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Medical Mastermind Community

Medical Mastermind Community. The first ideal pipeline-like program for the geographically isolated and financially disadvantaged. Outline. Quality, affordable health care for all Medically underserved populations Physician supply and demand Distribution of physicians around the US

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Medical Mastermind Community

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  1. Medical Mastermind Community The first ideal pipeline-like program for the geographically isolated and financially disadvantaged.

  2. Outline • Quality, affordable health care for all • Medically underserved populations • Physician supply and demand • Distribution of physicians around the US • Efforts to remedy the imbalance • Ideal vs. non-ideal pipeline programs • Grant solutions and future research www.Medical-Mastermind-Community.com

  3. Quality, Affordable Health Care For All http://www.amsa.org/about/ www.Medical-Mastermind-Community.com

  4. Quality, Affordable Health Care For All • This is: • AMSA’s motto • An important humanistic ideal • Professional and ethical obligation • This is NOT: • A debate on the funding the care www.Medical-Mastermind-Community.com

  5. Quality, Affordable Health Care For All • Physicians set their own ethical codes • Beurocrats didn’t tell US this is important • As a group, we need to come up with ways to meet the imbalances that exist. www.Medical-Mastermind-Community.com

  6. Examination of Medically Underserved • No universal definition exists… • Population densities • Financial income • Student Academic strength • Minority status • Family college background • Population’s general organization • Availability of exclusive privileges www.Medical-Mastermind-Community.com

  7. Examination of Medically Underserved • The characteristics of those with highest probability of becoming physicians: • Access to exclusive resources • Most organized • Closest proximity to concentrations of physicians, income, and population www.Medical-Mastermind-Community.com

  8. Distribution of Physicians in the US • 20% of US citizens live in rural areas • Only 9% of physicians are rural • That’s 60 million people in underserved areas! www.Medical-Mastermind-Community.com

  9. Distribution of Physicians in the US www.Medical-Mastermind-Community.com

  10. Distribution of Physicians in the US www.Medical-Mastermind-Community.com

  11. Distribution of Physicians in the US • It is a free country and physicians themselves decide their specialty and practice setting…so far. • Equality takes priority in an ever-changing legal landscape. • We must remedy the inequality in health care delivery ourselves or else we risk losing our autonomy. www.Medical-Mastermind-Community.com

  12. Logic for Selecting the Underserved • N = 20,112 (64% of graduates in 2003-2004 on an AAMC survey) www.Medical-Mastermind-Community.com

  13. Logic for Selecting the Underserved • Physicians serve people like themselves… www.Medical-Mastermind-Community.com

  14. Logic for Selecting the Underserved www.Medical-Mastermind-Community.com

  15. Logic for Selecting the Underserved • There is not a perfect proportion of applicants that represent the population. • For example, • Asians apply in proportionally high numbers. • Blacks apply slightly less • White women apply slightly less white men www.Medical-Mastermind-Community.com

  16. Logic for Selecting the Underserved

  17. Logic for Selecting the Underserved • Physicians serve people like themselves… • AND • Applicants don’t represent the population…(minority programs may change this in the future) www.Medical-Mastermind-Community.com

  18. Examination of Medically Underserved • That’s why there are underserved populations! • Complex Barriers exist: • Population densities • Financial income • Student Academic strength • Minority status • Family college background • Population’s general organization • Availability of exclusive privileges www.Medical-Mastermind-Community.com

  19. Take home point: • Underserved applicants serve underserved populations. • Since the 1960’s the name of the game has been get the underserved into the pipeline. …but at all costs?

