We’ll spend the next few weeks providing some highlights and commentary.
Challenges and Opportunities in Expanding GME Experience (p.17)
“Although the data on the impact of training sites on the quality of care provided by GME graduates is limited, there is a common misperception that only training in large academic centers can produce graduates who have the skills to provide high quality care. Asch and colleagues have found obstetrical outcomes are affected by training site, linking quality of training site with the outcomes of care provided by the trainees. However, other studies on this topic leave doubt about which markers should be used to evaluate physician practice quality in relation to residency training sites.
“In addition to concerns about quality of teaching and patient care in community and ambulatory settings, another barrier to expanding GME training to these sites is the lack of financial support for community-based programs. Present payment and training incentives for community-based training are insufficient to develop and maintain these ambulatory and community-based programs, even though it costs less to provide patient care and GME training in these sites, than AHCs and other teaching hospitals. The increased costs of AHCs and other teaching hospitals are in part due to their higher patient care costs. This includes the number of underinsured, biomedical research missions, and the maintenance of standby capacity for medically complex patients, in addition to the expenses incurred by teaching programs.”
For GMEC, this is key as training in Southwest Virginia offers the local, ambulatory, outpatient experience. On page 23, the report states, people “expect the medical education system to produce physician specialists who reflect the cultural and economic characteristics of the patients they serve“.
With this expectation in mind – the medical education community needs to recognize that the only way to fully prepare a future physician to serve in rural Appalachia is to train that student in Appalachia. Reviewing information about rural Southwest Virginia is not sufficient to produce a culturally competent doctor – immersion is required.
According to healthfinder.gov one in three children in the United States is overweight or obese. Childhood obesity puts kids at risk for health problems that were once seen only in adults, like type 2 diabetes, high blood pressure and heart disease.
Vaccines give parents the safe, proven power to protect their children from over a dozen serious diseases before the age of 2. Diseases such as flu, measles and whooping cough (pertussis) can be life threatening to newborns and young babies. Women should receive the Tdap (tetanus, diptheria, pertussis) vaccine with each pregnancy between the 27-36 week time frame.
Children age 4 to 6 need boosters for DTaP (diptheria, tetanus, pertussis), chickenpox, MMR (measles, mumps, rubella) and polio. At 11 or 12 years of age preteens and teens need Tdap (tetanus, diptheria, pertussis), MenACWY (meningococcal conjugate vaccine) and HPV (human papilloma virus) vaccines. Yearly flu shots are recommended for children 6 months and older.
Young men and women who have not started or finished the HPV vaccine series can be vaccinated through 26 years of age. Meningococcal vaccine is recommended especially first-year students who will be living in residence halls.
Immunization helps prevent dangerous and sometimes deadly diseases. To stay protected against serious illnesses like the flu, measles and tuberculosis adults need to get their shots—-just like children do. All adults get the yearly flu vaccine and Tdap once if not received at adolescence to protect against pertussis (whooping cough) and a Td (tetanus) booster every 10 years. Other adult vaccines such as shingles (caused by the chicken pox virus varicella), pneumococcal, hepatitis and HPV depending on life style and health status.
Vaccines protect not only individuals but entire communities and that is the reason vaccines are such a vital part of the public health goal of preventing diseases.
Skin cancer is the most common type of cancer in the United States. Ultraviolet (UV) rays from the sun are the main cause of skin cancer and UV damage can cause wrinkles and blotchy skin.
Skin cancer is preventable and communities, health professionals and families can work together toward prevention. Wear sunscreen, hats, UV blocking sunglasses and learn the most dangerous times for UV exposure.
Skin cancer affects people of all ages, including older adults.
Dr. Anna Lovett is a second year resident at the University of Virginia’s Medical School and following are some of her impressions and thoughts she gained while in rural Southwest Virginia.
Spending time working with family medicine physicians in Lebanon and Honaker, VA, through the GMEC Rural Rotation has provided a realistic and refreshing perspective on what it means to practice medicine through serving rural communities and patients in an environment based upon love for God and one another. From seeing coal miners or welders after small accidents that result from their occupational hazards to COPD patients with pneumonia who refuse hospitalization until the family is forced to call 911 to interesting rashes of all kinds on patients of all ages, there have been countless opportunities to expand my understanding of medicine and what it means to practice whole person care in a beautiful setting with down to earth patients with a variety of health care needs.
Thank you, again, for everything. This has been a wonderful and refreshing month! I am grateful I had the opportunity to come to SW VA and have been blessed in so many ways.