Exodus of medical graduates in Arizona stirs concerns

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by Ken Alltucker - Apr. 24, 2012 11:17 PM The Republic | azcentral.com

Medical schools in Arizona more than doubled their enrollment in the past decade, but most of those young doctors won't establish a practice in your neighborhood or work at a local hospital.

That is because most students who graduate from Arizona medical schools train out of state, and physicians are more likely to establish careers where they complete their residency training during those pivotal years after medical school.

One key reason that medical-school graduates leave Arizona is that the state does not have enough residency slots at hospitals or community health centers that allow doctors to train and practice their craft after graduating. The shortage has been made worse by a federal limit on Medicare-funded slots, state funding cuts to graduate medical education and some hospitals' reluctance to start or expand training programs.

Medical-school representatives and business leaders say the physician training crunch is an issue that affects health, quality of life and the economy in Arizona, where there is an ongoing physician shortage. With two new medical schools planned, the problem could grow even larger.

"We talk about importing physicians, but we are exporting graduates," said Lori Kemper, dean of the Arizona College of Osteopathic Medicine at Midwestern University of Glendale.

Kemper and other medical-school representatives met Tuesday at the University of Arizona College of Medicine-Phoenix to discuss a newly released report funded by St. Luke's Health Initiatives, a health-policy foundation, about Arizona's medical education challenges.

The report shows that Arizona ranked 20th in the nation in medical-school enrollment but 37th in the number of residency slots. The report suggests the state needs to add 848 to 885 residency slots at a cost of $89 million to $93 million to meet national averages.

If medical-school students train in Arizona, they are much more likely to practice medicine here. The St. Luke's report shows that 75 percent of active physicians who graduated and trained in Arizona stayed, while only 28 percent of Arizona medical-school graduates who completed training out of state returned to Arizona to practice.

Most residency slots are paid by the federal government through agencies such as Medicare and the Department of Veterans Affairs. The Medicare program, which provides about two-thirds of government funding for residency slots in Arizona, has capped funding of most new residency slots since 1997. Since then, Arizona's population has grown more than 25 percent.

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Exodus of medical graduates in Arizona stirs concerns

UHealthSolutions to Provide Patient Communications Services to Edward M. Kennedy Community Health Center in New Pilot …

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WORCESTER, Mass.--(BUSINESS WIRE)--

UHealthSolutions, Inc., a University of Massachusetts Medical School affiliate, is piloting enhanced patient communications services for community health centers through a new partnership with the Edward M. Kennedy Community Health Center (Kennedy CHC). The two organizations will work collaboratively to design and develop a suite of services targeted toward the needs of community-based health care organizations.

UHealthSolutions, a nonprofit company that manages business operations for health care organizations, will provide the Kennedy CHC with after-hours answering services, patient scheduling, and outbound appointment reminder calls giving the Kennedy CHC clinicians and support staff more time to engage with patients and provide patient care. UHealthSolutions is committed to promoting a culturally competent and linguistically diverse workforce to ensure an engaged experience for patients. The opportunity to partner with the Kennedy CHC will provide valuable insight to UHealthSolutions in the design and implementation of enhanced patient communications services for community-based health care organizations.

I am excited to start this relationship with the Edward M. Kennedy Community Health Center, said David P. Crosby, managing director, UHealthSolutions. This collaborative approach ensures that the patient is at the center of all communications, and allows health center staff to do what they do best provide exceptional patient care.

This new relationship will allow us to realign resources and focus our attention on the patient, said Antonia G. McGuire, Kennedy CHC president and chief executive officer. Kennedy CHC is a private, nonprofit community health center that serves over 100 communities in the greater Worcester and Metrowest areas. I look forward to working with Dave and the UHealthSolutions team to create and deliver additional communications services to better serve our patients.

About UHealthSolutions, Inc.

As a nonprofit affiliate of the University of Massachusetts Medical School, UHealthSolutions, Inc., takes a different approach to developing innovative, effective and cost-saving business solutions for health care clients. UHealthSolutions uses evidence-based methods and a clinical focus to assess the needs of health care organizations.

Formerly known as Public Sector Partners, UHealthSolutions is a 501(c)(3) nonprofit health care management and consulting firm. Since 2001, the organization has been committed to improving health care services by offering a full array of third-party administration, patient communication, program management, technology and consulting services.

