopathy school ASU is contemplating, won't help doctor shortages.
Least shocking news of the day is that, as I predicted back in September, a consultant hired by Arkansas State University has confirmed the university's belief that there's sufficient demand to start a medical school osteopathic medicine variety — in Jonesboro.

The Delta Regional Authority has thrown its weight behind the idea. The selling point is to create more primary care doctors, particularly for the Delta. Many discussions will be held about whether doctors produced in these fields can be counted on to stay in the underserved areas the program is supposed to help.

Yet to be heard, too, are the likely cautionary words from the state's existing medical school, which enjoys a state subsidy through both direct contributions and UAMS' role as a major recipient of federally subsidized health spending dollars. The country's med schools are already producing more graduates than residencies to accommodate them. But the expansion of government health care might spur a demand for doctors that rebalances that equation. Note that UAMS has expanded its educational arm to Northwest Arkansas, though not yet with a full medical school.

UPDATE: UAMS Chancellor Dan Rahn talked to Leslie Peacock about his reaction to ASU's announcement. His reaction: "I don't think this proposal addresses our problems in Arkansas." 

To be eligible to practice as a licensed physician, doctors must have completed some kind of post-graduate training in an approved residency program. Rahn said that nationally, 582 med school graduates were unable to get into residency programs last year, and nine UAMS graduates did not. Some of them may have been simply outmatched, but, according to the chancellor, while medical schools have been graduating more doctors, "the number of available residencies has not kept pace with the medical school graduation rate." One reason is the fact that Medicare capped the number of residencies it would support in 1997. 

What's needed to address the shortage of primary care physicians, especially in Arkansas's rural areas, Rahn says: Keep the "private option" viable to insure the working poor and help hospitals' bottom line, plan at the state level on ways to increase the number of resident slots and push forward with reforms of the healthcare delivery system, including adding to the numbers of advanced practice nurses and physicians assistants.

Those were the conclusions that Rahn and Paul Halverson, who was director of the state Health Department at the time, provided in a report to Gov. Mike Beebe. 

Rahn also noted that private osteopathy schools will cost students far more in tuition and fees than the state-subsidized UAMS, where tuition and fees come to around $24,000. According to   this chart by the American Association of Colleges of Osteopathic Medicine, which tuition and fees as high as around $54,000 and none lower than around $30,000. 

A feasibility study is also underway about starting a D.O. medical school in Fort Smith.

A med school in Jonesboro with 100 students will create "thousands of jobs," the news release says.

Beyond the ASU boosterism, there's a serious discussion to be had. It might ultimately weigh in ASU's favor, but building a medical school strikes me as a poor place to start economic prosperity, as  the news release seems to suggest. Some elitism will figure in the debate, too. Traditional med schools are generally considered harder to enter. Osteopathic medicine is a holistic discipline. But graduates of both may become licensed physicians, though D.O.'s tend more toward primary care. Not a bad thing.

The ASU release follows.

JONESBORO – A feasibility study by nationally renowned Tripp Umbach concludes an osteopathic medical school at Arkansas State University would help meet the demand for more primary care physicians in the Delta and have an initial $70 million economic impact on Northeast Arkansas.

Arkansas State, with support from the Delta Regional Authority, contracted with Tripp Umbach in September to analyze the feasibility of developing a school for osteopathic physicians (D.O.s). Tripp Umbach is a nationally recognized research firm that has completed studies for more than 50 leading academic medical centers and their hospitals.

“Medical experts agree that the way to adequately address the physician shortage in our country is to create new medical schools and closely align graduate medical education,” said Paul Umbach, founder and president of the Pittsburgh-based firm. “Our research shows that because of its mission, history, location and existing academic programs, Arkansas State is well-positioned to collaborate with healthcare partners across the state to help fulfill these needs. These efforts would make a significant social and economic impact in Arkansas and the Delta.”

Key findings of the study include:

• There is a current shortage of physicians in Northeast Arkansas and the Delta that will worsen as more than a quarter of Arkansas’ physicians retire within the next five years and the state’s overall population ages.

• Additional doctors will be needed in Northeast Arkansas and the Delta as more individuals have access to the healthcare system under the Patient Protection and Affordable Care Act and seek preventative care.

• Unlike other states, medical education opportunities are limited in Arkansas with only one medical school, and educating students locally is a critical piece to keeping physicians in the region long-term.

• The medical school will be a major driver of the regional economy, creating thousands of jobs and hundreds of millions in annual net impact to the region. The direct and indirect impact during the two-year startup period is expected to total $69.9 million, provide 317 jobs and add $2.1 million in taxes to local communities. The regional economic impact is expected to grow to $88 million annually.

• There is a need to expand graduate medical education and residency training, so Arkansas State must work with state universities, hospitals, health centers, government entities and businesses to add residency positions statewide.

“Our analysis of hospitals and clinics in the Jonesboro area indicates that a significant amount of clinical activity is present to support the education of up to 120 medical students per class,” Umbach said. “About 76 percent of the residency positions are housed in Little Rock with only 24 percent of the state’s total population. The residency position distribution is skewed.”

The school’s goal should be retaining 60 percent of all D.O. graduates in the Northeast Arkansas region, Umbach said. If there were 100 medical school students in each class, the D.O. school would anticipate 60 new physicians in the region annually beginning eight years after it opens. The majority would be primary care physicians.

“The addition of a new medical school would be a much needed investment into the health, welfare, and economy of Northeast Arkansas and the greater Delta region,” stated Chris Masingill, federal co-chairman of the Delta Regional Authority. “We have a dire need for more physicians in the Delta region, as currently 230 of counties and parishes in the Delta are considered to be health professional shortage areas. The DRA is proud to be a partner in this project that will help to address our region's need for more physicians and increase access to quality health care for families in our rural communities."

A-State Chancellor Tim Hudson said the study shows a medical school would be transformative not only to the university, but also to the region and state.

“While the main benefit is to educate much-needed primary care physicians and improve the health and well-being of Arkansans, the D.O. school would also strengthen Jonesboro and our neighboring communities economically and accelerate expansion of an innovation economy,” Hudson said. “Tripp Umbach’s blueprint presents opportunities and challenges for Arkansas State and its partners. We’re committed to moving forward with the process.”

A-State Vice Chancellor for University Advancement Jason Penry said the university would continue to reach out to healthcare, education and government leaders in the state and share findings of the feasibility study. Negotiations remain under way with the New York Institute of Technology College of Osteopathic Medicine under a non-binding memorandum of understanding for the development of a branch school on the Jonesboro campus.

Arkansas State’s planning committee for the D.O. project includes Hudson and Penry representing the university; Mayor Harold Perrin of Jonesboro; Mark Young, CEO of the Jonesboro Regional Chamber of Commerce; Chris Barber, CEO of St. Bernards Healthcare; Darrell King, CEO of NEA Baptist Clinic and executive director of the Arkansas Division at Baptist Medical Group; and Dr. Shane Speights, a practicing osteopathic family physician who is vice president of medical affairs at St. Bernards Medical Center.

Hudson said a recommendation on how to implement the study’s findings will be made to ASU System President Chuck Welch, and a proposal is expected to be on the ASU Board of Trustees agenda for its Feb. 28 meeting.

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