University of Washington’s Vice-Dean Suzanne Adams to Give 24th Charles E. Odegaard Lecture Lecture at 28th National Conference on Primary Health Care Access

Suzanne Allen, MD; University of Washington WWAMI Program Boise, Idaho

Suzanne Allen, MD; Vice-Dean
University of Washington WWAMI Program
Boise, Idaho

Suzanne Adams, MD, MPH, University of Washington’s Vice-Dean for Academic, Rural and Regional Affairs, has been named the 24th Charles E. Odegaard Lecturer at the 28th National Conference on Primary Health Care Access.

The Lecture is scheduled for Wednesday, April 12th at the Hyatt Regency New Orleans.

At the University of Washington School of Medicine (UWSOM), Suzanne Allen works broadly across academic affairs and regional affairs to enhance the excellence of medical education for the UWSOM and the five-state WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region.

WWAMI started in 1971 and is accredited through the University of Washington School of Medicine and provides publically supported medical education for citizens of the participating states.  WWAMI students complete the classroom phase of the curriculum in their home state and then their required and elective clinical rotations may be completed at locations across the five-state region.

In addition to serving as the Vice Dean for Academic, Rural and Regional Affairs, Dr. Allen holds a Clinical Professor faculty position within the Department of Family Medicine at the University of Washington School of Medicine. Dr. Allen is an attending physician at the Family Medicine Residency of Idaho and an active physician in the Department of Family Medicine at Saint Alphonsus Regional Medical Center and Saint Luke’s Medical Center located in Boise, Idaho. Dr. Allen is committed to medical education and rural healthcare.

“Access”: Improving Health Care Access in California’s Central Valley, Part 1: Adventist Healthcare’s Service to the San Joaquin Valley

One the second and third days of the 28th National Conference on Primary Health Care Access (to be held April 10-12, 2017 at the Hyatt Regency New Orleans), the program will center on strategic initiatives, sponsored by health professions educational systems, mission-oriented healthcare institutions, state and local governments, and federal programs through the Department of Health and Human Services.

Such initiatives include long-term strategies to build a workforce and institutional base for effective primary health care systems in rural and underserved areas.

Adventist Health Systems’ Strategic Initiatives in Medically Underserved Areas

White Memorial Medical Center's service area, East Los Angeles, California

White Memorial Medical Center’s service area, East Los Angeles, California

Previous National Conferences have devoted several sessions to the success of the Adventist Health Systems efforts to establish a viable primary healthcare workforce in the Latino neighborhoods of East Los Angeles and Eastern Los Angeles County.

The cornerstone of these efforts is the White Memorial Medical Center Department of Family Medicine’s residency training program in family medicine, described by Hector Flores, MD, at the very first of the National Conference on Primary Health Care Access in April 1990 [see First National Conference on Primary Health Care Access (4th Plenary Panel, Part 2, Flores).

Adventist Medical Center, Hanford, California

Adventist Medical Center, Hanford, California

Another Adventist Health Systems’ initiative is the network of rural health clinics throughout the agricultural counties of the San Joaquin Valley, the Southern part of California’s Great Central Valley.

Such strategies are aimed at  improving access to care and physician recruitment and retention to better serve the communities in the Central Valley.

Derrick Gruen; Adventist Health Systems, Hanford, California

Derrick Gruen; Vice President
Adventist Health Systems Central Valley Region, Hanford, California

A presentation on this initiative will be made by the Regional Vice President, Derrick J. Gruen, PT, DPT, MALOS and the Medical Director, Adalberto Renteria, MD, for the Adventist Health Central Valley Region.

Their presentation will cover the challenges of delivering quality health care in a geographically dispersed rural health clinic system.

The Central Valley of California is one of the world’s most productive agricultural regions.

The counties that comprise it – including Kern, Kings, Tulare, Fresno and Madera Counties – have historically suffered chronic shortages of physicians, in both primary and specialty care.

Adalberto Renteria, MD; Medical Director, Adventist Health Systems

Adalberto Renteria, MD;
Medical Director, Adventist Health Systems Central Valley Region, Hanford, California

Medicaid patients and those who “self pay” include a high proportion of agricultural farmworkers and their families, have had to be referred to the distant cities of Los Angeles and San Francisco for specialty care.

The Adventist Healthcare Systems’ initial commitment to the Central Valley dates from 1993. By 2005 the organization was operating 18 licensed healthcare clinics.

Dr. Gruen oversees multiple departments across  including Adventist Health Community Care Clinics (Rural Health).

