Panel: Cooperation, collaboration key to stronger health care industry

A “Healthy” Discussion was the focus of The 5th Annual The Compass Conference on Thursday (April 17) at Mercy Fort Smith. The conference, presented by The City Wire and sponsored by Benefit Bank, featured a panel discussion on the current state of healthcare in the Fort Smith region, as well as what the future holds in the rapidly growing segment of the Fort Smith regional economy.

Cooper Clinic CEO Doug Babb started the forum by stating what many in the industry have been expressing for the last several years — the Affordable Care Act (also known as Obamacare) has changed everything within the industry.

Kyle Parker, the newly-appointed President and CEO of the planned-Arkansas School of Osteopathic Medicine, said while the intent of the law was noble, it was doing nothing to address the physician shortage taking place not only in the Fort Smith region, but nationally.

“It's a great premise, Obamacare itself. We're the richest nation in the world. You're trying to take care of healthcare. It makes a lot of sense, right? The problem with that is when you make insurance mandatory, you tend to use it. If I'm paying for it, I want to go use it. We simply don't have enough doctors. Period. They can't handle the onslaught of the people that are going to want to come into this. … It's not taking care of this problem. It's not adding to the residencies,” Parker explained.

That is among the reasons for the creation of the new school, Parker said, adding that it hoped to address both current needs in the community and needs in the future. And the needs will only increase.

According to Sparks Health System Chief Operating Officer Jeremy Drinkwitz, while his hospital system has a need for more than 80 physicians, regionally there is a need for more than 200 physicians. In specialty areas the challenge is even more daunting. Pointing to the urology specialty, he said only 250 urologists will enter the marketplace this year in the United States, essentially guaranteeing them a job anywhere they would like across the nation. The low number both specialists and primary care physicians is making it more and more difficult to recruit in the increasingly competitive medical field.

As a result, the region's three large medical providers — Cooper Clinic, Mercy Fort Smith and Sparks — have begun to partner and share physicians in order to ensure that all its patients can be served, according to Matt Keep, Mercy Clinic's chief operating officer.

"There are things that we can do together. We talk about Sparks, we talk about Mercy, we talk about independent physician groups — but when you think about it, Mercy physicians are on staff at Sparks and Sparks physicians are on staff at Mercy. And Cooper physicians are on staff at both places. Mercy Clinic physicians refer to Cooper Clinic physicians. And the circle just goes on and on and on. So basically, we're in this together, we just have to figure out how to put this together in the new marketplace that's going to incentives population management, it's going to expect better outcomes at a lower price. We're going to have to figure those things out. I don't have a lot of answers on that, but I do know it involves more physicians."

The new osteopathic school will help with that, with all three of the medical providers represented on the panel committing to working with the school to ensure physicians can complete their residencies, Parker said.

And even with the cost of medical school rising and fewer students looking to enter the medical profession, Parker said he expects the osteopathic school to fill at least some of the need by offering lower tuition than what his son, who was recently admitted to medical school himself, will be paying.

The tuition rate for the Arkansas School of Osteopathic Medicine, he said, would be about $43,000 each year, while his son's tuition looks to be about $75,000 per year. For students who do not have the financial backing of wealthy parents or some other funding, that could leave a hefty $350,000 to $400,000 in students loans.

"The way that we addressed it was we simply looked from a pro-forma basis and what we could do from a revenue standpoint but at the same time, giving back to the community. So we set our tuition in at $43,000 a year. Most medical schools sit north of $50,000 to do that. We know that we can be successful at those rates, doing that," Parker said, adding, "It's about $75,000 a year to put a kid through medical school. …It's a major problem. You look at the wages these doctors are making today and they'e going to be $300,000 in debt plus the interest that's going to be charged on that."

To go through all of that for lower pay rates, all the men on the panel acknowledged that it would be more difficult to encourage individuals to pursue an education and career in medicine.

All the local hospital groups have said that they are prepared to invest to bring the region's medically underserved population more primary and specialty care, but they acknowledge that it is a problem that is faced not only in Fort Smith, but other places, as well, according to Babb.

"I don't think this (physician recruitment) is a Fort Smith area or regional issue," he said. "This is a national issue and we can't be blaming ourselves and feeling badly about this wondering community. What we need to do is recognize the shortage. We all need to go out and seek our own providers and bring them in so we increase the number of providers. And that's what everyone is trying to do. I really believe, both (when I was at) Beverly with professionals and now at Cooper with physicians – as Kyle said – that if you bring someone to our community and you show them the symphony, show them UAFS, show them the wonderful things we have in our community, they will take the position. The problem is they can go anywhere in the country, any community they want to because they're so scarce. That's the way I see it."