family practice issues and general life events

Archive for April, 2013

Saving a hospital

First of all, I did not attend residency at the OSU Center for Health Services in Tulsa. I went to medical school at OSU Center for Health Services, and did clinical rotations at the hospital then named TRMC. However, I did a rural family practice residency, which I don’t regret, but I still fill a need to try and save the hospital associated with the medical school.

In Oklahoma last year, half of the medical graduates went into the primary care specialties of family practice, pediatrics, and general internal medicine. This is from both OU medical school and OSU College of Osteopathic Medicine. While that sounds great, remove the graduates from OSU, the number drops to 25-30%, which even fewer went to the rural areas. I don’t necessarily argue that the specialists are not needed, we are in a physician shortage, and while not advertised through the media, the specialists are also in short supply. And I am saying physician shortage, despite there being a place in the health care arena for midlevels of Physician Assistants and Nurse Practitioners, they cannot take the place of a fully trained physician even in primary care.

Back to the hospital, why would saving this hospital mean anything to me, who did not even attend residency there? Well closure of that hospital would worsen the already post-graduate training crisis. Last year it was reported that the number of slots was equal to the number of newly graduated physicians from medical school. As medical schools increase the number of physicians that they produce, there needs to be training facilities for them. And thanks to the budget of 1998, the ability to increase or produce residency slots is difficult especially if it not a virgin hospital. So essentially those slots disappear.

Schools are supported by hospitals and hospitals support school in a symbiotic relationship.

So why does this matter for the state as a whole. Studies have repeatedly proved that physicians tend to stay in the state which they trained. In fact, they tend to stay within 100 miles of their training facility. As a state that consistently ranks 49 in states’ health, we can hardly afford to lose more physicians to training programs in other states.

State funding of teaching hospitals is not unheard of, in fact there is a precedent. In 1998, the state of Oklahoma stepped in and started supplementing the OU Medical Center in Oklahoma City at the rate of $30 million a year. This continues into this day. In fact, OSU-COM and the OSU system supported this measure as a means to continue the training programs of future programs.

The OSU-Center for Health Sciences needs that help now, at a rate of $18.25 million a year from the state. This will allow the physical improvements to be performed, and allow for a buyer of the hospital willing to join the partnership to make improvements to the hospital. This partner would then recruit further specialties into the hospital with the goal of making the OSU Center for Health Sciences a tertiary referral center for the rest of the state. This will help to keep care of our citizens inside the state, instead of being referred out to Texas and/or Joplin.

Those living in the rural areas will benefit as well, as the OSU Center for Health Sciences has consistently rated high in the US News and World Report in producing the rural practitioner. 60% or higher of its graduates choose residencies in the primary care specialties. Loss of this training center will hinder the recruitment of these providers to stay in the state. Can we as a state afford that?

I urge those across the state to contact their state senators and representatives to help save this hospital and its programs. Even if you argue their are other programs that can take their place, they are not ready, and are not currently available. We need to save current training slots to improve the health of the state.

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