About the University of Massachusetts Medical School

UMass Medical School, one of the fastest growing academic health science centers in the country, has built a reputation as a world-class research institution, consistently producing noteworthy advances in clinical and basic research. The Medical School attracts more than $270 million in research funding annually, 80 percent of which comes from federal funding sources. The mission of the Medical School is to advance the health and well-being of the people of the commonwealth and the world, through pioneering education, research, public service and health care delivery. Commonwealth Medicine, the Medical Schools health care consulting and operations division, provides a wide range of care management and consulting services to government agencies and health care organizations. For more information, visit commed.umassmed.edu.

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Campbell medical school gets go ahead, hopes to address physician shortfall

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Campbell Universitys medical school took an important step toward becoming the fifth medical school in the state.

The Commission on Osteopathic College Accreditation awarded Campbells School of Osteopathic Medicine provisional accreditation status, which allows the school to begin recruiting applicants for its inaugural class for August 2013. The status was awarded Friday and is effective July 1, according to a Campbell University press release.

The school aims to eventually produce 150 primary care physicians each year, addressing an often-noted nationwide shortage. In particular, the school will look to aid rural and poor areas that experience the biggest shortfalls in medical care. After two years at the new facility, third- and fourth-year medical students will train in community hospitals across the state, according to the schools dean, Dr. John Kauffman.

This is an exciting moment, said Dr. Jerry Wallace, president of Campbell University. This medical school will train primary care physicians to address a critical shortage of healthcare professionals throughout our state.

Campbell joins established medical schools Duke, Wake Forest, UNC-Chapel Hill and East Carolina University as accredited med schools in the state. According to data from the American Association of Medical Colleges, those four schools currently enroll roughly 2,000 students, meaning that with an eventual goal of 600 students, the states capacity to produce doctors could rise nearly 30 percent.

That goal would give Campbell University the second-highest enrollment in the state after UNC.

The primary care physicians that Campbell intends to recruit will address a pressing need. The AAMC estimated in 2010 that the already-strapped field could face a nationwide shortage of 63,000 physicians in 2015 as millions of Americans acquire health care under the Affordable Care Act. Specialists also face a shortage, even while earning substantially more than primary care doctors.

Rural areas face the greatest shortages, and Kauffman said he hopes doctors will continue to live and work in such communities after they finish their two years earning their medical degrees there.

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Campbell medical school gets go ahead, hopes to address physician shortfall

‘Significant’ UM medical school cutbacks coming in May

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University of Miami President Donna Shalala announced Tuesday that the medical school will take difficult and painful but necessary steps next month to reduce costs, including staff cuts.In a letter to employees, she called the cuts significant but provided no details about how many employees might be laid off.

The process will take place in stages, and affected employees will be notified during the month of May, Shalala wrote. Reductions will not impact clinical care or our patients and will primarily focus on unfunded research and administrative areas.

Shalala said the cuts were necessary because of unprecedented factors including the global downturn of 2008, decreased funding for research and clinical care, plus cutbacks in payments from Jackson Health System. The Jackson reductions have had a profound effect on our finances, she wrote.

UM is not alone. Many medical schools are having to make difficult decisions, particularly because of the growing difficulties in getting research grants, said Ann Bonham, chief scientific officer of the Association of American Medical Colleges.

Sal Barbera, a former hospital executive now teaching at Florida International University, said UM created many of its own problems when it bought Cedars Medical Center in 2007 for $275 million. Paying off that debt is a significant financial responsibility, he said.

Jackson Health System, which has lost $419 million the past three years, cut its payments to UM by $16 million this year, and next fiscal year is working on a new operating agreement with UM that could mean far more drastic reductions.

In her letter, Shalala wrote that UM reaffirmed our continued commitment to our partnership with Jackson.

Since the arrival of Pascal Goldschmidt as medical school dean in 2006, expansion has been swift. UHealth, the clinical enterprise , now employs more than 8,200 employees, according to the UM website. Employees are working on 1,500 research grants, funded by $200 million in outside private and public grants.

The schools financial problems have been exacerbated by the shrinking of federal research dollars, and UM researchers, like those elsewhere, have found themselves battling for grants.

A number of medical schools are having serious conversations and looking hard at medical research, said Bonham, the AAMC officer. She said the National Institutes of Health, the primary funding source for research, is now only granting about one in every six applications, a historical low.

