Andria Quintero’s Post

<< For centuries in this country, White-only medical schools, with exclusionary policies and practices, made it virtually impossible for Black people to receive medical training…It wasn’t until Reconstruction that a number of Black medical schools sprang up in the South, enabling Black people to finally have access to medical training in greater numbers. These schools were Howard University College of Medicine, established in D.C. in 1868; Meharry Medical College, established in Nashville in 1876; Leonard Medical School, established in Raleigh, N.C., in 1882; New Orleans University Medical College, founded in 1887; Knoxville College Medical Department, founded in 1895; Chattanooga National Medical College, founded in 1902; and the University of West Tennessee College of Physicians and Surgeons, founded in Memphis in 1904. By 1905, those Black medical schools had trained 1,465 doctors. Each of those doctors was poised to train a new generation of physicians, who would have gone on to train a generation of their own. And then, that promising legacy was abruptly extinguished. The reason was the publication of the Flexner Report… After the Flexner Report, five of the seven Black medical schools in the United States were forced to close, leaving only Howard and Meharry. >>

Duke University Health System is a staple of North Carolina health care today, but when crews began construction on Duke Hospital in 1927, many asked, “Why here?” Durham — a city with a population of 47,000 — already had two hospitals. Why did it need another? How could a small population support a teaching hospital? As Duke celebrates its Centennial year, learn more about how the founding of Duke University Hospital, Duke University School of Medicine and Duke University School of Nursing transformed Duke into the medical powerhouse that it is today. #DukeinNC https://lnkd.in/eTwjbRAS

We need to rethink our approach to philanthropy in the medical field. Offering free medical school education should come with a commitment to internal medicine and family medicine residency programs. The AAMC's latest projections reveal a potential shortage of up to 86,000 physicians in the US by 2036. Without a focus on primary care and family medicine, we are at risk of a more severe shortage by 2030. #MedicalEducation #PhysicianShortage #PrimaryCare #FamilyMedicine #HealthcareFuture https://lnkd.in/gMpdCbDT

And just like that, St. George's University continues to expand its incredible list of offerings for our third- and fourth-year clinical students! The updated list includes a 13th state (Arizona) in which students can choose to complete their hands-on clinical rotations, and another training site in the greater Miami area -- taking the total to eight in Florida alone. "All of us at SGU are ecstatic to add more hospitals, giving students more location options to complete their clinical training in order to progress from the Basic Sciences into clinicals without delays," said Dr. Robert T. Grant, SGU’s senior associate dean, clinical studies. "A major benefit to SGU’s wide clinical network is that students have the opportunity to form professional relationships with residents, attending physicians, and hospital administration. Given that Abrazo Health has several residency programs associated with the institution, a clinical placement could also eventually lead to a residency interview for students." #SGU #StGeorges #medschool #medicalschool #clinicalrotations #corerotations #electiverotations #clinicaltraining #arizona #clinicals #doctors #residency #graduates

New doctors need to complete graduate medical education before practicing independently, and lifting the cap on Medicare GME funding will help alleviate the doctor shortage. Bipartisan legislation introduced in both the House and the Senate (H.R. 2389 and S. 1302), would help address the doctor shortage by increasing the number of Medicare-supported residency positions by 14,000 over seven years. This increase would make progress toward providing the necessary primary care and specialty physicians necessary to meet the country’s workforce needs. Access more AAMC resources and information on the issue at https://ow.ly/y9LX50SKw4K. And learn more about Belmont University's new Thomas F. Frist, Jr. College of Medicine via this recent WPLN article: https://ow.ly/JoiU50SKw4J

