August 3, 2008

New OU Program Focuses on Community Medicine

By April Marciszewski, Tulsa World, Okla.

Aug. 3--It's about caring for the entire community, not just individual patients.

It's about harnessing the altruism of first-year medical and physician assistant students before the hard work of school wears them down.

It's about walking down the street from a hospital, as University of Oklahoma-Tulsa President Dr. Gerry Clancy did almost 15 years ago in Iowa, and taking medical care to a homeless shelter full of people with mental illnesses.

But OU-Tulsa's new concept of community medicine isn't only about taking care of the health of the poor, Clancy said. It's also about putting a clinic in an office building so busy professionals can fit in doctor's appointments and keep up their productivity.

"It's about the entire health care system working better," Clancy said, challenging 20 new OU medical students and 20 physician assistant students at a summer institute last week to research and brainstorm solutions for Tulsa's health problems.

A $50 million donation from the George Kaiser Family Foundation to OU-Tulsa in February created the School of Community Medicine. The physician assistant students are already part of the school, and the medical students will complete their first two years of school

at the OU Health Sciences Center in Oklahoma City before having the option to choose the community medicine track starting their third year.

OU leaders hoped to inspire the new students with the joy of community medicine so they will return to it when they start their careers. The Kaiser gift includes financial assistance, so students won't be saddled with such enormous loan debt when they graduate and will be able to choose less lucrative but more philanthropic work.

Dr. Dan Duffy, an OU-Tulsa College of Medicine senior associate dean, said OU wants to shape students into "positive deviants" who will improve the health care system.

As part of the institute, OU-Tulsa sent students and professors across Tulsa last week to interview police, social workers, school leaders, prison employees, business people, doctors and others about Tulsa's health needs.

By the end of the week, students had come up with solutions to a few of the problems: understanding cultural differences as medical professionals take care of patients' health, addressing the medical needs of older people, using mapping tools to put medical resources where they're needed and more.

During one discussion, physician assistant students Holly Shalhoop and Jamie Teeter lamented that payment systems don't encourage doctors to spend 30 minutes -- or even 15 -- talking with patients about exercise or other preventive measures. Shalhoop also pointed out that patients who wait to see a doctor at one OU Bedlam Clinic end up missing the last buses of the night.

But within the same conversation, students also came up with a few answers. Shalhoop suggested teaching elementary school students about healthy eating and exercising.

Physician assistant student Sara Enyart said she wondered how effective that would be if parents were buying hot dogs, hamburgers and Twinkies for their children to eat.

"I was thinking, as a dietician, . . . if they had a low-income cooking class . . .," Shalhoop began, and others chimed in with their enthusiasm for the idea.

On Tuesday, students twisted the idea of shadowing and followed patients, instead of doctors, through their appointments at OU's Bedlam Longitudinal Clinic, where patients don't have to have insurance and they get to see the same doctor every time they visit.

First-year med student Ryan Huey of Tulsa chatted with Michael Butler of Broken Arrow about Butler's family, his soccer refereeing and their favorite steakhouse in Texas while Butler waited for a checkup for his diabetes.

Butler mentioned that he had lost 35 pounds after giving up eating french fries and his wife's chocolate chip cookies. His glucose blood count evened out.

"Have you been able to tell any difference?" Huey asked.

Butler said he had more energy and "I'm enjoying life right now."

The conversation returned to soccer and then morphed toward how Butler met his wife before they moved to an exam room and OU nursing student Brad Littleton asked preliminary questions and third-year medical student John Weber checked on Butler's medicines.

Huey thinks he'll choose the community medicine track two years from now because of the enthusiastic leaders at OU who aren't "afraid to try things."

Clancy said that's what OU wants out of the students, too. He told them, "Your fresh ideas are really important right now."

April Marciszewski 581-8475 [email protected]


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