His responsibilities also include Physician Recruitment and Retention, and oversight of the Adventist Health Systems’ “Physician 1206L Foundation Clinics” a special category of hospital-affiliated community-based multispecialty practices established by California law.

The Community Care Clinics are a network of 36 licensed rural health clinics with 160+ physician partners, covering a service area of 4000 square miles, providing a safety net to the underserved in the Central Valley of California. It is the largest hospital-based rural health clinic system in California and the second largest in the nation. 

Dr Renteria serves as the Adventist Health Systems Regional Medical Director for Central California. HImself the product of a family engaged in agriculture (he has personal experience in grape harvesting, while his father’s long career was devoted to vineyard management in the Napa Valley), Dr Renteria has insight into farmworker’s health and social needs and rapport with the farmworker families that the Adventist rural clinics serve.

The National Conferences are invitational. For information on the invitation process, contact William H. Burnett at whburnett@coastalresearch.org.

 

Dean James Herman to Give 27th G. Gayle Stephens Address at 28th National Conference on Primary Health Care Access

James Herman, MD, MSPH, Dean, University of Oklahoma/Tulsa University School of Community Medicine; Tulsa

James Herman, MD, MSPH, Dean, University of Oklahoma/Tulsa University School of Community Medicine; Tulsa

James Herman, MD, MSPH, the Dean of the Uiniversity of Oklahoma/Tulsa University School of Community Medicine, Tulsa, has been named the 27th G. Gayle Stephens Lecturer at the 28th National Conference on Primary Health Care Access. The Lecture is scheduled for Tuesday April 11, 2017 at the Hyatt Regency New Orleans.

Doctor Herman was previously Associate Dean for Primary Care and Department Chair of Family and Community Medicine at the Penn State University/Milton B. Hershey School of Medicine in Hershey, Pennsylvania, where he headed the Pennsylvania Area Health Education program.

The Tulsa School of Community Medicine, whose commitment to community-oriented primary care has been noted in previous sessions of the National Conferences, is in the process of expanding to a four-year medical school.

The Stephens Lectures are named after the late G. Gayle Stephens, MD, a noted author and pioneer of the resurgence of family medicine and primary care in the United States.

Dr Stephens presented the first Stephens Lecture, which became famously known as the “Big Red Bull” speech, because its use of a metaphorical image of the American system of medical care [Proceedings of the Second National Conference: The First G. Gayle Stephens Lecture by G. Gayle Stephens, MD.]

Later Stephens Lecturers have included many prominent figures in American medical education, including the late Charles E. Odegaard of the University of Washington,  F. Marian Bishop of the University of Utah, and Lynn Carmichael of the University of Miami.

The National Conferences’ Named Lectures

G. Gayle Stephens, MD (right) with 12th Stephens Lecturer John Geyman, MD

The Coastal Research Group has sought to honor major intellectual leaders in the Family and Community Medicine movements.  Typically, each of the National Conferences on Primary Health Care Access has one of three named lectures associated with the conference.  One honors G. Gayle Stephens, MD, one honors the late Charles E. Odegaard, Ph.D. and the third honors J. Jerry Rodos, DO.  The lecturers in each series include many eminent figures in these movements.

The National Conferences have established named lecture series to honor three colleagues who have achieved prominence in their professional careers, and have additionally made significant contributions to the National Conferences. Continue reading

28th National Conference: Dr Donald Frey Presents “Physician Workforce—An Issue of Medical Ethics as well as National Priority”

Donald Frey, MD; Creighton University, Omaha, Nebraska

Donald Frey, MD; Creighton University, Omaha, Nebraska

On the first morning of the 28th National Conference on Primary Health Care Access, Creighton University’s Doctor Donald R, Frey will present a Thought Provocateur session entitled “Physician Workforce—An Issue of Medical Ethics as well as National Priority”.

At Creighton University, a Jesuit institution based in Omaha, Nebraska, Doctor Frey has held the Dr Roland L Kleeburger Endowed Chair since 1996.

As Creighton University’s Vice President for Health Sciences, Dr Frey is responsible for the oversight of Creighton’s schools of dentistry, medicine, nursing, and pharmacy and health professions. He has had long service at Creighton as Chair of the university’s Department of Family Medicine, preceded by the Directorship of the Family Medicine Residency Program.

Doctor Frey will discuss the American way of funding physician education. For the past half century, the major source of federal funding for medical education are the “direct” and “indirect” graduate medical education funds appropriated through the Medicare budget, currently administered by the Centers for Medicare and Medicaid Services.

