By G. Richard Olds5 p.m.Jan. 1, 2015<\/p>\n
The United States spends more money on health care than any other country in the world. So how does Costa Rica outperform the United States in every measure of health of its population? Costa Ricas government spends more money per capita than ours on prevention and wellness. <\/p>\n
Sadly, it has become the American way to leave many chronic diseases untreated until they become emergency situations at exorbitant cost to the U.S. health care system. For many patients, this care is too late to prevent life-changing disabilities and an early death. <\/p>\n
When people ask me why we started the UC Riverside School of Medicine last year the first new public medical school on the West Coast in more than four decades I talk about the need for well-trained doctors in inland Southern California. But we also wanted to demonstrate that a health care system that rewards keeping people healthy is better than one which rewards not treating people until they become terribly ill. <\/p>\n
At UC Riverside, we are supplementing the traditional medical school curriculum with training in the delivery of preventive care and in outpatient settings. Our approach is three-pronged. <\/p>\n
First, we work with local schools and students to increase access to medical school through programs that stimulate an interest in medicine and help disadvantaged students become competitive applicants for admission to medical school or other professional health education programs. These activities start with students at middle school age, when students begin to formulate ideas about what they want to be when they grow up. <\/p>\n
Second, we focus on students from Inland Southern California because students who live here now will be among those best equipped to provide medical care to our increasingly diverse patient population. Doctors who share their patients backgrounds are better at influencing their health behaviors. And we need to increase the number of physicians in Inland Southern California in primary care and short-supply specialties. Our region has just 40 primary care physicians per 100,000 people far below the 60 to 80 recommended and a shortage in nearly every kind of medical specialty. Students who have been heavily involved in service such as the Peace Corps, or who are engaged in community-based causes, are more likely to go into primary care specialties and practice in their hometowns. <\/p>\n
Then, we teach our medical students an innovative curriculum. For instance, the Longitudinal Ambulatory Care Experience, called LACE for short, replaces the traditional shadowing preceptorship, where students follow around different physicians. Instead, our students follow a panel of patients and gain an in-depth understanding of the importance of primary care, prevention and wellness. Our approach also includes community-based research that grounds medical students in public health issues such as the social determinants of health, smoking cessation, early identification of prediabetic patients, weight loss management and the use of mammograms to detect breast cancer.<\/p>\n
We try to remove the powerful financial incentive for medical students to choose the highest paying specialties in order to pay off educational loans. We do this with mission scholarships that cover tuition in all four years of our medical school. This type of scholarship provides an incentive for students to go into primary care and the shortest-supply specialties and to remain in inland Southern California for at least five years following medical school education and residency training. If the recipients practice outside of the region or go into another field of practice before the end of those five years, the scholarships become repayable loans. <\/p>\n
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