New Medical School Wants To Build Ranks Of Primary Care Doctors

Apr 2, 2013
Originally published on April 2, 2013 11:30 am

Michael Ellison has a tough assignment. He's the associate dean of admissions choosing the first class of a brand new medical school, the Frank H. Netter School of Medicine at Quinnipiac University in Hamden, Conn.

"We have over 1,600 applicants, and we will interview 400 for 60 spots," Ellison says.

The school has a very specific mission: minting doctors who want to go into primary care practice.

Under the Affordable Care Act, millions more people with insurance may be headed to the doctor's office. That means the medical system will need more doctors, nurses, physician assistants and other health care workers to meet the demand. Quinnipiac is one of about a dozen new medical schools cropping up, and it's spending $100 million just to get up and running.

The school's dean, Bruce Koeppen, says he knows why new physicians don't usually choose primary care. They don't make as much money as specialists, they have to know about everything from the common cold to severe depression, and primary care physicians don't always get the respect that specialists do.

To tackle these challenges, Koeppen says, it's important to admit the right students to the program.

"Turns out that women are more likely to go into primary care than men. Individuals who are coming to medicine as a second career are more likely to go into primary care," Koeppen says.

David fits into that second category. He is a 35-year-old pharmacist who has applied for the fall semester. (He asked that his last name not be used because his employer doesn't know he's thinking of a change.)

In his interview with Ellison, David described wanting to have a greater impact on patients' lives, such as calming a child who is anxious during an exam or restoring a patient's heart rhythm in an emergency. "These moments weren't available to me within the context of pharmacy practice," David says.

In addition to career changers like David, Koeppen says, students who are first in their families to go to college and students who've come from medically underserved areas are more likely to pursue primary care.

Henry Sondheimer of the Association of American Medical Colleges says it's good for schools to be clear with applicants right away.

"To the extent that you clarify your mission to your students who apply and, most importantly, when they interview, so they get to see what you're doing and what you're looking for, then you will find the students who will fit your mission," Sondheimer says. "This is not for show. I think this is a very important, and very serious, effort by these schools."

The question is, can it work?

Kevin Dorsey says it can, and it does. He's the dean of the Southern Illinois University School of Medicine in Springfield. His school started in the 1970s with a specific mission that still guides it: The school wants students who will stay in central and southern Illinois when they graduate because that part of the state needs doctors.

"I think we take, through a holistic admissions process, people that we think would be a good fit for this region," Dorsey says. "They are of and from the region, they know the values of the area, we train them here, and they gravitate back."

Training matters, too, he stresses. His school designed a curriculum that gives prospective doctors hands-on, local experience.

That's a strategy that Quinnipiac also aims to try, in part by sending its students out regularly to spend a day with primary care doctors. Nationally, about a third of graduating doctors go into primary care and stay there; Quinnipiac's goal is 50 percent.

This piece is part of a collaboration between NPR, WNPR, and Kaiser Health News.

Copyright 2014 Connecticut Public Radio. To see more, visit http://www.wnpr.org.

Transcript

STEVE INSKEEP, HOST:

Here's a side-effect of the new health care law here in the United States. That law is intended to give millions more Americans access to health insurance and medical care, which could mean the medical community needs to hire more doctors, nurses and other health care workers. One school hopes to capitalize. Quinnipiac College in Connecticut is starting a medical school with the goal of creating primary care physicians. Quinnipiac is spending $100 million to get the school up and running.

Here's Jeff Cohen of member station WNPR.

JEFF COHEN, BYLINE: Michael Ellison has a tough assignment. He's the associate dean of admissions choosing the first class of a brand new medical school.

MICHAEL ELLISON: We have over 1,600 applicants, and we will interview 400 applicants for 60 spots.

COHEN: But Ellison's job gets even harder because his school, the Frank H. Netter School of Medicine at Quinnipiac University, has a very specific mission. The school wants students who want to go into primary care.

ELLISON: David, tell me a little bit where you're coming from and why medicine and why the Netter School of Medicine in particular.

COHEN: Ellison is interviewing David, a 35-year-old pharmacist who's applied for the fall. He asked that we not use his last name. His employer doesn't know that he's thinking of a change.

DAVID: The first time I saw a critical care physician bring a patient's heart rhythm back, these moments, these weren't available to me as a pharmacist.

COHEN: Quinnipiac is one of more than a dozen new medical schools on the horizon, a handful of which hope to turn out a certain kind of doctor. Bruce Koeppen is the new school's dean. He says there are lots of reasons why new physicians don't choose primary care. They don't make as much money as specialists, they have to know about everything from the common cold to severe depression and primary care physicians don't always get the respect that specialists do.

Koeppen says he'll work to change some of that once he gets his first class of students in the building, but first he has to get the right students in the door.

BRUCE KOEPPEN: There is some demographic data out there. Turns out that women are more likely to go into primary care than men. Individuals who are coming to medicine as a second career are more likely to go into primary care.

COHEN: Students like David, a second career guy. Add to that students who are the first to go to college in their family and students who've come from medically underserved areas and you've got a big potential applicant pool. Henry Sondheimer is with the Association of American Medical Colleges. He agrees that it's good to be clear with your applicants on the front end.

HENRY SONDHEIMER: And I think to the extent that you clarify your mission to your students who apply and, most importantly, when they interview, so they get to see what you're doing and what you're looking for, then you will find the students who will fit your mission. This is not for show. I think this is a very important and very serious effort by these schools.

COHEN: The question is, can it work? Kevin Dorsey says it can, and it does. He's the dean of the Southern Illinois University School of Medicine in Springfield, Illinois. His school started in the 1970s with a specific mission that still guides it. The school wants students who will stay in central and southern Illinois when they graduate because that part of the state needs doctors.

KEVIN DORSEY: I think we take, through a holistic admissions process, people that we think would be a good fit for this region. They are of and from the region, they know the values of the area. We train them here, and then they gravitate back, if you will.

COHEN: So first he picked the right students, but training matters, too, so his school designed a curriculum that gives prospective doctors hands-on, local experience.

DORSEY: The students are farmed out very frequently back to their local communities to work with a family medicine physician in that community and so they eat, drink and sleep family medicine for about a month.

COHEN: That's a strategy that Quinnipiac also aims to try, in part by sending its students out regularly to spend a day with primary care doctors. And Kevin says he hopes that strategy works because he's got an ambitious goal. Nationally, about a third of graduating doctors go into primary care and stay there; Quinnipiac goal is 50 percent. For NPR News, I'm Jeff Cohen.

INSKEEP: Jeff's reporting is part of a partnership between NPR and WNPR and Kaiser Health News.

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INSKEEP: It's MORNING EDITION from NPR News. Transcript provided by NPR, Copyright NPR.