These funds are distributed to eligible hospitals with physician residency positions by means of formulas that become increasingly complex over the decades, with major modifications of the program included within the Patient Protection and Affordable Care Act (ACA).

The provision of high quality health services throughout the nation requires a physician workforce sensitive to the needs to all the nation’s geographical areas and populations. The challenges, dangers and opportunities that face the nation’s postgraduate medical training (i.e., physician residency positions and fellowships) will be the subject of Dr Frey’s Thought Provocateur session.

 

 

Norman B. Kahn, Jr., MD to Give 23rd J. Jerry Rodos Lecture April 10, 2017 at 28th National Conference on Primary Health Care Access

Norman B. Kahn, Jr, MD Council of Medical Specialty Societies, Chicago

Norman B. Kahn, Jr, MD
Council of Medical Specialty Societies, Chicago

Doctor Norman B. Kahn, Jr., the Executive Vice-President of the Council of Medical Specialty Societies, will present the 23rd J. Jerry Rodos Lecture on Monday April 10, 2017, the first morning of the 28th National Conference on Primary Health Care Access.

The academic and professional career of Doctor Kahn, a Senior Fellow of the National Conferences on Primary Health Care Access, brings him unparalleled insights into issues of access in the United States health system.

Dr Kahn was one of the residency classes for the new specialty of family medicine, training in the early 1970s at University of California San Francisco community-based public hospital, San Francisco General, thereby gaining professional experience in caring for San Francisco’s multicultural, diverse-lifestyle population.

Within a few years of his graduation, he was appointed family medicine residency director for Stanislaus County’s Scenic General Hospital, in the heart of California’s Central Valley, one of the nation’s major agricultural regions. Dr Kahn oversaw the Scenic residency program’s establishment of a community health center in the small, agricultural town of Hughson, one of the early experiments in teaching family medicine residents to provide care in a community health center setting.

Doctor Kahn subsequently replaced Doctor John Geyman (also a Senior Fellow of the National Conferences) in the role of administrator of the University of California Davis’ Network of Affiliated Residency Programs. From that position he was invited to join the executive staff of the American Academy of Family Physicians in Kansas City, Missouri, where he served Executive Vice President for education.

Dr Kahn was a strong advocate for cooperative activities between the primary care medical specialties, and, later, for cooperative activities for all of the medical specialties. These ideas were incorporated into the Council of Medical Specialty Societies, an institution which he has served as Executive Vice President.

 

 

 

28th National Conference on Primary Health Care Access: Charles Q. North, MD and Jeremy Fish, MD: “Assessing Access to a Primary Health Safety Net”

north-300On Monday, April 10, 2017, the first day of the 28th National Conference on Primary Health Care Access, the first plenary panel will follow individual presentations by Doctors David Sundwall and John Geyman, relating to the status of the Affordable Care Act.

The first plenary panel will be comprised of Charles Q. North, MD, MS of the University of New Mexico and Jeremy Fish, MD of the Contra Costa County Medical Services in Martinez, California.

Doctor North’s Presentation

Doctor North, a Senior Fellow of the National Conferences on Primary Health Care Access, served as a career officer in the United States Indian Health Service.

In a “Great Debate” about whether the Patient Protection and Affordable Care Act [ACA] could be considered a success that took place in the 26th National Conference in 2015, Doctor North took the opposition position [see Time Will Tell”: the Proceedings of the 26th National Conference – The Great Debate: Obamacare has been a Great Success, Part 2 (North for the Negative)]

Dr North argues that the debate about how health care should be financed has obscured the debate about how the delivery system should be reformed to assure access to comprehensive, continuous health care that recognizes the importance of community-oriented medicine, and public health and its social determinants.

He has found that many of his patients, who previously had had access to most of the health services they needed through the Bernalillo County-financed health care system based in Albuquerque, have since the passage of ACA, found themselves assigned to prohibitively expensive insurance plans with narrow provider networks that do not meet their needs.

A fundamental error in Obamacare has been the imperative of enrolling patients in insurance plans that are basically designed as “risk pools” whose fees are priced to cover the expenditures required for the  health care needs of all the persons covered in the plans.

Yet, when very sick people, whose care may previously have been subsidized by government funds, sign up for a given plan, the costs of care to the very sick are shifted from “taxpayers in general” to the specific persons enrolled in the plan. The increase in costs shouldered by the plan’s recipients, it can be argued, are not the fault of sick persons who were seeking ways to manage their health care costs coverage, but are the result in defects in the legislation.

