New Yakima DO school 'deferred'

[OLYWA]

The wait for info on the proposed new school is finally over.

Today I got an email (finally) from the AOA. The mail reads "The decision on PNUHS pre-accreditation was deferred to the April 21, 2007, COCA meeting."

Well...finally we know. No media/press releases have been made by either the school or the AOA as of yet...so it's tough to know what went on at the meeting and/or what the 'issues' were that yielded this decision.

I must say...maybe it's just me...but I find this situation 'troubling'...as it really brings into question the possible legitimacy of the school.

Anyone have any input, info, or viewpoints?

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[Dr JPH]

Anyone have any input, info, or viewpoints?

Stop opening more DO schools and concentrate on improving the education of the ones you have.

The end.

 

[Faraaz23]

Stop opening more DO schools and concentrate on improving the education of the ones you have.

The end.

AMEN. Even the automotive juggernaut Toyota is starting to experience quality problems from growing way too fast... if its happening to them, just imagine whats happening to the backwards, stupid AOA. I've heard some of the schools out there which I am not going to mention names don't exactly have the most spectacular board passing rates and averages.

 

[Doctor Bagel]

Stop opening more DO schools and concentrate on improving the education of the ones you have.

The end.

Generally agree, but we really do need more schools in the pacific northwest. The proposals to open new DO schools in places like New Jersey, NY and Pennsylvania are a little more distressing since those states already have plenty of schools.

 

[DropkickMurphy]

Stop opening more DO schools and concentrate on improving the education of the ones you have.

The end.

OK.....how do you recommend they improve the education at the current schools?

 

[Dr JPH]

Generally agree, but we really do need more schools in the pacific northwest. The proposals to open new DO schools in places like New Jersey, NY and Pennsylvania are a little more distressing since those states already have plenty of schools.

I disagree.

More postgraduate progams there, yet. Not more schools.

 

[Dr JPH]

OK.....how do you recommend they improve the education at the current schools?

I dont think the undergraduate education is bad...in fact, thats pretty damn solid most everywhere.

Use resources to put more money into graduate education.

The complaint is "there arent enough docs in ______ and we need DOs in _______"

Well, the way to go about that is to put some top notch residency programs there and pull docs from the 24ish DO schools already in existence. simply placing a medical school in an area wont increase the number of docs there if the post-graduate training isnt strong.

 

[DropkickMurphy]

I dont think the undergraduate education is bad...in fact, thats pretty damn solid most everywhere.

Use resources to put more money into graduate education.

The complaint is "there arent enough docs in ______ and we need DOs in _______"

Well, the way to go about that is to put some top notch residency programs there and pull docs from the 24ish DO schools already in existence. simply placing a medical school in an area wont increase the number of docs there if the post-graduate training isnt strong.

Speaking as someone who comes from an underserved community (our nearest primary care doc is 20+ miles away), I can attest that it's not a shortage of doctors, it's the fact that most of the people from these areas who want to become docs are using that career path as a way to escape. Also given that people are leaving these areas at the earliest possibility, you're going to have a hard time convincing people who have a lot of options to:
1. Do a primary care residency
2. Say no to better pay
3. Agree to move to the middle of nowhere and practice there....

I'm not going to malign them for opening more schools, because it increases my chances of getting in.....but I do agree with your points, however I doubt they will help solve the issue at hand. Regardless of where I do my residency (most likely a major city because of my interests), chances are I won't practice there (unless offered a very lucrative package) and I would imagine many other people are probably of a similar mindset.

 

[Dr JPH]

Speaking as someone who comes from an underserved community (our nearest primary care doc is 20+ miles away), I can attest that it's not a shortage of doctors, it's the fact that most of the people from these areas who want to become docs are using that career path as a way to escape.

Exactly.

We need ways of enticing more docs to move to or to stay in these areas.

I dont know how to do it. If it were easy I think it wouldnt be a topic of discussion right now.

 

[DropkickMurphy]

I still say my suggestion to not require docs practicing in these areas to pay taxes for the first 5-10 years would be the best incentive. Hell, I might even come back to this area if they gave me a break like that!

