Page 4 - COM Outlook - Winter 2013

4 COM Outlook . Winter 2013
— Fred Lippman, R.Ph., Ed.D.
tion actually impacts the Affordable Care Act. This is an important
point to examine, especially when you consider that millions of U.S.
citizens will now have the opportunity to access health care, which
they will be paying for out of their pockets. Still, the question re-
mains: Where are the physicians?
Because residency programs are not funded to an adequate level, it
has impacted the number of graduates who can actually gain entry
into a residency of their choice. Additionally, because reimbursement
rates are extremely low in many areas of the United States, those
areas tend to have an insufficient physician population.
As a result, we’ve seen the evolution of other health care profes-
sionals that are also serving as primary care providers. And that’s
why you’re going to find huge numbers of health care providers
distributed amongst the areas of the country where there is a pau-
city of physicians. The way I see it, the medical home paradigm is
paramount to the success of providing prevention and wellness ser-
vices because it allows the physician to work in tandem with nurse
practitioners, physician assistants, pharmacists, optometrists, and
dentists to enhance overall patient care.
In my opinion, the recent national election will prove to be ben-
eficial for the future growth of graduate medical education, which
has already experienced some positive enhancements. In the
past year, the state of Florida received 325 new medical residency
positions at existing sites that include Broward Health, Palmetto
General Hospital, and Miami Children’s Hospital, which are long-
time members of the College of Osteopathic Medicine’s Consor-
tium for Excellence in Medical Education.
What I foresee is a dramatic opportunity for institutions like NSU,
which are already home to a comprehensive compendium of health-
related academic programs, to place a strong emphasis on collabo-
rating with as well respecting their fellow health care professionals.
That’s why NSU’s Health Professions Division has been providing
interdisciplinary learning opportunities for its students for many
years. It also explains why the various HPD colleges are housed
within one complex shared by all health professions.
In the world of education, it is imperative for all the health profes-
sions programs to be communicative with one another, to under-
stand each other, and to treat each other equitably. The beneficia-
ries of this interdisciplinary collaboration will be the citizens of the
United States. In order to create efficiency in health care, you must
provide for wellness, which as we all know, starts with focusing on
the critical precept of prevention.
Over the past several years, I have dis-
cussed the subject of health care avail-
ability for the American public multiple
times in the pages of COM Outlook.
However, now that the people of the
United States have reelected the Presi-
dent, they have also helped certify the
much-debated Patient Protection and Affordable Care Act—other-
wise known as Obamacare.
As a person who has been involved in health care for many years, I
believe it’s quite evident that certain elements of the Affordable Care
Act have been embraced by the general public. These include tenets
such as the closure of the controversial donut hole in Medicare Part
D prescription drug coverage and the elimination of citing preexisting
conditions as a means to deny health insurance coverage.
I’ve mentioned the following topic numerous times, but it bears re-
peating: At Nova Southeastern University, particularly in the College
of Osteopathic Medicine but also within all our health care education
programs, we’ve been teaching the issues of wellness, prevention,
and the medical home for many years. As a result, because we’ve
embraced and incorporated these practices within the various Health
Professions Division colleges over the past decade, I think we have
a dramatic advantage over many other educational institutions.
One concern that has become very apparent in recent years is
we simply don’t have enough health care providers in the United
States. Based on various sets of statistics, there are approximate-
ly 32 to 34 million people who are going to be receiving health
care coverage who weren’t covered before. You will also have,
depending on which states choose to participate, another 12 or so
million people who will become Medicaid eligible. Consequently,
when you review the overall figures, you’re talking about any-
where from 40 to 46 million additional people who will have the
opportunity to receive health care coverage.
In order to unearth the origins of the ongoing physician shortage,
you need to look back in time. It certainly can’t be blamed on a
lack of establishing new U.S. medical schools because in Florida
alone, the number continues to rise, with nine medical schools now
located throughout the state. If the truth be told, the true culprit
was the 1997 Budget Reconciliation Act that came out of Congress,
which basically capped funding for all existing residency programs.
Now that 16 years have passed since the Budget Reconciliation
Act was enacted, it’s imperative to assess how this piece of legisla-
HPD Chancellor’s Communiqué