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1 Medical Mastermind Community The first ideal pipeline-like program for the geographically isolated and financially disadvantaged.

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Presentation on theme: "1 Medical Mastermind Community The first ideal pipeline-like program for the geographically isolated and financially disadvantaged."— Presentation transcript:

1 1 Medical Mastermind Community The first ideal pipeline-like program for the geographically isolated and financially disadvantaged.

2 2 Outline Quality, affordable health care for all Medically underserved populations Physician supply and demand Distribution of physicians around the US Efforts to remedy the imbalance Ideal vs. non-ideal pipeline programs Grant solutions and future research

3 3 Quality, Affordable Health Care For All

4 4 Quality, Affordable Health Care For All This is: –AMSA’s motto –An important humanistic ideal –Professional and ethical obligation This is NOT: –A debate on the funding the care

5 5 Quality, Affordable Health Care For All Physicians set their own ethical codes Beurocrats didn’t tell US this is important As a group, we need to come up with ways to meet the imbalances that exist.

6 6 Examination of Medically Underserved No universal definition exists… –Population densities –Financial income –Student Academic strength –Minority status –Family college background –Population’s general organization –Availability of exclusive privileges

7 7 Examination of Medically Underserved The characteristics of those with highest probability of becoming physicians: Access to exclusive resources Most organized Closest proximity to concentrations of physicians, income, and population

8 8 Distribution of Physicians in the US 20% of US citizens live in rural areas Only 9% of physicians are rural That’s 60 million people in underserved areas!

9 9 Distribution of Physicians in the US

10 10 Distribution of Physicians in the US

11 11 Distribution of Physicians in the US It is a free country and physicians themselves decide their specialty and practice setting…so far. Equality takes priority in an ever-changing legal landscape. We must remedy the inequality in health care delivery ourselves or else we risk losing our autonomy.

12 12 Logic for Selecting the Underserved N = 20,112 (64% of graduates in on an AAMC survey)

13 13 Logic for Selecting the Underserved Physicians serve people like themselves…

14 14 Logic for Selecting the Underserved

15 15 Logic for Selecting the Underserved There is not a perfect proportion of applicants that represent the population. For example, –Asians apply in proportionally high numbers. –Blacks apply slightly less –White women apply slightly less white men

16 16 Logic for Selecting the Underserved

17 17 Logic for Selecting the Underserved Physicians serve people like themselves… AND Applicants don’t represent the population…(minority programs may change this in the future)

18 18 Examination of Medically Underserved That’s why there are underserved populations! Complex Barriers exist: –Population densities –Financial income –Student Academic strength –Minority status –Family college background –Population’s general organization –Availability of exclusive privileges

19 19 Take home point: Underserved applicants serve underserved populations. Since the 1960’s the name of the game has been get the underserved into the pipeline. …but at all costs?

20 20 Take home point: AAMC’s AspiringDocs.org

21 21 Ideal vs. Non-Ideal Pipeline Programs Merit-based competition in a free market –Increase matriculation of applicants with altruistic, humanitarian spirit –No discrimination of persons - abolishment of affirmative action –Equal distribution of quality, affordable care –Make exclusive resources and professional contacts/mentorship available for everyone: level the playing field: Academically, Geographically, and Financially.

22 22 Efforts to Remedy the Imbalance Many attempts to improve imbalances in physician distribution have been made. We’re closer to ideal solutions than we’ve ever been before, thanks to prolific research in this area.

23 23 Efforts to Remedy the Imbalance –The Legislative Branch: The Congress of the United States –The Judicial Branch: The Supreme Court and lower courts’ rulings –The schools themselves –The state legislatures –Accrediting Bodies: AAMC, AOA, and ACGME –Student Organizations: SNMA –Political Organizations: AMA and AMSA Let’s not wait for the Executive Branch!

24 24 Efforts to Remedy the Imbalance Congress: –$7 billion is spent annually by Medicare to controls physician supply by changing the number of medical residency positions.

25 25 Efforts to Remedy the Imbalance The Supreme Court’s ruling on affirmative action: –Grutter vs. Bollinger, 2003 narrow use temporary need to develop race neutral solutions –Gratz vs. Bollinger, 2003 Automatic point system illegal

26 26 Efforts to Remedy the Imbalance

27 27 Efforts to Remedy the Imbalance

28 28 Efforts to Remedy the Imbalance

29 29 Efforts to Remedy the Imbalance The Schools –Debakey High School for Health Prof. Preps “minorities” Better because students compete in the free market for med school, and do well. Have to be geographically available to participate.

30 30 Efforts to Remedy the Imbalance Origin of Magnet Schools like Debakey:

31 31 Efforts to Remedy the Imbalance The Schools –Texas A&M Medical School is already race neutral. Argue that minorities serve the underserved in increased proportions so less of them are needed - it washes out in the end. No data support the outcome that we’re on the right track, but they refuse to violate the constitution.

32 32 To be fair and balanced:

33 33 Efforts to Remedy the Imbalance The Schools –Baylor’s Premedical Honors College Pipeline of minorities enrolled in high school Condition acceptance to Baylor (72 since 1994) Could be found noncompliant with Gantz vs. Bollinger, but Texas State Legislature said the program should be replicated.