 

[JonnyG]

I still say my suggestion to not require docs practicing in these areas to pay taxes for the first 5-10 years would be the best incentive. Hell, I might even come back to this area if they gave me a break like that!

Its not just a money thing. For instance, a doc i know turned down an insane amount of money to work in central PA because every doc at the hospital sends their kids away to boarding school for high school. Why because the area doesn't have good schools. You have to consider everything when trying to entice docs to an area.

 

[DropkickMurphy]

Yeah, but our area has pretty good schools, a reasonably low crime level, and the cost of living is below the national average. But you'd have to cut me a tax break or pay me WELL above average to get me to come back here.

 

[WALKE219]

My idea from before is that more larger, established schools start osteopathic medical colleges. My reasoning is this : When you have an established university, with a lot of funding and a lot of pride... I believe they are LESS likely (disclaimer: not impossible) to fail, or to have a sub par level of education. I think the problem comes from when these small, independent schools simply pop up all over the place.. Like you all have said, this results in lower funding and lower quality at times. I would like to see more major universities have osteopathic schools associated with them, I think this, overall, would increase public opinion and awareness of the practice as well... Right now, I believe MSUCOM is the only com associated with a truly national, major university. Not to say that MSUCOM is superior to all other com's because it is at a huge university, but it does help to have it be highly acknowledged in at least Michigan. I think if Washington St. U, UCLA, UNLV, UW, Iowa, etc (just random examples of schools that came to mind) would open up osteopathic schools, it would do more for the practice than if a bunch more small independent schools opened up. Plus it might also get osteopathic into reasearch a whole lot more because of funding issues... this might be a little against what osteopathic was originally about , but lets face it... more with the times... No need to attack, just a thought.

 

[Buckeye(OH)]

Call me a prick; but Im glad to see this happen.

 

[DoctorMom78]

Speaking as someone who comes from an underserved community (our nearest primary care doc is 20+ miles away), I can attest that it's not a shortage of doctors, it's the fact that most of the people from these areas who want to become docs are using that career path as a way to escape. Also given that people are leaving these areas at the earliest possibility, you're going to have a hard time convincing people who have a lot of options to:
1. Do a primary care residency
2. Say no to better pay
3. Agree to move to the middle of nowhere and practice there....

I'm not going to malign them for opening more schools, because it increases my chances of getting in.....but I do agree with your points, however I doubt they will help solve the issue at hand. Regardless of where I do my residency (most likely a major city because of my interests), chances are I won't practice there (unless offered a very lucrative package) and I would imagine many other people are probably of a similar mindset.

LOL! That is EXACTLY what I want to do with my life and medical career... RURAL FAMILY MEDICINE!!! So what if I get paid in chickens...

 

[LastDance]

My idea from before is that more larger, established schools start osteopathic medical colleges. My reasoning is this : When you have an established university, with a lot of funding and a lot of pride... I believe they are LESS likely (disclaimer: not impossible) to fail, or to have a sub par level of education. I think the problem comes from when these small, independent schools simply pop up all over the place.. Like you all have said, this results in lower funding and lower quality at times. I would like to see more major universities have osteopathic schools associated with them, I think this, overall, would increase public opinion and awareness of the practice as well... Right now, I believe MSUCOM is the only com associated with a truly national, major university. Not to say that MSUCOM is superior to all other com's because it is at a huge university, but it does help to have it be highly acknowledged in at least Michigan. I think if Washington St. U, UCLA, UNLV, UW, Iowa, etc (just random examples of schools that came to mind) would open up osteopathic schools, it would do more for the practice than if a bunch more small independent schools opened up. Plus it might also get osteopathic into reasearch a whole lot more because of funding issues... this might be a little against what osteopathic was originally about , but lets face it... more with the times... No need to attack, just a thought.

i agree with this completely...this is exactly what the AOA should do...

