Strategies for Developing a Rural Physician Workforce Kayse M. - - PowerPoint PPT Presentation
Strategies for Developing a Rural Physician Workforce Kayse M. Shrum, D.O. President, Oklahoma State University Center for Health Sciences Dean, College of Osteopathic Medicine MISSION AT OSU MEDICINE OSU College of Os OSU College of
Kayse M. Shrum, D.O. President, Oklahoma State University Center for Health Sciences Dean, College of Osteopathic Medicine
MISSION AT OSU MEDICINE
OSU College of Os OSU College of Osteopathic Medicine educates teopathic Medicine educates
teopathic primary care ph y care physicians with an emphasis icians with an emphasis
ing rur rural and under and underser erved Oklahoma. Oklahoma.
2
OKLAHOMA’S POOR HEALTH STATUS
United Health Foundation’s 2017 America’s Health Rankings Annual Report
all health
cardiovascular deaths iovascular deaths
premature deaths
primary care phy y care physicians icians
3
PRIMARY CARE PHYSICIAN SHORTAGE
HPSA Counties
PCPs per 100,000
With no PCPs
With 1 PCP
2018 County Health Rankings & Roadmaps
4
AGING RURAL PHYSICIAN WORKFORCE
average age of rural primary care physicians percentage of rural primary care physicians over the age of 55 percentage of rural primary care physicians over the age of 65
5
OSU MEDICINE GRADUATES SELECTING PRIMARY CARE RESIDENCIES (1977 – 2018)
average since 1 age since 1977
pr producing greates
% of
primar primary care residents y care residents
6
RURAL PHYSICIAN PIPELINE MODEL
Recruit from Rural Communities
7
Blue Coat t Blue Coat to White Coat White Coat Oper Operation Or ation Orange ange Dr
. Pete’s Medical Immer ’s Medical Immersion Camp ion Camp Native Explorer Native Explorers OKS OKStar ars
RURAL ENRICHMENT PROGRAMS
8
ENRICHMENT PROGRAMS BY THE NUMBERS
Oper ation Or ange Blue Coat to White Coat
par tic ipants annually
par tic ipants annually
9
TRIBAL ENGAGEMENT WITH RURAL TALENT IDENTIFICATION
Operation Orange Immersion Camp Native Explorers OKstars
Cherokee Nation Choctaw Nation Chickasaw Nation
In discussion
10
MEASURABLE OUTCOME
16% 13% 11% 11%
11
MEASURABLE OUTCOME: OSU MEDICINE CLASS OF 2018 GRADUATES
American Indian medical graduates aduates
aduating class
Tribal Nations ibal Nations Represented: presented: Cher Cherokee Nation
Chic Chickasaw Nation kasaw Nation Choct Choctaw Nation of Oklahoma w Nation of Oklahoma Muscogee (Creek) Muscogee (Creek) Nation Nation Osage Nation Osage Nation Seminole Nation of Oklahoma Seminole Nation of Oklahoma
12
3+1 ADMISSIONS PROGRAMS
Acceler Accelerated medical pr ted medical progr
am Par Partner nerships with regional hips with regional univer universities and OSU Stillwat sities and OSU Stillwater Interes Interest in pr in practicing rur acticing rural l primar primary care medicine y care medicine
13
3+1 ADMISSIONS PARTNERING UNIVERSITIES
Lawton Durant Ada Tahlequah Tulsa Langston Claremore
Cameron University East Central University Langston University Rogers State University Northwestern OSU University
Alva
Oklahoma State University Southeastern OSU University Southwestern OSU University Northeastern State University
Weatherford Stillwater Edmond
University of Central Oklahoma
14
RESIDENCY PROGRAMS 2008 SNAPSHOT
Durant Tulsa
OSU Medical Center 130 slots (multiple)
Oklahoma City
Integris SW Medical Center 36 slots (emergency medicine)
27 slots (OB/GYN & family medicine) Alliance Durant 14 slots (family medicine)
Urban‐based residency program Rural‐based residency program 15
RESIDENCY PROGRAMS 2018 SNAPSHOT
Lawton Durant Tahlequah Tulsa Oklahoma City McAlester Talihina Ada Norman
Since 2008…
McAles McAlester ter: 23 23 slots slots (f (family amily & int & internal medicine) rnal medicine) Norman: 2 Norman: 24 slots slots (emer (emergency gency medicine) medicine) Tahlequah: 22 ahlequah: 22 slots slots (f (family amily & int & internal medicine) rnal medicine) Talihina: 9 lihina: 9 slots slots (f (family medicine) amily medicine) Ada: 1 Ada: 12 slots slots (f (family medicine) amily medicine)
16
Lawt Lawton: 28
slots (f (family & amily & emer emergency medicine) gency medicine)
KEYS TO RURAL RESIDENCY SUCCESS
EDUCATIONAL AND FUNDING PARTNERSHPS
OSU Medicine Rural Residencies Tribal and Community Health Partners State Legislature Health Resources and Services Admin. Oklahoma Health Care Authority Tobacco Settlement
Endowment
Trust
$3.08M one‐time, non‐recurring appropriation in 2012 $3.8M grant in 2015 $5.6M grant in 2015 Community and local support HRSA teaching health center grants in 2013 ($150K per year for 60 residency slots)
17
RURAL PIPELINE HOTSPOTS
Tulsa
The Rural Physician Pipeline Trifecta Effect:
Enrichment Program
3+1 Partner University Rural Residency Program Operation Orange
Lawton Durant Tahlequah Enid Ada
In negotiations to establish residency program In negotiations to establish Operation Orange camp
18
NATION’S FIRST TRIBALLY AFFILIATED MEDICAL SCHOOL
Up to 50 medical students per entering class Full four years of medical school curriculum Target date for enrollment: Fall 2020 Located in Tahlequah, OK 60,000 ft2 dedicated space
Partnership with the Cherokee Nation
19
SHORT-TERM SOLUTION TO RURAL PHYSICIAN SHORTAGE
Evidence‐based knowledge and best practices from OSU‐CHS is pushed out to clinicians, cooperative extension offices, and school districts in rural communities
20
PROJECT ECHO SERVICE LINES
Addiction Medicine Pediatric Psychiatry Hepatitis C Alzheimer’s Adult Psychiatry Obesity Medicine Viral Disorders
21
PROJECT ECHO MEASURABLE OUTCOME
January 2017 – August 2018
22
POLICY RECOMMENDATIONS
Policy Recommendations to Address Rural Physician Shortage
Create Innovative Models for Non‐Traditional Residencies Support
Technology‐Enabled
Care Delivery Models Expand Loan Forgiveness and Tuition Waiver Programs
funding for programs like Project ECHO
pilot programs
loan forgiveness and tuition subsidy programs
target rural and underserved areas
23
reduces dependence on Medicare funding
permanent
workforce should be created
Kayse M. Shrum, D.O. President, Oklahoma State University Center for Health Sciences Dean, College of Osteopathic Medicine kayse.shrum@okstate.edu
24