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‘Significant’ UM medical school cutbacks coming in May

Campbell University's medical school cleared to recruit students

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BUIES CREEK - Campbell University's medical school has been cleared to recruit students.

The Commission on Osteopathic College Accreditation decided Saturday to give Campbell's School of Osteopathic Medicine provisional accreditation status. The accreditation, which becomes effective July 1, allows the school to admit students and offer medical instruction with an approved osteopathic curriculum.

Medical school officials can recruit students before the accreditation status becomes effective.

Dr. John Kauffman, the medical school's founding dean, said the school will begin accepting student applications June 1. Classes are expected to start in August 2013.

Campbell officials say the medical school will eventually graduate about 150 doctors a year. Many will go on to practice in rural areas of North Carolina, they say.

Students will spend their first two years training in a 96,500-square-foot medical school being built on U.S. 421. Third and fourth year medical students will train in community hospitals across the state, Kauffman said.

Jerry Wallace, president of Campbell University, said the accreditation is exciting for Campbell, the medical school, Harnett County and North Carolina.

"This medical school will train primary care physicians to address a critical shortage of healthcare professionals throughout our state," he said.

- Steve DeVane

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Campbell University's medical school cleared to recruit students

University of Colorado medical school heals diversity gap

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Over the past six years, the University of Colorado has more than tripled the number of racially and ethnically diverse students enrolled in its medical school on the Anschutz Medical Campus in Aurora.

Just 11 percent of the 144 students in the class of 2005 were minorities, compared with 33 percent of the 160 students in last year's graduating class.

The university has made a concerted effort to improve diversity among its students since its accrediting body the Liaison Committee on Medical Education cited the school for "noncompliance" in 2010, when just 106 of 614 students were minorities. The medical school is not scheduled for another visit until 2016-17.

"It was abysmal," said Dr. Rob Winn, associate dean for admissions at the medical school. "Part of the problem here had been the traditional approach that Colorado has mountains, and mountains attract people. That may be true, but it may not attract kids from inner-city Philadelphia."

While grades are important, Winn looks at much more, including standardized tests, life experiences, research activity, clinical participation and especially community service.

"We don't seek diversity, we seek excellence," Winn said. "They need to have the ability to articulate their passion for helping others. That's what taking the job of a doctor is."

Winn and his staff approached the job as a relationship-building exercise. They reached out to student advisers and faculty nationwide to make sure they were aware of CU's program.

The strategy has worked. Over the past decade, the number of applicants to the medical school has increased from 2,148 in 2001 to 5,425 so far this year for just 160 spots. The admissions department interviews 700 students to cull the number.

"If we could expand the class to 400, we'd get 400 amazing students," Winn said.

It's not just ethnic and racial diversity that's important to the university. The admissions department also is seeking geographic diversity. About a third of the school's students were from out of state last year, compared with just 10 percent a few years ago.

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Step One: A Medical School Pivot Point

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The morning of my Board exams, my mother packed me a lunch comprising of seedless grapes, two Greek yogurts, a cheese sandwich, a bag of pistachio nuts, two cappuccinos, a diet coke, chocolate-covered coffee beans and a pouch of pretzels.

Mum, this isnt the Hunger Games, I joked.

Well no duh. You have absolutely zero hand-eye coordination, she said.

I gave her a sour look.

But if there was ever a nerd equivalent, this would be it, I said, compensating. Someone needed to deliver a pep talk, after all, and clearly mum wasnt stepping up. Today, I do battle.

Mum ignored my inquiries about whether we had any war paint lying around the house. But this was hardly overkill. The USMLE Step 1 exam, otherwise known as the Boards, is an eight-hour test, designed to test medical students of the completeness and depth of their preclinical learning. Commonly taken right at the end of the second year of medical school, before students transition from classrooms onto the hospital wards, the exams represent a months-long effort on our part to frantically cram mountains of information, from the basics of mitosis to the specifics of anti-diarrheals, in hopefully a systematic and organized way. The three-digit score that one receives four weeks later plays a part in determining a students competitiveness for certain residencies and such. To what extent no one can really say. And therefore no one wants to chance it.

Did I mention that its an eight-hour test?