 

[primadonna22274]

I love rural family med too but I don't think my creditors will accept chickens. We're a long ways from the days of Doc Baker... (did you know he lived in Oregon after his Little House days?)....
I'm bummed about the Yakima program though. It's already a year later than we thought it was going to be. It was definitely on my list as a means to get back home

LOL! That is EXACTLY what I want to do with my life and medical career... RURAL FAMILY MEDICINE!!! So what if I get paid in chickens...

 

[Dr JPH]

Lots of small, rural hospitals give student loan repayment options to docs who come practice there.

 

[Kuba]

Call me a prick; but Im glad to see this happen.

me too

 

[mletter]

Oh, the school will open up next cycle I am sure. It just shows that the AOA IS trying to make sure the program is good and acceptable of accredidation. No matter what DO and MD schools have to provide students with a modern and credible education so that they can pass the boards. This is why I am confident in the schools that are given permission to open and I am all for more DO schools. I really believe in the DO philosopy. I believe this philosophy is the way of the future of medicine. We need more DO's and all doctors for that matter period. DO's are the medical professionals that are going to be more likely to serve in underserved areas which is where doctors are needed SO badly. There is like 150 MD schools and only 23 DO schools. So, if the argument is going to be made that anyone is spreading themselves to thin shouldn't the MD schools be the ones in question? Just a thought.

 

[Kuba]

Oh, the school will open up next cycle I am sure. It just shows that the AOA IS trying to make sure the program is good and acceptable of accredidation. No matter what DO and MD schools have to provide students with a modern and credible education so that they can pass the boards. This is why I am confident in the schools that are given permission to open and I am all for more DO schools. I really believe in the DO philosopy. I believe this philosophy is the way of the future of medicine. We need more DO's and all doctors for that matter period. DO's are the medical professionals that are going to be more likely to serve in underserved areas which is where doctors are needed SO badly. There is like 150 MD schools and only 23 DO schools. So, if the argument is going to be made that anyone is spreading themselves to thin shouldn't the MD schools be the ones in question? Just a thought.

itd be nice to have 150 DO schools, sure. But it can't happen overnight. The AOA has to ensure that every program is solid first before moving on to the next project.

 

[DropkickMurphy]

Lots of small, rural hospitals give student loan repayment options to docs who come practice there.

I've never seen this except for the really less than desirable specialties.....FM, general IM, peds, etc. Basically the same people who are already able to take advantage of other programs.....I've yet to hear a major loan repayment offer to a pulmonologist, an EM doc, a cardiologist, or anyone else in a specialty that you would expect the rural hospitals would have a far time wooing than the average primary care doc.

 

[It'sElectric]

I've never seen this except for the really less than desirable specialties.....FM, general IM, peds, etc. Basically the same people who are already able to take advantage of other programs.....I've yet to hear a major loan repayment offer to a pulmonologist, an EM doc, a cardiologist, or anyone else in a specialty that you would expect the rural hospitals would have a far time wooing than the average primary care doc.

I'd say that loan repayments are offered more often than people actually realize. They won't necessarily pay off all $200,000+, but they will certainly cover a sizeable portion of it.

Not saying every single doc out there has done this, but many do in various fields. Unless of course you're starting salary is 500K+, then that pretty much covers loans anyways, now doesn't it .

 

[Dr JPH]

I've never seen this except for the really less than desirable specialties.....FM, general IM, peds, etc. Basically the same people who are already able to take advantage of other programs.....I've yet to hear a major loan repayment offer to a pulmonologist, an EM doc, a cardiologist, or anyone else in a specialty that you would expect the rural hospitals would have a far time wooing than the average primary care doc.

Ahh...not true.

I currently know a small hospital in NE Pennsylvania offering 75% loan repayment for (1) general surgeon and (2) ER docs.

The opportunities ARE out there, they dont last long for certain specialties.

True, FP is the biggest need but you just have to look around. Also realize that many times the hospitals dont always openly advertise this type of benefit. If they can get someone to come work for them simply by posting a job opening and NOT having to pay the additional $$ then naturally that is better for them. Sometimes its thrown on the table as a bargaining chip or as an extra incentive to a candidate that they really like.