Before enactment of the ACA, the health care costs of many “uninsured” persons were absorbed by various publically-financed programs, most of which continue to function, but, for some programs in some states and communities, are partly channeled through the health care plans.

Currently, the federal government re-insures the private insurance companies by paying for catastrophes through government insurance (Medicare, Medicaid, the Indian Health Service [IHS], the Veterans Administration [VA], the Department of Defense [DOD], End Stage Renal Disease [ESRD], Ryan White, etc.) and by subsidizing local hospitals through trauma care support and other disease specific schemes (Breast and Cervical Cancer screening program.)  These are all “work arounds” that avoid the appearance of the taxpayer paying for re-insurance and to allow for a private for-profit insurance industry to survive.

Doctor Fish’s Presentation

Jeremy Fish, MD John Muir Health, Walnut Creek, California

Jeremy Fish, MD
John Muir Health, Walnut Creek, California

Doctor Fish is the founding family medicine residency program director at a new residency program based John Muir Health, in Walnut Creek.

Previously, Dr Fish served as the residency director for the health system for California’s Contra Costa County, one of the early leaders in the creation of comprehensive county-financed health services. The Contra Costa County family residency program is part of a unique Registrar model for training traditional full-spectrum family physicians.

The new John Muir program will open in June 2017 and will focus on a clinic-first, new model full-spectrum family medicine, that will include the local population of all ages, genders and conditions (a feature of most family medicine programs, and all payer residency practice, which is planned to serve 50% Medicaid, with the goal of providing seamless care across the payer spectrum.

The residency program’s primary purpose is to develop graduates to “joyfully provide comprehensive Family Teamcare”, including common office procedures.

Dr Fish describes himself as passionate for the all-payer aspect. He argues that the multi-payer, single payment model should be the next step beyond ACA, since he believes that we are likely decades away from a single payer financing system

Dr Fish intends to highlight what is precious to primary care medicine in ACA that must be preserved, and what are the opportunities might exist for legislative improvements to strengthen primary care.

ACA’s commitment to assuring health care for all should continue as a national priority, whatever revisions might be made to its legislative format.

The ACA includes features that, fully implemented as originally envisioned, should improve the quality of the health care system.

Strategic Initiatives to Promote Access

The panel will introduce one of the themes that will continue through the plenary sessions of the three National Conference days – an examination and celebration of strategic initiatives that have proven successful models of entities that provide and enhance access to comprehensive primary health care.

These thematic presentations will include discussion of community-oriented health centers, community-based primary care physician residency programs, Area Health Education Centers, and teaching health centers.

28th National Conference – John Geyman MD on Health Care Reform 2017: What are our Options Now?

John Geyman, MD

John Geyman, MD

Doctor John Geyman’s insightful analyses of what he believes are the fundamental errors in the Patient Protection and Accountable Care Act [ACA] have been highlights of the National Conference on Primary Health Care Access over the past half decade.

Dr Geyman returns as a featured speaker at the 28th National Conference on Primary Health Care Access, to be held April 10-12, 2017 at the Hyatt Regency New Orleans.

A prolific author on health care policy, Dr Geyman’s latest book, Crisis in U. S. Health Care: Corporate Power vs the Common Good is scheduled for release in early Spring. The book will incorporate (as will Dr Geyman’s presentation in New Orleans) Dr Geyman’s analysis on the new Administration’s proposals for revising ACA and other federal health priorities.

Dr Geyman’s presentation will take place on Monday morning April 10th.

Dr Geyman will be joined by a reactor panel enlisted from the permanent faculty of the National Conferences on Primary Health Care Access.

The National Conferences are invitational, and consist of approximately four to five dozen drawn from experts on health care policy, public health, community health centers and teaching health center projects, and academic health sciences center faculty. The National Conferences are conducted by the Coastal Research Group, a 501c-3 non-profit corporation devoted to healthcare workforce issues.

For information on the invitation process, contact William H. Burnett, Coordinator of the National Conferences at whburnett@coastalresearch.org.

Confirmed Faculty: The 28th National Conference on Primary Health Care Access

The following members of the permanent faculty of the National Conferences on Primary Health Care Access have confirmed their participation in the 28th National Conference, to be held April 10-12, 2017 at the Hyatt Regency New Orleans. Other confirmations are expected soon. The list will be continuously updated.