34 34 Efforts to Remedy the Imbalance Texas State Legislature –Acknowledged Baylor’s Premedical Honors College –Recommended replicating the program, hopefully simply because it helps the outcome - “Quality, affordable health care for all.”

35 35 Efforts to Remedy the Imbalance GPA 3.25, MCAT 23

36 36 Efforts to Remedy the Imbalance Accrediting Bodies: –AAMC - certifies medical schools that grant MD degrees Manage medical school application service Administer the MCAT –AOA - certifies DO schools –ACGME - certifies residency programs

37 37 Efforts to Remedy the Imbalance –AAMC: Summer Medical and Dental Program AspiringDocs.org Health Professions Partnership Initiative - grant money to fund underrepresented minorities in Georgia –K-12, Communities, & Undergraduates.

38 38 Efforts to Remedy the Imbalance

39 39 Efforts to Remedy the Imbalance

40 40 Efforts to Remedy the Imbalance –Interjection of efficacy: 5 UC premedical programs Control group n= 396, test cohort n=265 Students competed in free market Statistically significant increase in admission

41 41 Efforts to Remedy the Imbalance AAMC’s HPPI program:

42 42 Efforts to Remedy the Imbalance HPPI: levels the playing field –Good because applicants still compete in the free market –Limited to Georgia and you have to be physically present to participate.

43 43 Efforts to Remedy the Imbalance AOA –What are you doing? –Go Dr. Bowman!

44 44 Efforts to Remedy the Imbalance ACGME: –Have nothing to do with such issues. –Perhaps the most ideal entity of all. –They focus on 7 core competencies of physicians and all research has shown that residency graduates perform equally well regardless of their individual background.

45 45 Efforts to Remedy the Imbalance Student Organizations Student National Medical Association –Good because they are web-based and community organization, therefore they reach a broader audience. –Only serve people “of color”.

46 46 Efforts to Remedy the Imbalance Student Organizations Student National Medical Association –Good because they are web-based and community organization, therefore they reach a broader audience. –Only serve people “of color”.

47 47 Efforts to Remedy the Imbalance Are we part of the solution here? What about Gantz vs. Bollinger?

48 48 Efforts to Remedy the Imbalance Great program, but white people drink over there…

49 49 Efforts to Remedy the Imbalance AMA –Funds scholarships –Health Care Reform lobbying

50 50 Efforts to Remedy the Imbalance AMSA –Health Care Reform lobbying –Diversity Education –AMSA Foundation funds programs

51 51 Efforts to Remedy the Imbalance What can I do solve this problem for my generation? JOIN AMSA!

52 52 Physician Supply and Demand

53 53 Physician Supply and Demand In 2006, AAMC recommended 30% increase in medical school enrollment and graduate medical education. Notice the year to which their projections cover Recall that Justice Day O’Conner said affirmative action should end by

54 54 Grant Solutions and Future Research Who should benefit? –Dr. Robert Bowman, my mentor, suggests that only including underrepresented groups would be noncompliant with the Supreme Court’s ruling in Gratz vs. Bollinger, –That would be an automatic, built-in discriminator of persons.

55 55 Grant Solutions and Future Research Different benefits from including all: –Underserved: learn organization –Adequately Served: gain awareness Engage both groups in health access projects and service-oriented mentors.

56 56 Grant Solutions and Future Research

57 57 Grant Solutions and Future Research

58 58 Grant Solutions and Future Research What is a mastermind? “Coordination of knowledge and effort of two or more people who work toward a definite purpose in a spirit of harmony.” “No two minds ever come together without thereby creating a third invisible, intangible force which may be likened to a third mind.”

59 59 Grant Solutions and Future Research –Make exclusive resources available for everyone: level the playing field: Academically - strengthen MCAT/USMLE scores Geographically - remote access to “discourse of medicine” and professional mentorship Financially - grant funded solutions

60 60 Grant Solutions and Future Research Geographic Information Systems can aid delivery of tele-mentoring programs.

61 61 Grant Solutions and Future Research

62 62 Grant Solutions and Future Research

63 63 Take Home Point Active grant-funded programs use web- based software can be used to assess students.

64 64 Ideal vs. Non-Ideal Pipeline Programs Geographical Solution: telementoring

65 65 Grant Solutions and Future Research Peer projects in medical access: Medical School LIFE Conference Academic Strengthening: MCAT and USMLE prep in autonomy-supportive environment Professional Contacts: Individualized coaching from physician role models Geographical Solution: –Web-based tele-mentoring to reach broad audience with state-of-the-art learning tools –Snail mail deliver of books and DVD’s for students without broadband internet access.

66 66 Grant Solutions and Future Research Emotional Intelligence development and periodic assessment Wellness Program: Stress Management development and periodic assessment Diversity Awareness Training

67 67 Special Thanks AMSA Dr. Robert Bowman AAMC AMSA Foundation Robert Wood Johnson Foundation National Science Foundation W.K. Kellogg Foundation The Rockefeller Foundation

68 68 Special Thanks Sullivan Commission Minority Affairs Consortium AAMC’s Community and Minority Program National Medical Association AMA SNMA U.S. Public Health Service Commission to End Health Care Disparities Institute of Medicine California Wellness Foundation JAMPS

69 69 Premedical Institute of Enrichment The first ideal pipeline-like program for the geographically isolated and financially disadvantaged.


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