If you ever get to know any higher-ups in some other rural hospitals ask them about the idea and see what they say.

Just because a hospital is small and rural doesnt mean they dont have the same need for specialty fields.

 

[brian30bulldog]

Oh, the school will open up next cycle I am sure. It just shows that the AOA IS trying to make sure the program is good and acceptable of accredidation. No matter what DO and MD schools have to provide students with a modern and credible education so that they can pass the boards. This is why I am confident in the schools that are given permission to open and I am all for more DO schools. I really believe in the DO philosopy. I believe this philosophy is the way of the future of medicine. We need more DO's and all doctors for that matter period. DO's are the medical professionals that are going to be more likely to serve in underserved areas which is where doctors are needed SO badly. There is like 150 MD schools and only 23 DO schools. So, if the argument is going to be made that anyone is spreading themselves to thin shouldn't the MD schools be the ones in question? Just a thought.

No, DO is the minority and will never change. Opening DO schools faster than McDonalds in the middle of nowhere is hurting the DO image they have strived to improve over the last couple of decades. At least thats what I heard from doctors (M.D. and D.O.) when I was considering DO schools.

 

[WALKE219]

Once again, start opening colleges at Universities that have reputations,history and funding instead of opening new little colleges... I think this would solve a lot of the problem and improve image.

 

[DragonWell]

Once again, start opening colleges at Universities that have reputations,history and funding instead of opening new little colleges... I think this would solve a lot of the problem and improve image.

It's easy to say this, but putting it into practice is another matter. What would motivate a large university to opt for a DO program instead of an MD? With the increasing trend of fewer DOs going into primary care/OMM, I think it becomes harder to make a case that we need to train DOs over MDs. Also, remember that most DO schools currently associated with state universities started out as private schools, and once successful, were assimilated into their respective state systems.

 

[hossofadoc]

I say opening schools in rural America is a good idea...1. It gets people to the area and will increase the chance of them staying. 2. Rural America/inner city is where we need docs...we don't need more physicians in the burbs...we need them in the small towns. For instance in KY, we had 23 physicians return to eastern KY in ten years from the UK and U of L...out of 1,500. Most of them stayed in the Lexington and Louisville area...since PCSOM has opened they have placed over 30 docs in the East KY.

There are numerous hospitals that are welling to repay loans in rural America, it just takes a little looking. I'm a forth year and have gotten 4 offers for my loans to be repayed.

 

[Bitsy3221]

I say opening schools in rural America is a good idea...

The only problem with this is that one of the most important things needed to train student physicians is patients, and lots of them. Hopefully with interesting pathology. Rural America is just that--rural. They by definition do not have tons of people living there, and this would severely limit the students' educational experience

 

[Dr JPH]

The only problem with this is that one of the most important things needed to train student physicians is patients, and lots of them. Hopefully with interesting pathology. Rural America is just that--rural. They by definition do not have tons of people living there, and this would severely limit the students' educational experience

Im not so sure about this.

There really arent fewer patients because of the larger area covered.

Generally the wider range that is served by a hospital or medical facility, the better the pathology. This is most true for rural areas where a single hospital may serve several hundred square miles.

You dont see the SAME pathology all the time as you do in the city, but you certainly see plenty of good learning cases.

 

[Lindyhopper]

There are many family practice training spots that go unfilled. As long as the AOA enforces accreditadation standards, I think expansion is a good thing.
More educational opportunties, especially in the sciences, are nearly always a good thing for the world.

 

[JonnyG]

There are many family practice training spots that go unfilled. As long as the AOA enforces accreditadation standards, I think expansion is a good thing.
More educational opportunties, especially in the sciences, are nearly always a good thing for the world.

AOA doesn't enforce accredidation, COCA does......................thats the problem

 

[DrBMX]

I agreed with the above post regarding post-doctoral education for DO. They need to improve the quality and quantity as well. The quality of DO residencies are questionable. They should not open more school. The MCAT for DO students are TOO low now. It looks like anyone can get into DO schools.

