medical mastermind community
DESCRIPTION
Medical Mastermind Community. The first ideal pipeline-like program for the geographically isolated and financially disadvantaged. Outline. Quality, affordable health care for all Medically underserved populations Physician supply and demand Distribution of physicians around the US - PowerPoint PPT PresentationTRANSCRIPT
1
Medical Mastermind Community
The first ideal pipeline-like program for the geographically isolated and financially
disadvantaged.
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
www.Medical-Mastermind-Community.com
3
Quality, Affordable Health Care For All
http://www.amsa.org/about/
www.Medical-Mastermind-Community.com
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
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
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
www.Medical-Mastermind-Community.com
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
www.Medical-Mastermind-Community.com
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!
www.Medical-Mastermind-Community.com
9
Distribution of Physicians in the US
www.Medical-Mastermind-Community.com
10
Distribution of Physicians in the US
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
12
Logic for Selecting the Underserved
• N = 20,112 (64% of graduates in 2003-2004 on an AAMC survey)
www.Medical-Mastermind-Community.com
13
Logic for Selecting the Underserved
• Physicians serve people like themselves…
www.Medical-Mastermind-Community.com
14
Logic for Selecting the Underserved
www.Medical-Mastermind-Community.com
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
www.Medical-Mastermind-Community.com
16
Logic for Selecting the Underserved
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)
www.Medical-Mastermind-Community.com
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
www.Medical-Mastermind-Community.com
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
Take home point:
• AAMC’s AspiringDocs.org
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.
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
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!
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
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
www.Medical-Mastermind-Community.com
26
Efforts to Remedy the Imbalance
www.Medical-Mastermind-Community.com
27
Efforts to Remedy the Imbalance
www.Medical-Mastermind-Community.com
28
Efforts to Remedy the Imbalance
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
30
Efforts to Remedy the Imbalance
• Origin of Magnet Schools like Debakey:
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
32
To be fair and balanced:
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
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.”
www.Medical-Mastermind-Community.com
35
Efforts to Remedy the Imbalance
• GPA 3.25, MCAT 23
www.Medical-Mastermind-Community.com
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
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
38
Efforts to Remedy the Imbalance
www.Medical-Mastermind-Community.com
39
Efforts to Remedy the Imbalance
www.Medical-Mastermind-Community.com
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
www.Medical-Mastermind-Community.com
41
Efforts to Remedy the Imbalance
• AAMC’s HPPI program:
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
43
Efforts to Remedy the Imbalance
• AOA
– What are you doing?
– Go Dr. Bowman!
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
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”.
www.Medical-Mastermind-Community.com
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”.
www.Medical-Mastermind-Community.com
47
Efforts to Remedy the Imbalance• Are we part of the solution here?• What about Gantz vs. Bollinger?
www.Medical-Mastermind-Community.com
48
Efforts to Remedy the Imbalance• Great program, but white people drink
over there…
www.Medical-Mastermind-Community.com
49
Efforts to Remedy the Imbalance• AMA
– Funds scholarships– Health Care Reform lobbying
www.Medical-Mastermind-Community.com
50
Efforts to Remedy the Imbalance• AMSA
– Health Care Reform lobbying– Diversity Education– AMSA Foundation funds programs
www.Medical-Mastermind-Community.com
51
Efforts to Remedy the Imbalance• What can I do solve this problem for my
generation?
• JOIN AMSA!
www.Medical-Mastermind-Community.com
52
Physician Supply and Demand
www.Medical-Mastermind-Community.com
http://www.aamc.org/workforce/workforceposition.pdf
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 - 2025.
• Recall that Justice Day O’Conner said affirmative action should end by 2028.
www.Medical-Mastermind-Community.com
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, 2003.
– That would be an automatic, built-in discriminator of persons.
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
56
Grant Solutions and Future Research
www.Medical-Mastermind-Community.com
57
Grant Solutions and Future Research
www.Medical-Mastermind-Community.com
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.”
www.Medical-Mastermind-Community.com
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
www.Medical-Mastermind-Community.com
60
Grant Solutions and Future Research
• Geographic Information Systems can aid delivery of tele-mentoring programs.
www.Medical-Mastermind-Community.com
61
Grant Solutions and Future Research
www.Medical-Mastermind-Community.com
62
Grant Solutions and Future Research
www.Medical-Mastermind-Community.com
63
Take Home Point
• Active grant-funded programs use web-based software can be used to assess students.
www.Medical-Mastermind-Community.com
64
Ideal vs. Non-Ideal Pipeline Programs
• Geographical Solution: telementoring
www.Medical-Mastermind-Community.com
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.
www.Medical-Mastermind-Community.com
66
Grant Solutions and Future Research
• Emotional Intelligence development and periodic assessment
• Wellness Program: Stress Management development and periodic assessment
• Diversity Awareness Training
www.Medical-Mastermind-Community.com
67
Special Thanks• AMSA• Dr. Robert Bowman• AAMC• AMSA Foundation• Robert Wood Johnson Foundation• National Science Foundation• W.K. Kellogg Foundation• The Rockefeller Foundation
www.Medical-Mastermind-Community.com
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
www.Medical-Mastermind-Community.com
69
Premedical Institute of Enrichment
www.Medical-Mastermind-Community.com
The first ideal pipeline-like program for the geographically isolated and financially
disadvantaged.