The AMA, AAMC, and many others cannot deliver on their promises to address deficits of workforce. More Graduate Medical Education, schools, programs, or special training will not work. Training interventions cannot beat the house. 1. The house is designed by CMS. 2. How CMS spends 1.4 trillion is most important 3. CMS plans pay less than cost of delivery. 4. Access is compromised by insufficient workforce where CMS plans are concentrated 5. Access is worsened by providers trying to survive by avoiding patients with CMS and other weak plans - which not surprisingly are concentrated where deficits of workforce span vast regions Employer based plans must be much better than CMS plans to address shortages. Cost cutting and micromanagement focus make the CMS plans worse, not better. Small slowest growing portions of our nation are favored with best plans, best populations, best outcomes, and best drivers of outcomes. But even where top concentrations of workforce are found, the insurance/payment design fails for pockets of population with worst plans and worst employers. Best plans result in concentrations of workforce, economics, jobs, and more. Worst private employer based plans have acted together with CMS plans for 41 years to kill hundreds of hospitals and countless practices. The deaths of hospitals, practices, workforce, team members, and people will continue and in 2621 counties growing fastest in population numbers, demand, and complexity. The worst employer based plans are not limited to rural areas. There are 90 million urban people that are found in 2621 counties lowest in health care workforce since forever. About 37 million rural people have no chance to resolve shortages such as half enough primary care, mental health, women's health, geriatrics, and basic surgical Expansions of GME, massive expansions of DO NP and PA, and new types of health professionals (70 years ago NP PA FM) have all failed and will continue to fail. Special schools and programs and pipelines do not work. Teaching CHCs will continue to demonstrate graduate outcomes that are desired, but the CHCs will remain with deficits. The greatest limitation of CHC structure and function is Medicaid, since this is 50% of CHC patients. Rural pipelines look great also Valid research demonstrates 6 to 12 times odds ratios of grads being in target locations for all of the special training, but the levels in the target areas remain deficit by financial design. Tracking databases reveal the truth over 30 years of observations. If you do not improve accounts receivable (and collect) and if you do not decrease accounts payable (being made worse) and if you do not improve practice environments and reduce major turnover costs and losses - most Americans will fall further behind by design.

Medical school curriculum is based on evidence, and those developing it use research to help ensure that future doctors learn the skills that will prepare them to treat all patients effectively. ➡ Evidence shows that patients do better with a health care team who listens, understands them, and takes their unique experiences into account. ➡ Evidence also shows that a person’s varied life experiences and attributes—age, gender, where they were raised, religion, race, disability status, and many others—impact how they prefer to engage with their health care team. In support of our member medical schools and teaching health systems and hospitals, the AAMC firmly reiterates our commitment to addressing and mitigating the factors that impair effective physician-patient relationships when preparing the future physician workforce. The presence of diversity, equity, and inclusion in medical school curricula is intended to train the next generation of physicians to respond most appropriately to the rapidly diversifying populations that they will serve. Doing so increases the likelihood for better health care and healthy lives for all patients, including individuals who have been historically marginalized by the health care system. https://ow.ly/pIKq50QYZka

The health of our communities depends on so much more than educating future physicians and other medical providers in the proper skills and knowledge they need to practice medicine competently. It is also dependent on educating them on the particular needs and perspectives of patients who come from different cultures and experiences. It depends on our future healthcare workforce being made aware of how implicit bias in healthcare providers can adversely affect patient outcomes. Future medical providers must have an understanding of how social and political structures can perpetuate health disparies in people who are already at a disadvantage. Finally, the health of our communities depends on recruitment and retention of a medical workforce that reflects the diversity of the community they serve, which leads to increased patient engagement in their care. As a medical educator, I am deeply concerned about legislation in certain States that bans Diversity, Equity, and Inclusion programs at State institutions of higher education. This undoubtedly will affect State medical schools where DEI programs have been stopped. The ramifications to the health of our patients is significant as physicians from these institutions will not have an opportunity to gain the knowledge needed to understand how to competently care of patients from different backgrounds, how to address health care inequities, and how to interact witha spirit of curiosity and respect with a patient who has a different set of beliefs and experiences. The AAMC has recognized the importance of DEI in the medical school curriculum. In fact, two of the AAMC’s core competencies for entering edical school and succeeding in medical school are cultural awareness and cultural humility (https://lnkd.in/e27Y58P3). States who ban DEI initiatives in their institutions of higher learning will make it difficult for medical students to to adequately achieve these competencies, as curricula in DEI depends on reseouces from an instituon’s DEI office. Also, undergraduate students at State schools where DEI efforts are discontinued may be at a disadvantage when applying to medical school when compared to students from undergraduate schools with robust DEI initiatives and student involvement in these initiatives. The concept of non-malficence—to first do no harm— is ingrained into our training as physicians. We must not take any action or inaction that would cause harm to our patients. Eliminating DEI training and initiatives in medical schools ultimately places our patients in potential harm. Medical educators must speak out in support of DEI in the medical school curriculum. By doing so, we will uphold our duty to advocate for all of our patients, especially those who are the most vulnerable.

"Teaching related to DEI, health equity and the care of our diverse population supplements, but in no way replaces, a strong focus on the latest science and evidence on human health and disease." - David J. Skorton, MD & Alison Whelan from Association of American Medical Colleges (AAMC) via WSJ (https://lnkd.in/gwK5w6hi) Let's read that again: "Teaching related to DEI, health equity and the care of our diverse population supplements, ***but in no way replaces,*** a strong focus on the latest science and evidence on human health and disease."

How do we “make the case”for our research? How do we frame communications to build trust in science? Looking forward to learning more from Krista Longtin, PhD during the American Academy of Nursing CANS state of the science conference!