 

[medicnick]

As someone who as worked hand in hand (blood, sweat & tears) with FPs in a rural setting (the county rates as a 21 for HPSA scoring), I find these references to chickens comical.

The MDs and DOs that I worked with five years ago made a very good living. Their pay ranged from $110,000-$250,000 for doing 5 days of clinic and rotating weekly ER call among five docs. A PA also made over $100,000 doing the same coverage. They did their own deliveries and a couple would do minor emergent surgical procedures.

I guess your definition of "middle of nowhere" would really be based on perspective. I have seen nowhere so am pretty sure I have seen the middle of it also. Being from the West, I am used to large distances between towns. Some of us probably have experienced remote living as well (towns of 50ish more than 30 miles from another town or the closest hospital).

I for one would be pleased to find a DO school anywhere in the Northwest. We could at least get a favorable look by a neighboring state rather than being several states removed. The WWAMI program being the allopathic version of how this could work. In fact, I would opine that this would help keep rural minded people in the rural areas. Once you completely leave it is difficult to go back - for a number of reasons.

Be safe!
medicnick

 

[deleted6669]

I for one would be pleased to find a DO school anywhere in the Northwest. We could at least get a favorable look by a neighboring state rather than being several states removed. The WWAMI program being the allopathic version of how this could work. In fact, I would opine that this would help keep rural minded people in the rural areas. Once you completely leave it is difficult to go back - for a number of reasons.

Be safe!
medicnick

agree-if they can ever get their act together and open I am VERY interested....

 

[OLYWA]

Hopefully it's just a tech problem.

But now 2 of my email messages to the school have been returned undeliverable.

PNUHS would open doors for a lot of people...both students AND future patients. It would seem things aren't 'together' yet as far as this school is concerned.

Hopefully the issues are fixed...and soon. Their reputation depends on it.

There are a lot of premeds out there counting on this school.

 

[MossPoh]

Its not just a money thing. For instance, a doc i know turned down an insane amount of money to work in central PA because every doc at the hospital sends their kids away to boarding school for high school. Why because the area doesn't have good schools. You have to consider everything when trying to entice docs to an area.

In central PA? I know plenty of very intelligent people who came from there and didn't go to a boarding schools. That sounds like a different issue in itself. Penn State is full of locals....including my friend from a class of 20 in high school who has a 3.9 in electrical engineering.

I think money is one big issue, but the real one is that people are scared to practice there. I think that someone coming from a crowded coastal area their entire life would have a very difficult time adjusting. The people that are used to it (dropkick and myself in this situation) generally want to escape it because it is something we have experienced a large chunk of our lives. Rural areas are just like urban environments....they take a lot of adjustment. People's personalities differ. It was brought up in one of the other threads how ER docs in the midwest make a lot....but nobody really seemed to mention that there is a much stronger mentality in the midwest to go to the ER than the east coast. (from my experiences and a doc I shadowed that moved to where I am located) People use it as primary care source everywhere, but in the midwest everyone in their mother comes in for stuff.....I even saw a person come in for tooth pain because they thought the guy could do dental stuff.....

Incentives are important, but the real thing is to make the people want to return to the area rather than fleeing the hell out. I'm a pretty simple guy. Give me a walmart, movie theatre, grocery store, and a couple of places to eat and I'm probably fine....but there is a point where you could make 50 grand a year more and drive an hour to all of that or you could take the hit and be within 10 minutes and have extras. I guess for me it comes down to laziness.

 

[sunnyjohn]

Is PNUHS a "for-profit" entity?

If they added a nursing school they would be beating applicants off with a stick. Waitlists are 2-3 years long in the area.

 

[jawicobike]

I don't know about a nursing school, but there are rumors about trying to start a dental school and maybe a PA program after the DO school gets going.

 

[NonTradMed]

Generally agree, but we really do need more schools in the pacific northwest. The proposals to open new DO schools in places like New Jersey, NY and Pennsylvania are a little more distressing since those states already have plenty of schools.

