Chelsea Standard | Walberg learns about successes, concerns at Chelsea Health Center visit
More area residents are getting access to quality health through local clinics, but who will provide that care in the future is a dark cloud looming on the horizon. That's the message Congressman Tim Walberg heard from physicians at the University of Michigan Family Practice Clinic at the Chelsea Health Center Monday morning (May 19). Times are good now for the clinic which has seen more patients through Medicaid expansion, but a lack of residencies in Michigan has some administrators concerned about tomorrow.
Walberg (R-Tipton) heard from the center's top physicians about what's going on at the facility and what their needs are going to be in the coming years.
"It was great to meet with the staff and patients and learn more about the challenges that our healthcare system faces as I toured U of M's Health Center in Chelsea this week," Walberg stated via email.
The health center is part of the University of Michigan Health system and offers family and primary care to the community at large. It opened in 1978 as the first clinical site for the U-M Department of Family Medicine.
The center is staffed by:
- 14 family medicine faculty physicians,
- 17 resident physicians
- 1 PhD clinical psychologist
- 1 physician assistant
- 1 nurse practicioner
- Social work, PharmD and Nutrition
- 43 staffers including RN, MA, clerical and custodians.
The center's approach is to inspire healthy community, one patient at a time. The center offers patient-centered, family-oriented care as an officially designated Patient Centered Medical Home.
Walberg heard from Medical Director Jill Fenske, MD and Anne Kittendorf, MD, an assistant professor for the university's Department of Family of Family Medicine on what the center does and how it helps patients find success in the plans set up by the primary care providers.
One of these approaches has physicians and staff working together an initiative calledCare Navigators. This has former patients who are trained in talking with current patients to make sure they are taking their medicine and understand the reasons as well as following other instructions from their doctor.
A patient of Dr. Randy Forsch, chief medical officer of Chelsea Community Hospital, was in attendance to speak of the effectiveness of the program and his relationship with his navigator, Belinda Fish. Maxwell credited Fish with helping him quit a 50-year smoking habit that no one before had been able to do.
"She bugged me long enough to quit smoking," Maxwell said. "It was worthwhile to have her; she got me to quit."
Fish said she went through an intensive five-day training program in chronic disease management to be a care navigator and is receiving ongoing training. The training helps show the patients how to take ownership of what they have to do.
Maxwell shared how he was only one of three people out of five who took the stop smoking class and graduated from it.
The success of the navigator program is "a win-win-win," said Professor and Chair Philip Zazove, MD. "We have to educate the next generation to do this."
But to continue this success, a constant stream of primary care and family practice physicians are going to be needed. The cost of college and medical school can leave many in debt or thwart some candidates from even attempting to become a physician.
Assistant Residency Director Samuel Romano said the current residency program he oversees has 11 new faces every year and the current roster has 32.
"Graduates do outpatient and primary care," Romano said. "About 65 percent do inpatient care."
Once the residency is completed most do not continue in family practice or primary care. One of the main deterrents is the low pay primary care offers.
Second-year resident Katherine Lemler, MD, spoke of coming out medical school with more than $215,000 debt. If she takes the full 20 years to repay the debt, she will have to shell out $430,000.
"Primary care doesn't reimburse the debt I graduated with," Lemler said. "Primary care has the second lowest pay."
She wants to enter a program where she works for a nonprofit and provides care for underserved population. She can then qualify to have 120 payments forgiven, if she makes 120 payments on time. While no one has been given debt forgiveness awards so far, she remains hopeful, even though she hears of plans to scale back the plan.
The staggering debt and low pay are hurting the areas that need physicians the most, Lemler said. The profession needs more qualified physicians to serve the lower and middle income populations.
"We want them because they will go back to their people," Lemler said. "They look and sound like them and will listen to them."
Walberg said the issue is one of his leading concerns.
"One of the greatest challenges that health centers face now is the difficulty of recruiting individuals to practice family medicine because of the increasing cost of higher education coupled with the lower compensation rates compared to other fields of medicine," Walberg said. That is why I am committed to continue to work to lower the cost of higher education."
Walberg asked about the impact of the Affordable Care Act on the center and the physicians responded that with the expansion of Medicaid more people are coming to the practice instead of the emergency room. With improved access to health care, the new patients are getting better care for improved health.
"We have found the volume at the free clinic diminishing," Eric Skye, associate chair for Educational Programs, said. "The populations we serve are getting access either through Medicaid expansion or through the exchanges."