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Sept. 17, 2013
WICHITA The University of Kansas School of Medicine’s campus in Wichita is among the nation’s top producers of primary care physicians, according to a recent survey of medical school data.
It also is placing far more physicians in rural and underserved areas than most medical schools.
“What’s happening in Wichita is fantastic,” said Dr. Candice Chen, an assistant research professor at George Washington University in Washington, D.C. “The data show that 30 percent of their residents are going to rural and underserved areas. That’s amazing when you consider that nationally it’s around 5 percent.”
Chen’s review of medical school data was the subject of an article, “Toward Graduate Medical Education Accountability: Measuring the Outcomes of GME Institutions,” in the September issue of Academic Medicine, a publication of the Association of American Medical Schools.
The data, she said, showed that 108 of the 233 physicians who completed their residencies at KU School of Medicine-Wichita between 2006 and 2008 chose to remain in primary care; 83 chose to practice in areas considered underserved and 46 joined rural practices.
In an appendix listing the nation's 20 residency programs with the highest percentages of primary care graduates between 2006 and 2008, KU School of Medicine-Wichita came in sixth with 46 percent.
The University of Nevada School of Medicine-Reno led the nation with 54 percent.
The list was limited to schools that had at least 200 graduates in the three-year period.
KU School of Medicine-Wichita was first in the number of graduates serving in underserved and in rural areas.
Dr. Rick Kellerman, chair of the school’s Department of Family and Community Medicine, said he was pleased with Chen’s findings.
“There may be some schools that aren’t in the top 20 that have better numbers in some of the categories than we do, but when you step back and look at numbers of primary care docs and the numbers going into rural and underserved areas, I have to say we’re doing pretty darn good,” he said.
He attributed the school’s success to its history.
“Let’s face it,” he said. “This campus was put here for a specific purpose, which was, first, to increase the number of physicians in Kansas and, second, for there to be a special emphasis on rural and underserved areas. The students who come here know that.”
Lawmakers created the Wichita campus in the early 1970s in response to a critical shortage of physicians throughout the state but especially in the state’s rural areas.
Since then, the school has graduated almost 1,900 physicians, half of whom chose to practice in Kansas.
“We have a bunch here in Wichita,” Kellerman said. “But we also have a bunch in Goodland, in Lakin, in Scott City. They’re all over the place.”
Many members of the school’s faculty, he said, either grew up or had practiced in small towns.
“There’s just so much working against physicians who want to practice in a rural area – the technology tends not to be there and it’s so much harder to specialize,” said Kellerman, who grew up in Greensburg and Hays. “But we’ve developed a philosophy, a training model, and a support system for anyone who wants to go to a rural area. That’s very much a part of who we are and what we do.”
The school also helps students take advantage of a state-funded program that offsets a portion of their textbook, tuition, and room-and-board costs in exchange for them practicing in rural or underserved areas.
In her article, Chen noted that the federal government spends billions on graduate medical education but does too little to determine if the spending is actually producing doctors for the areas of the country or the types of practices that most need them.
“Medicare puts about $10 billion into GME each year,” Chen said. “Medicaid puts in about $3 billion. It’s a huge workforce investment with significant implications for our health care system. But there’s not a lot of accountability. There’s a formula that determines how much you get, but there’s not much in the way of using the formula to fill gaps in the system.”
She said medical schools that produce the fewest primary care doctors often receive the most funding.
The 20 medical schools with the highest percentages of primary care graduates, for example, received $292 million in total Medicare GME payments between 2006 and 2008, while the 20 schools with the lowest percentages received $842 million.
Chen said her study showed that existing data could be used to measure schools’ successes in meeting the health care system’s needs.
The report also addressed shortages in the specialties of psychiatry, general surgery, obstetrics and gynecology.
Chen said the data used in her study was derived from the American Medical Association, Medicare, and the National Health Service Corps.
The study was a project of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care and the George Washington University School of Public Health and Health Services.
The Robert Graham Center has developed a website that allows users to compare their state’s graduate medical education efforts to those on other states.
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