MOre med schools are needed in states without med schools, and on the west coast. However, I think the newer DO schools are being added b/c of the demand for people who want to be doctors, not based on real need.

We need ways of enticing more docs to move to or to stay in these areas.

I dont know how to do it. If it were easy I think it wouldnt be a topic of discussion right now.

I'm skeptical there is really *any* way we can get doctors to stay in rural areas. The type of person who is attracted to medicine---ambitious college students who are focused on their career and have delayed gratification---are less likely to go into rural primary care than the general populace. This is a world wide problem, and I'm not sure there is a good solution.

 

[jawicobike]

What keeps getting lost in this whole debate is the schools that were opened with the intention of bringing docs to rural areas and haven't strayed from that. Putting a school in rural Kentucky has (and should continue to do so because of the students accepted) had an effect on the number of doctors in Eastern Kentucky. There aren't too many people who want to live in rural Kentucky who aren't from rural Kentucky, but those people from that area love it there and are going to set up practice there.

 

[Oculus Sinistra]

More med schools are needed in states without med schools, and on the west coast.

I'd like to see one in every state. That would definitely help out with the public perception of DO's.

I'm skeptical there is really *any* way we can get doctors to stay in rural areas. The type of person who is attracted to medicine---ambitious college students who are focused on their career and have delayed gratification---are less likely to go into rural primary care than the general populace. This is a world wide problem, and I'm not sure there is a good solution.

I absolutely agree. The percentage of people who are like DoctorMom is very small. It's awesome that she wants to do that but I understand why schools and states have a difficult time trying to convince ambitious premeds to give away most of their early adulthood to be paid in chickens.

I don't even know what I'd do with a chicken if someone paid me in chickens. It almost seems wrong to eat them, so basically they've just added to the list of pets I don't have time for because I'm a physician

Aye yie yie.

I honestly think we should stop kidding ourselves and reshape nurse/doctor education. If you want to go into primary care, become a nurse practitioner. There are plenty of nurses who'd love to move up and take those spots. On the other hand, if you want to be a specialist (like most med students do anyway), you go to medical school.

No more guilt-tripping the medical students, you fill your primary care residencies, and the nurses stop complaining about promotional ceilings.

And if you can throw in some free pizza somewhere along the way, the plan works out even better.

 

[Oculus Sinistra]

It's easy to say this, but putting it into practice is another matter. What would motivate a large university to opt for a DO program instead of an MD? With the increasing trend of fewer DOs going into primary care/OMM, I think it becomes harder to make a case that we need to train DOs over MDs.

In Florida they're opening up two new MD schools, which is of course amazing because MD schools almost never open.

I can definitely imagine universities wanting to open an MD school, getting shot down by the state, then partnering with people who were going to start up a private DO school anyway so they figured they might as well collaborate for the interests of everybody involved.

Medical schools, osteopathic or not, bring prestige to institutions. Lots of Tier 4 universities could use the benefit. I wouldn't think it a hard sell at all.

 

[NonTradMed]

In Florida they're opening up two new MD schools, which is of course amazing because MD schools almost never open.

I can definitely imagine universities wanting to open an MD school, getting shot down by the state, then partnering with people who were going to start up a private DO school anyway so they figured they might as well collaborate for the interests of everybody involved.

Medical schools, osteopathic or not, bring prestige to institutions. Lots of Tier 4 universities could use the benefit. I wouldn't think it a hard sell at all.

I think the difficulty of opening up MD schools has to do with the requirements of an MD school. You have to have X amount of money, show that the places where students do clinicals have Y number of beds etc. If it was up normal supply and demand, there would be MD schools popping up as much as DO schools (given the demand for med school spots). I think there has been artificial barriers deliberately created to prevent MD schools from opening based on supply and demand.

 

[dseattle]

with over 600+ do's practicing in washington, a new do school would do much to create visibility for the profession in this region that really needs more primary care physicians and health care professionals overall. also combined with atsu-com-mesa establishing a presence in seattle there is an even greater possiblity of gme and residencies here. i hope it happens in the next 4 years though.