Much this year has been about such numbers. The number of hours you can study a day. The number of practice questions. Percentages. Percentiles. Five-hour energy drinks. The number of times you looked over the glycolysis pathway and still forgot an enzyme. The number of simulated tests. The number of days you overslept and missed classes out of sheer exhaustion.

In late September, I met with an academic advisor at school for help in planning a study schedule. She pulled out a college-ruled notebook and drew a long horizontal line intersected with many little strokes. In neat print, she outlined the various books and web resources I might find helpful and the goals I needed to be reaching by various dates on the timeline. She had relationships with many a successful student in the past, she said. I nodded fervently. Surrounded on all sides by what I could do, I just wanted someone to tell me what I should.

I would advise you that as you move closer to test, to limit how much time you spend on other activities, she said.

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Step One: A Medical School Pivot Point

MU medical school eyes Springfield expansion

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By Jodie Jackson Jr.

Saturday, April 7, 2012

Expanding the University of Missouri School of Medicine to include a clinical campus in southwest Missouri would require an estimated $30 million building project in Columbia.

A proposed new medical school teaching facility would provide education for an additional 32 medical students, increasing by one-third the number admitted each year to the MU School of Medicine. The first two years of the program would be spent in Columbia; the third and fourth would be spent training with physicians in the Springfield area. Officials outlined the plan yesterday at a Springfield news conference.

An economic impact study suggested construction alone would add 475 jobs and $56.5 million to the state's economy, with significantly higher impact once trained doctors are in place.

MU School of Medicine officials and representatives of Springfield hospitals Sisters of Mercy Health and CoxHealth began discussing the plan more than two years ago. The Springfield hospitals initiated the talks with an eye on aging baby boomers, demand for rural doctors and the steady flow of retiring family physicians.

"There's just not enough physicians to take care of the current population, let alone the increasing population over the next 20 years," said Weldon Webb, associate dean for rural health at the MU School of Medicine.

David Barbe, regional division president of Mercy Clinic, said building a new free-standing medical school in Springfield would cost $500 million to $800 million, so this plan could increase the number of medical school students "at the least possible cost."

"Any other model would cost more," he said, adding that new buildings, labs and faculty would be needed in Columbia to accommodate a larger crop of students.

"Right now in Columbia, they're on top of each other," Barbe said. "We couldn't shoehorn another in if we had to."

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Harvard Medical School Adviser: Fix underlying cause of Baker's cyst

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QUESTION: I have a Baker's cyst in my right knee. I've had it drained twice, but it keeps coming back. Are there any other treatments? Is there an operation that can fix it once and for all?

ANSWER: Your situation is fairly common. A Baker's cyst (also called a popliteal cyst) is a fluid-filled sac that can develop in the popliteal space, the hollow at the back of the knee joint.

Baker's cysts are named for William Morrant Baker, a 19th-Century surgeon who first described the condition. The cyst is filled with synovial fluid, which lubricates the knee joint. Synovial fluid reduces friction between the various parts of all your joints, including your knee, which needs lubrication to flex and extend smoothly.

Although there are several ways to treat a Baker's cyst, surgery is an uncommon choice. But whatever the treatment, the cyst will often recur if the underlying cause hasn't been corrected.

A Baker's cyst can be caused by an injury to the knee, such as a tear in a meniscus. Damage to the cartilage from conditions such as rheumatoid arthritis or osteoarthritis can lead to Baker's cysts. These conditions may cause the synovial cells lining the knee joint to produce excess fluid. If the fluid bulges into the popliteal space, a cyst can develop. The excess fluid could cause the whole knee to become swollen, too.

A Baker's cyst is often found during a physical exam or an ultrasound performed for other reasons. It may cause no symptoms at all. But it can cause pain, swelling and joint stiffness. Sometimes the bulge is so large that it's hard to fully bend or straighten the leg.

Baker's cysts aren't dangerous, and they may go away on their own. But, occasionally, they burst. If that happens, synovial fluid can leak into your calf below, causing pain and swelling.

These symptoms are similar to the symptoms associated with having a blood clot in your calf, deep vein thrombosis (DVT). DVT is a serious condition that requires immediate treatment. That's why it's important to find the source of the problem right away.

If your Baker's cyst causes discomfort or interferes with your daily activities, there are several things you can do. To bring down swelling, apply a cold pack to the area or use a compression wrap. To reduce inflammation, take an over-the-counter nonsteroidal anti-inflammatory drug such as ibuprofen (Motrin or Advil).

