不良研究所导航网址

Jafry, a medical student in a new teaching program that aims to bridge doctor shortages in smaller towns, listened as the patient described how after 25 years as a pipefitter, he began experiencing dizzy spells at work so severe he thought he might pass out. Last February he was diagnosed with Parkinson鈥檚. Jafry looked closely as he held up a picture on his phone of a brain scan.

It was late morning, and the patient was one of nearly a dozen Jafry had already seen with Dr. Briccio Cadiz during her second day in the primary care clinic in Festus.

Just a month into the program, Jafry said her eyes had been opened to the physician shortages suffered by many communities across the U.S. She reflected on her hometown of Naperville, a Chicago suburb of around 150,000 people.

鈥淭here鈥檚 so much access to health care there,鈥� Jafry said. 鈥淚t鈥檚 very different from Festus, where there鈥檚 such a shortage.鈥�

In June, 13 students arrived from the Lake Erie College of Osteopathic Medicine. They will spend the next two years in Jefferson County, shadowing doctors and finishing the final years of their medical degrees. Officials hope the program 鈥� Mercy鈥檚 first non-urban teaching site 鈥� can grow over time and show future doctors the opportunities available to them, should they choose careers in places like Jefferson County.

As it stands, patients in the area regularly spend months waiting for appointments, including many who drive in from smaller towns around eastern Missouri, where hospitals have steadily scaled back over the years.

Officials believe that the teaching program may offer a remedy for those shortages. They posit that doctors are more likely to take jobs in the communities where they were trained. And if they succeed, they will create a pipeline of health care workers for an area that needs them.

Academia takes note

The primary care clinic where Jafry spent the morning is on the outer edge of the St. 不良研究所导航网址 metro area, where Mercy has a 321-bed hospital and network of clinics. While the area has grown in population over the decades and leans suburban, the hospital campus there draws patients from smaller towns with fewer medical services.

Cadiz said many of his patients are of Medicare age, and tend to use more health care services than most. And specialists are hard to come by in the area. Getting a patient in to see the county鈥檚 only neurologist can take a year. Even the large medical centers 40 miles north in St. 不良研究所导航网址 are short of neurologists, so Cadiz at times refers patients 80 miles south to Cape Girardeau.

At another Mercy primary care clinic 13 miles west in Hillsboro, Dr. Emily Govro, who has also begun taking on students, said her patients sometimes drive in from an hour away. Living in areas with fewer medical services means some have untreated ailments, like diabetes or high cholesterol.

鈥淎 lot of people say, 鈥楾his is the first time I鈥檝e been to a doctor in 20 years,鈥欌�� Govro said. 鈥淭hey鈥檝e been walking around with a lot of stuff for a long time.鈥�

The world of academic medicine has taken notice of these shortages, said Kate McOwen, senior director of educational and student affairs for the Association of American Medical Colleges. In the U.S. there are now a growing number of so-called 鈥渞egional medical campuses,鈥� where, like the Mercy program, a school sends students to learn in a hospital or clinic in a smaller town.

And there are benefits to teaching programs in smaller communities. Students may get more one-on-one attention from their mentors, and it gives doctors there opportunities to have faculty appointments.

Dr. Michael Rowane, associate dean of clinical education for Lake Erie, recalled that when he worked for a health system in Ohio, the organization had small-town hospitals that received great patient satisfaction scores, but struggled to recruit doctors.

When officials studied the problem, they found that two types of people typically worked in those facilities: People who grew up in the area, and people who had early career experience there.

Curbside consults

Should Jafry 鈥� or any of her 12 peers in the program 鈥� one day return to Jefferson County to practice medicine, they may find themselves in a clinic not unlike Cadiz鈥檚. His primary care clinic is his patients鈥� gateway to the more complex specialists, procedures and tests they often need. It鈥檚 a 鈥渂oots-on-the-ground鈥� effort, Cadiz said, and it鈥檚 rewarding work.

Cadiz trained at SSM St. Mary鈥檚 Hospital in Richmond Heights, and did rotations in two of the region鈥檚 largest, busiest hospitals: St. 不良研究所导航网址 University Hospital and Barnes Jewish Hospital. But he went on to spend much of his career at Ste. Genevieve County Memorial Hospital, a 25-bed facility in the community where his wife鈥檚 family lives. After 20 years there, many of his patients followed him 30 miles north to Mercy鈥檚 campus in Jefferson County.

Practicing in a smaller community is different, Cadiz said.

鈥淭he resources are scarce,鈥� Cadiz said. 鈥淵ou鈥檙e a jack of all trades, master of none.鈥�

During Jafry鈥檚 second day in the clinic, as they moved from visit to visit, Cadiz asked after patients鈥� family members, many of whom he knew from a long career in Jefferson and Ste. Genevieve counties. As Cadiz listened to patients鈥� lungs, he adopted a gentle, joking tone to inquire if they had been smoking. He peppered his explanations of their ailments with references to historical figures: Dr. Friedrich Lewy, the German physician and eponym of Lewy Body Dementia; Charley, the fabled, stumbling equine who may have inspired the term 鈥淐harley Horse.鈥�

The visits often ended with a hug.

When Cadiz and his wife go to the grocery store, he said, she sometimes asks him to stay in the car, knowing that he may otherwise be pulled into a series of curbside consults.

鈥淚n the city it鈥檚 more like you鈥檙e a statistic,鈥� Cadiz said. 鈥淗ere, I go to their weddings. I go to their funerals. You share your life with the community.鈥�

Jafry said she was struck by the doctor鈥檚 relationships with his patients. In other clinics, Jafry observed, patients are often nervous to see a doctor. At the clinic in Festus, they were excited to see Cadiz.

鈥淗e doesn鈥檛 even have to look at their charts,鈥� she said. 鈥淗e treats them like family.鈥�

Jafry said she鈥檚 still open to all possibilities 鈥� from rural medicine to practicing in a big-city hospital. But, she said, during her short time in Jefferson County she鈥檇 already received a lot of one-on-one training, and the doctors, nurses and other staff had been welcoming in a way that you don鈥檛 always experience in bigger, urban hospitals.

鈥淵ou don鈥檛 get that sense of community and family when you go elsewhere,鈥� she said. 鈥淚t鈥檚 definitely opened my eyes to how welcoming the medical community could be.鈥