A half-century ago perceived deficiencies in American health care delivery were addressed with initiatives designed to solve problems. The federal Medicare and Medicaid programs were implemented to assist with the financing of health care for the elderly and those of lower income.
In the decade following passage of these federal health care financing programs, several initiatives were advanced to address the geographic and specialty distribution of physicians.
Some, like the expansion of numbers of medical schools and of medical students enrolled per school, substantially increased the numbers of specialist physicians in urban areas, but fell far short of the professed goal of increasing the percentages of primary care physicians and those working in rural and underserved areas.
Within a few years it became evident that an institution accepting federal or extramural to become a “primary care-oriented medical school” rarely resulted in what was promised.
Other programs – strategically targeted to specific geographic and specialty goals – proved more successful.
The family physician specialty with its comprehensive curriculum and required experiences in providing continuity of care in family health centers was responsible for a significant increase in the numbers (though not the percentage) of well-trained primary care physicians.
With a curriculum strongly based in the medical needs of specific patient populations, the residency programs in family medicine proved more successful in building relationships with such health care delivery organizations as community health centers and rural health networks.
Several plenary panels at the 26th National Conference on Primary Health Care Access will relate to this half-century in which curricular strategies associated with targeted community needs show evidence of success.
One such plenary panel will be presented by faculty from the Northeast Ohio College of Medicine (NEOCOM), a medical school that is located in the tiny village of Rootstown, located to the East of Akron and Cleveland.
Representing NEOCOM will be Doctor John Boltri, the Chair of the Department of Family and Community Medicine and his Vice-Chair, Doctor Janice Spalding.
The will describe an effective targeting strategies for underserved areas – two six year “pipeline” programs – one oriented to rural areas, the other to urban – that includes two pre-medical school years.
The students selected for this program come with the recommendations of community leaders, particularly those of local undergraduate colleges and representatives of the local hospitals and health care systems.