Because stress on the knee joint can increase inflammation, rest your leg and keep it elevated whenever you can. When you're up and about, use a cane or crutch. Sometimes, as in your case, a Baker's cyst needs to be drained. Your doctor may want to inject cortisone into your knee joint to quell inflammation.

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Harvard Medical School Adviser: Fix underlying cause of Baker's cyst

Fox In Socks! Dartmouth Names Its Medical School After Dr. Seuss

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Adam Cole/NPR

An imagined new facade for Dartmouth's school of medicine (with apologies to Dr. Seuss).

At the college of Dartmouth, in the year '24 There lived a young humorist named Theodor. Though boozing was banned as a crime and a sin, Theo hosted a party with plenty of gin. But then in through the door without even a knock Burst the grinch who stole gin-mas: Dean Craven Laycock.

The dean started shouting. His face turned bright red. "Put down your tumbler and listen up, Ted! I'm kicking you out of those clubs that you're in. Your work won't be published at Dartmouth again!"

But Theodor just wouldn't take such abuse He published again with the nom de plume Seuss! Well, that name stuck. It's the one he would use For Green Eggs and Oobleck and Horton and Whos. Folks bought his books for their sons and their daughters And Seuss sent the cash back to his alma mater.

Spring turned to summer and summer to autumn (That whole gin episode was completely forgotten) 90 years passed. And then: a great honor For Dartmouth's most famous, least medical doctor They've renamed their medical school after him And his wife! "It's a tribute," says President Kim*.

But I have a question (and maybe it's strange): With this new name will the school itself change? Will students write poems and skip their exams Or learn to prescribe green eggs and green ham? If your dear father's heart has come to a stop Will your Dartmouth-trained doctor advise, "Hop on pop"?

Millions of Dr. Seuss fans are grateful for his cute pictures and great rhymes, but Dartmouth College is also grateful for his donations.

Dr. Seuss whose real name was Theodor Geisel (Dartmouth Class of 1925) liked to share his wealth with his alma mater, where he edited the humor magazine, the Jack-O-Lantern, until he was caught drinking gin.

In return, this week the New Hampshire college officially renamed its medical school "The Audrey and Theodor Geisel School of Medicine" in honor of the author and his second wife, a nurse, who is the 90-year-old curator of her late husband's works. (Dr. Seuss died in 1991.)

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Fox In Socks! Dartmouth Names Its Medical School After Dr. Seuss

Booming medical school brings life to downtown Pomona

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The economic downturn was tough on the urban core of many U.S. cities. But Pomona got a booster shot from an unlikely source: Western University of Health Sciences.

The institution constructed a new clinic and a classroom building as part of a $110-million expansion. The school had previously rehabilitated existing retail space in Pomona's once-blighted center. Its Health Professions Center, for example, is a renovated former Buffum's department store. Nearby, a building that once held a JCPenney houses the University Research Center.

The changes have helped entice developers to construct residential lofts downtown. New businesses are sprouting. There's even a bi-monthly art walk.

"It's humming down there," said Frank Garcia, executive director of the Pomona Chamber of Commerce. "Things are starting to come alive. Restaurants are coming back."

Western University is also well-positioned to take advantage of changing U.S. demographics. As the American population ages, primary care doctors are expected to be in short supply.

Its osteopathic medical school, the College of Osteopathic Medicine of the Pacific, is one of only two in the state and has been churning out general practitioners for more than three decades. With nearly 1,000 students, enrollment is up more than 40% since 2000.

Many of the students were attracted by the institution's philosophy of patient-focused, holistic healing. Most of them probably will become primary care doctors, reflecting a core tenet of the institution: to provide care for patients in underserved areas.

"We try to pay attention to our community and needs of state, and we were rewarded by prospering in that way to grow," said Clinton Adams, dean of Western University's osteopathic medical school.

Started in 1977, private, nonprofit Western University began as a tiny osteopathic school in a strip mall with a few dozen students. Today it encompasses nine colleges that train nurses, pharmacists, dentists and other healthcare professionals.

With total enrollment of 3,300 students and 900 full-time staff members, Western University is among Pomona's largest employers and an anchor of the city's downtown.

