Tri-Cities medical education faces funding cuts and doctor shortages, but mulls participating in CMU med school

by Naomi Gumprich-Munn
http://www.mlive.com/

While proposed funding cuts and projected doctor shortages threaten community health systems around the country, one medical education facility in the Tri-Cities is expanding operations.

Synergy Medical Education Alliance in Saginaw is launching a new masters in public health degree program in collaboration with Davenport University, Chief Academic Officer Christine Rohr said. The 43-credit hour program will begin in September and contains an international health focus, Rohr said.

“Whether you’re an engineer or nurse or into environmental safety, this program will provide any learner with an international health experience,” she said. A two-week internship in a Central American country is included in the program.

Synergy is a 40-year-old, community-based training program for medical students and residents. The alliance provides undergraduate education to students in their final two years of medical school, residency training after graduation and continuing medical education for area physicians.

Michigan State University medical students complete on-site training with about 80 Synergy staff physicians. Currently the program contains 80 students who rotate between Covenant HealthCare and St. Mary’s of Michigan Medical Center, Rohr said.

Doctor shortage and federal cutbacks

So far looming federal funding cuts to teaching hospitals haven’t affected Synergy, Rohr said. “We are faring very well,” she said. “We’re financial stable and our work force is stable.”

I assume that like all other businesses we’re just really closely monitoring all other businesses and cautiously investing in our own growth,” Rohr said.

Federal budget cuts proposed for 2009 recommend reducing payment to teaching hospitals by more than 60 percent, and also would prohibit matching state funds for graduate medical education support.

But ” we already feel some small impact from the physician shortage,” she said. “It’s not easy to recruit physicians to the area now. Some of that is due to our economic status as a state and some is due to physician shortages.”

Michigan will have a shortage of 600 physicians by 2020, according to a state medical society report. State medical schools graduated 651 doctors in 2007, however they could expand to 1,100 or more in the next decade. Michigan State University’s College of Human Medicine is doubling its capacity by 2013, while Oakland University announced plans to open a college of medicine that could eventually admit 200 students per year.

Family practice shortage

The resident family practice training program at Mid-Michigan Medical Center in Midland is going well, but is still not at capacity due to a recent lack of interest in the field, program coordinator Lou Rosencrants said.

“I think our hardest thing is recruitment,” she said. “We’ve seen a decrease in family medicine in past years but this year we’ve seen an increase. It wasn’t a big increase, but it was a hopeful one.”

Working in family practice means longer hours and less pay than other specialties, Rosencrants said. The program currently has 17 residents, but has room for one more. Residents are chosen from all state medical schools, and also Caribbean medical school graduates, she said.

“It truly takes a special person to want to go into family medicine,” Rosencrants said. “You continue to take care of that person until either you stop practicing or that person passes on and you see it from start to finish.”

 

“I very much liked the notion of taking care of people from cradle to grave, of being there at the important crossroads in their lives,” MidMichigan family practice doctor Sasha Savage said.

Savage knew while still in medical school that he wanted to go into family practice, but he said the choice isn’t valued by all students.

“There’s a very strong sentiment at these universities who think that family medicine has very little value — all you do is wipe noses and shuttle them back out of your clinic,” he said.

Having to pay off huge student loans is also a factor in choosing better-paying specialties over a more modest family practice income, Savage said. “I feel fortunate to make the money that I do, but it’s vastly less than most of my specialty colleagues.”
“People in medical school come out with a quarter million dollars in debt,” he said. “I can’t blame people for making that decision.”

Physician shortages are making his work day longer and more challenging, but the shortage is also creating an overwhelming situation at area emergency rooms, Savage said.

“The emergency room doctor is being flooded with primary care patients, and as a result of that flooding, they’re buried. I think it impacts patient care,” he said.

Recruiting relationships

Synergy’s recruiting strategy fosters training relationships with community hospitals and medical students “in hopes that they’ll identify with the community and have a desire to go back,” Rohr said.

Another tactic is to “act as a conduit” for information on area hospitals to physicians in Synergy’s graduating class, Rohr said.

“We’re limited, really,” she said. “You can take more medical students, but that won’t relieve the shortage because you have to have resident positions for those students.”

After completing their degrees, doctors spend another three to five years in residency training for specific fields like surgery or pediatrics. But the federal government has capped the number of subsidized resident physician placements since 1996. New positions won’t be created without further funding, Rohr said.

Medical education in the Tri-Cities region is of central importance to meeting growing needs for attracting and retaining outstanding doctors, said St. Mary’s of Michigan Chief Medical Officer Mark Lester.

The Saginaw hospital works closely with Synergy by offering clinical sites for its medical students and residents.

“Providing medical education also helps us as we strive to improve clinical care for our community,” Lester said.

St. Mary’s of Michigan is working with Synergy and Covenant HealthCare to evaluate the a Central Michigan University proposal for a new medical school with a satellite campus in Saginaw to open in 2012, Lester said.

While details are still in the planning stages, the university has approached Synergy on potential working relationships, Rohr said. “We have had cordial discussions with CMU but it’s too early to know if it’s even feasible to have a medical school in Saginaw,” she said. “It’s exciting news, but it’s just starting to bud like the flowers in spring.

Naomi Gumprich-Munn is a freelance writer living in Saginaw.

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