The 28th National Conference Faculty (confirmed as of January 31, 2017):

A neighborhood in New Orleans' French Quarter

A neighborhood in New Orleans’ French Quarter

Suzanne M. Allen, MD, MPH, University of Washington WWAMI Program, Boise, Idaho

Marc E. Babitz, MD, Utah Department of Health, Salt Lake City

John Boltri, MD, Northeast Ohio Medical University, Rootstown, Ohio

Eileen Chiang, CMA, Family Health Center, Kalamazoo, Michigan

J. Scott Christman, MPDS, Office of Statewide Planning and Development, Sacramento, California

Mary T. Coleman, MD, Louisiana State University, New Orleans

Denise Crawford, MBA, Family Health Center, Kalamazoo, Michigan

Delight F. Erickson, RNC, FNP, MPH, Radius Medicine Group, Andover, Minnesota

Jeremy Fish, MD, John Muir Health, Walnut Creek, California

Rick Flinders, MD, Sutter Hospital, Santa Rosa, California

Donald Frey, MD, Creighton University, Omaha, Nebraska

John Geyman, MD, University of Washington Emeritus Faculty, Friday Harbor, Washington

Ivan Gomez MD, California Statewide Area Health Education Center, Fresno, California

Derrick Gruen, Adventist Heatlh Systems, Hanford, California

Jimmy H. Hara, MD, Charles R. Drew University, Los Angeles, California

Steven Harrison, MD, Natividad Medical Center, Salinas, California

Charles Henley, DO, Sam Houston University College of Osteopathic Medicine, Huntsville, Texas

James M. Herman, MD, MSPH, University of Oklahoma School of Community Medicine, Tulsa

Norman B. Kahn, MD, Council of Medical Specialty Societies, Chicago, Illinois

Gary LeRoy, MD, Wright State University, Dayton, Ohio

Samuel C. Matheny, MD, MPH, University of Kentucky, Lexington

Dennis E. Means, MD MMM, CPE, Family Health Center, Kalamazoo, Michigan

William A. Norcross, MD, University of California, San Diego

Charles Q. North, MD, MS, University of New Mexico, Albuquerque

Keosha Partlow, Ph.D., MPH., Charles R. Drew University, Los Angeles, California

Perry A. Pugno, MD, MPH, American Academy of Family Physicians Emeritus, Lebanon, Ohio

Adalberto Renteria, MD, Adventist Health Systems, Hanford, California

Janice Spalding, MD Northeast Ohio Medical University, Rootstown, Ohio

David Sundwall, MD, University of Utah, Salt Lake City

Allan Wilke, MD, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan

Teresa Zyrd, MD, Wright State University Boonshoft School of Medicine, Dayton, Ohio

Doctor Sundwall Scheduled for Keynote of 28th National Conference on Primary Health Care Access

David N. Sundwall, MD; University of Utah

David N. Sundwall, MD; University of Utah

Doctor David Sundwall will provide the keynote presentation at the 28th National Conference on Primary Health Care Access. The conference will be held April 10-12, 2017 at the Hyatt Regency New Orleans. 

A member of the University of Utah medical school faculty, Doctor Sundwall has served as Director of Public Health for the State of Utah, as Head of the United States Department of Health and Human Services’ Health Resources and Services Administration [HRSA] under Presidents Ronald Reagan and George H. W. Bush, and previous to that Minority Consultant (staff member to vice-chair Senator Orrin Hatch)  on the United States Senate Labor and Health Committee, chaired by Senator Ted Kennedy.

During Doctor Sundwall’s tenure at HRSA, he oversaw many progressive public health initiatives, including the rejuvenation of the National Health Service Corps [NHSC] and the creation of the NHSC Loan Repayment Program and the Ryan White Act. He is a strong advocate of legislation that advances national public health goals.

Doctor Sundwall’s presentation will describe and analyze the major legislative proposals for modifying or replacing all or part of the Patient Protection and Affordable Care Act [ACA] that is popularly known as ObamaCare.

The discussion in Congress likely will highlight the trillions of dollars of unfunded obligations in Social Security and Medicare.These unfunded obligations are in addition to current federal debt that approaches 18 trillion dollars. That is likely to be the context for discuss variety of proposals have been put forward to rein in future costs.

These proposals are expected to include a greater use of block grants in federal health care financing, creation of high-risk pools, changing the basis of health care financing from “defines benefits” to “defined contributions”.

Doctor Sundwall will address the specific proposals under consideration by the incoming administration and Congress, particularly those that have a chance of being implemented in whole or in part.

He will analyze the role of the state governors (a majority of whom are of the same party as the President-elect and Congress) in proposing how ACA should be changed, as well as how Medicaid should be administered in the future.