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Booming medical school brings life to downtown Pomona

El Paso medical school offers lessons for Austin's effort

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By Ralph K.M. Haurwitz

AMERICAN-STATESMAN STAFF

Updated: 11:08p.m.Sunday,April1,2012

Published: 8:49p.m.Sunday,April1,2012

EL PASO The Rock Kiss bar, with its neon pink walls, stands a few steps from the Paul L. Foster School of Medicine, the state's newest medical school. Although a sign advertises happy hour, the bar is shuttered, having been acquired by the growing school to make way for a parking lot, trees and shrubs.

Across the street, a children's hospital opened earlier this year, as did an adjacent women's hospital within a recently renovated county hospital.

Thus, in ways large and small, a sizable medical complex is emerging in El Paso, a high-desert city of 649,000 people along the border with Mexico and New Mexico.

Political, business and nonprofit leaders reached a consensus more than 10 years ago that educating medical students, treating patients and exploring biotechnology are essential to the future well-being of this area's people and economy. Several hundred million dollars from local tax proceeds, legislative appropriations and philanthropic donations have flowed into the effort.

Probably the singular thing here was to have a very consistent message that this is the most important thing to us," said Woody Hunt, a businessman and philanthropist who helped organize a 1998 economic summit that focused attention on the health care field following the collapse of the garment industry, which had been an economic mainstay.

Hunt added, "You've got to have vision. You've got to be organized. You've got to be patient."

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El Paso medical school offers lessons for Austin's effort

MU medical school seeks to establish Springfield campus

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SPRINGFIELD, Mo. -- Mizzou wants to expand its medical school by partnering with both Mercy and Cox in Springfield.

This is in the planning phase but the hope is this partnership will help bring more doctors to rural areas of southwest Missouri.

A recent study says 90% of Missouri counties lack adequate access to physicians with Webster County being among most needy.

In a nutshell, Mizzou medical students will come to Springfield and do their residency with either Mercy or Cox. In 10-years, 51-medical students and 27-physicians will be in place in southwest Missouri.

MU says the Springfield "campus" would offer significant economic benefits to the state, create thousands of new jobs and expand medical care in rural counties.

The MU medical school now admits just 96 new students each year out of 1,500 applicants. That makes its enrollment about half those of such institutions such as the Kansas City University of Medicine and Biosciences and the medical school at Saint Louis University. ----

Edited news release from MU School of Medicine:

Medical Education Expansion Would Enhance Economy, Create Jobs Clinical Campus Supporters Announce Economic Impact and Investment Figures

A plan to improve health by expanding medical education in southwest Missouri would add more than $390 million annually to the states economy and create 3,500 new jobs. The economic growth figures were unveiled Friday at the Springfield Area Chamber of Commerce by supporters of establishing the citys first medical school clinical campus.

CoxHealth and Mercy Health Systems in Springfield and the University of Missouri School of Medicine in Columbia are designing the campus to expand MUs medical student class size and meet the need for more physicians. More than 90 percent of Missouri counties lack adequate access to health care professionals. Missouri also ranks among the top 20 states in terms of the number of people 65 and older who will require more medical care as they age. While the number of elderly is expected to double by 2030, the number of physicians who care for aging patients with chronic illnesses is expected to decline.

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MU medical school seeks to establish Springfield campus

MU medical school seeks Springfield campus

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COLUMBIA, Mo. (AP) Faced with a national shortage of rural physicians, heavy but unmet demand from would-be doctors and limited classroom space, the University of Missouri wants to expand its medical school with a second campus in Springfield.

The Columbia-based School of Medicine joined health care providers CoxHealth and Sisters of Mercy Health to support a clinical campus in southwest Missouri. The program would provide third- and fourth-year medical students who started their training in Columbia with hands-on experience treating patients at two Springfield hospitals, under the supervision of doctors at CoxHealth and St. Johns Hospital, which is owned by the Mercy Health system. The plan was outlined Friday afternoon at a news conference at the Springfield Area Chamber of Commerce.

You literally require more patients to build up a medical school, said Steve Edwards, president and chief executive officer for CoxHealth. And Springfield is one of the largest cities in the country without a medical school.

Most of the medical schools physical expansion would occur in Columbia, which now admits just 96 new students each year from 1,500 applicants.

That makes the medical school at the states largest university roughly half the size of peer institutions at St. Louis University, Kansas City University of Medicine and Biosciences and even the Kirksville College of Osteopathic Medicine at A.T. Still University, in terms of student enrollment. Under the proposed expansion, Missouri would boost its first-year class by 32 students, a one-third increase.

And doctors trained in Columbia nearly 45 percent are more likely to remain in the state after they graduate, said Weldon Webb, associate dean for rural health at the University of Missouri School of Medicine.

Were the No. 1 provider of practicing physicians in the state, even though we are one of the smaller programs in Missouri, he said.

Edwards and other boosters of the Springfield program note the region is growing faster than the rest of the state, particularly in the resort town of Branson and communities near Table Rock Lake. A recent Missouri Hospital

Association report shows the states rural areas have fewer primary care physicians per person than urban ones, with a disproportionate share of rural doctors approaching retirement age.

We forecast future needs that will outstrip our ability to serve the region, Edwards said.

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MU medical school seeks Springfield campus

Ex-Temple med school official sentenced in fraud case

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Former Temple University physician and medical school assistant dean Joseph J. Kubacki was sentenced in federal court Thursday to more than seven years in prison after being convicted by a jury of defrauding Medicare, private insurers, and patients by filing false medical claims.

Kubacki, 63, was convicted in August of 150 counts of health-care fraud, wire fraud, and making false statements in health-care matters. U.S. District Judge Eduardo C. Robreno also ordered Kubacki to repay Temple about $1 million and patients a total of $5,445 for co-pays they should not have been billed for.

Kubacki was chairman of the ophthalmology department at Temple University School of Medicine and also served as an assistant dean. According to prosecutors, he submitted false claims amounting to $4.5 million in charges for services to patients he did not see or evaluate between 1996 and 2007.

"Health-care fraud costs the public billions of dollars a year," U.S. Attorney Zane Memeger said in a statement. "But when an accomplished member of the medical profession perpetrates this type of fraud, the costs cannot be measured in dollars alone. Fraud erodes public trust, and today's sentence should send a message that regardless of your stature in society, the government will seek significant prison time for violating that trust."

Nick DiGiulio, special agent in charge for the Department of Health and Human Services' Office of Inspector General, said: "We rely on honest citizens and health-care workers to turn in dishonest people. We want people to call our hotline," 800-447-8477.

Temple personnel discovered Kubacki's actions and turned him in to prosecutors. Public and private insurers are being reimbursed by Temple nearly $1.8 million.

"Kubacki acted on his own initiative and in defiance of Temple's repeated compliance training about proper billing method," university spokesman Ray Betzner said via e-mail. "Temple trusted Kubacki, and Kubacki abused that trust."

Kubacki's attorney, Judson Aaron, said Kubacki's previously distinguished career ended as a "human tragedy."

Contact David Sell at 215-854-4506 or dsell@phillynews.com, or follow on Twitter @PhillyPharma. Read his "PhillyPharma" blog on philly.com.

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Bristol Evening Post published Prominent doctor fails to overturn his ban on contacting former…

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A FORMER Bristol Medical School lecturer and renowned researcher has failed to get a restraining order against him lifted.

Cardiac physiology specialist Dr Allan Levi is banned from making any contact with his ex-wife Dr Jackie Addison, who practises as a GP in Shirehampton.

A court heard the pair, who have three grown-up children, had an acrimonious divorce in 2001 after Dr Addison had an affair with their gardener, Gordon Strong. Following a number of offensive letters sent by Dr Levi to Dr Addison, her parents, sisters and work colleagues, a restraining order was imposed in May 2004.

Yesterday, Dr Levi represented himself as he made an application at North Somerset Magistrates' Court to lift or vary the order.

It bans him from any contact with his ex-wife except through solicitors for matrimonial matters and from going anywhere she resides or works. One aspect, "clause C", makes it an offence for Dr Levi to send any correspondence or documents concerning his relationship with Dr Addison or his relationship with his children to any person or organisation apart from his parents, sister or legal advisors. Since, 2004, he has also been banned from contacting Mr Strong in any way, and he also applied to lift that condition yesterday.

Dr Addison, of Easton-in-Gordano, told the court: "I feel the current restraining order, as it is, is sufficient to protect me from having to go through what I went through in 2003 and 2007 and I feel that if it was dismissed, something would happen again."

Asked by Paul Ricketts, on behalf of CPS, what her specific fears were, she added: "That he'll start again basically, which will cause huge distress to me and my family, and particularly the children."

Much of Dr Levi's argument focused on clause C, which he believes is severely damaging his medical career.

"It is greatly unjust and disproportionate," he said. "It is a very wide-ranging and unusual clause to have in a restraining order."

In September last year, the General Medical Council suspended the 56-year-old from practising medicine for a year. Significant factors in that decision were the harassment conviction and restraining orders, and a diagnosis from 1999 that he suffered from bipolar mental disorder.

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Bristol Evening Post published Prominent doctor fails to overturn his ban on contacting former...

Harvard Medical School Adviser: Research shows that coffee is safe for your heart

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QUESTION: I drink coffee every day, sometimes as much as three or four cups. I also have heart disease. I'd hate to give up coffee, but I worry it may be adding to my heart trouble. Should I quit or cut down?

ANSWER: Coffee is popular because it tastes good, and it makes most people feel better. Perhaps that's why it's been blamed for innumerable woes. Some people assume that anything that feels good or tastes good must be bad for you.

Coffee has taken the rap for serious illnesses ranging from heart attacks and strokes to cancer of the pancreas. Careful studies have debunked these fears, but lingering concerns persist.

That's why coffee lovers will welcome a study that makes coffee seem a bit sweeter. The research was conducted in Israel, where coffee is nearly as popular as in the U.S.

Instead of testing coffee in a cup, a team of Israeli scientists evaluated its most notorious ingredient, caffeine. Their subjects were 80 volunteers with an average age of 53. Half the participants had stable coronary artery disease, while the others were free of cardiovascular disease; 83% were male.

Each volunteer underwent two tests, performed one to two weeks apart. On each occasion, endothelial function -- critical to vascular health -- was tested just before and again one hour after the individual swallowed a capsule containing the test substance. On one of the two tests, the capsule contained a placebo; on the other, it contained 200 milligrams of caffeine, about 2 1/2 times the amount in a typical cup of coffee.

Caffeine actually improved endothelial function. The improvement was substantial in both groups, but was greater in the healthy subjects than in the patients who had atherosclerosis. Caffeine did not affect the response to nitroglycerin, a standard drug for angina, in either group.

The study does not make coffee into a health food. But it does add to the large brew of scientific evidence that tells us coffee is safe for the heart. So, listen to your body; if it handles coffee well, then enjoy drinking it.

Have a question? Send it to harvard_adviser@hms.harvard.edu

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Harvard Medical School Adviser: Research shows that coffee is safe for your heart

Squaw Valley native prepares for graduation from medical school

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Cezanne Manor hails from Squaw Valley and is on her way to becoming a successful doctor.

At 15 years old, Manor began taking pre-med classes at Reedley College. Ten years later, she has graduated from medical school and is now preparing to enter a residency program in Arizona this June.

I knew I wanted to be a doctor ever since I was about 12 and my plan was to get started as early as possible, Manor said.

Manor entered Reedley High as a freshman in 2001, and before the start of her sophomore year, she had already taken and passed the California High School Proficiency Exam. Other than the golf team and Mrs. Merciers science class, Manor said most of the high school classes bored her and she was ready to accept a more difficult challenge. By the summer of 2002, Manor had enrolled in medical classes at Reedley College.

Since medical school is expensive, Manor has supplemented her income by working as a waitress at the Outback Steakhouse in New York City where she currently resides.

Manor is one of eight children born to Rhon and Sheri Manor of Squaw Valley. When Rhon would ask his young children what they wanted to be when they grew up, Manor would respond by saying that she wanted to be an artist since she loved to draw.

He told me that I was already an artist and that I needed to study something else in college. I loved science and always admired my family doctor, Manor said.

Manor said her parents have been one of her biggest sources of encouragement on her journey to becoming a doctor. Her father flew an F-16 at the Fresno Air National Guard. Her mother, having eight children, was a stay-at-home mom.

My father was very successful in everything he did. I always admired him for protecting our country and for his accomplishments in the air force and academically. He was the one who taught me that I could become anything in the world I wanted to be - even the President of the United States, Manor said.

Manor said her mother is an equally amazing person. She said her mothers example of patience, kindness, empathy and self sacrifice are the driving force behind her desire to become a doctor.

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Squaw Valley native prepares for graduation from medical school