  20. Take home point: • AAMC’s AspiringDocs.org

  21. Ideal vs. Non-Ideal Pipeline Programs • Merit-based competition in a free market • Increase matriculation of applicants with altruistic, humanitarian spirit • No discrimination of persons - abolishment of affirmative action • Equal distribution of quality, affordable care • Make exclusive resources and professional contacts/mentorship available for everyone: level the playing field: Academically, Geographically, and Financially. www.Medical-Mastermind-Community.com

  22. Efforts to Remedy the Imbalance • Many attempts to improve imbalances in physician distribution have been made. • We’re closer to ideal solutions than we’ve ever been before, thanks to prolific research in this area. www.Medical-Mastermind-Community.com

  23. Efforts to Remedy the Imbalance • The Legislative Branch: The Congress of the United States • The Judicial Branch: The Supreme Court and lower courts’ rulings • The schools themselves • The state legislatures • Accrediting Bodies: AAMC, AOA, and ACGME • Student Organizations: SNMA • Political Organizations: AMA and AMSA Let’s not wait for the Executive Branch! www.Medical-Mastermind-Community.com

  24. Efforts to Remedy the Imbalance • Congress: • $7 billion is spent annually by Medicare to controls physician supply by changing the number of medical residency positions. www.Medical-Mastermind-Community.com

  25. Efforts to Remedy the Imbalance • The Supreme Court’s ruling on affirmative action: • Grutter vs. Bollinger, 2003 • narrow use • temporary • need to develop race neutral solutions • Gratz vs. Bollinger, 2003 • Automatic point system illegal www.Medical-Mastermind-Community.com

  26. Efforts to Remedy the Imbalance www.Medical-Mastermind-Community.com

  27. Efforts to Remedy the Imbalance www.Medical-Mastermind-Community.com

  28. Efforts to Remedy the Imbalance www.Medical-Mastermind-Community.com

  29. Efforts to Remedy the Imbalance • The Schools • Debakey High School for Health Prof. • Preps “minorities” • Better because students compete in the free market for med school, and do well. • Have to be geographically available to participate. www.Medical-Mastermind-Community.com

  30. Efforts to Remedy the Imbalance • Origin of Magnet Schools like Debakey: www.Medical-Mastermind-Community.com

  31. Efforts to Remedy the Imbalance • The Schools • Texas A&M Medical School is already race neutral. • Argue that minorities serve the underserved in increased proportions so less of them are needed - it washes out in the end. • No data support the outcome that we’re on the right track, but they refuse to violate the constitution. www.Medical-Mastermind-Community.com

  32. To be fair and balanced: www.Medical-Mastermind-Community.com

  33. Efforts to Remedy the Imbalance • The Schools • Baylor’s Premedical Honors College • Pipeline of minorities enrolled in high school • Condition acceptance to Baylor (72 since 1994) • Could be found noncompliant with Gantz vs. Bollinger, but Texas State Legislature said the program should be replicated. www.Medical-Mastermind-Community.com

  34. Efforts to Remedy the Imbalance • Texas State Legislature • Acknowledged Baylor’s Premedical Honors College • Recommended replicating the program, hopefully simply because it helps the outcome - “Quality, affordable health care for all.” www.Medical-Mastermind-Community.com

  35. Efforts to Remedy the Imbalance • GPA 3.25, MCAT 23 www.Medical-Mastermind-Community.com

  36. Efforts to Remedy the Imbalance • Accrediting Bodies: • AAMC - • certifies medical schools that grant MD degrees • Manage medical school application service • Administer the MCAT • AOA - certifies DO schools • ACGME - certifies residency programs www.Medical-Mastermind-Community.com

  37. Efforts to Remedy the Imbalance • AAMC: • Summer Medical and Dental Program • AspiringDocs.org • Health Professions Partnership Initiative - grant money to fund underrepresented minorities in Georgia • K-12, Communities, & Undergraduates. www.Medical-Mastermind-Community.com

  38. Efforts to Remedy the Imbalance www.Medical-Mastermind-Community.com

  39. Efforts to Remedy the Imbalance www.Medical-Mastermind-Community.com

  40. Efforts to Remedy the Imbalance • Interjection of efficacy: • 5 UC premedical programs • Control group n= 396 , test cohort n=265 • Students competed in free market • Statistically significant increase in admission www.Medical-Mastermind-Community.com

  41. Efforts to Remedy the Imbalance • AAMC’s HPPI program: www.Medical-Mastermind-Community.com

  42. Efforts to Remedy the Imbalance • HPPI: levels the playing field • Good because applicants still compete in the free market • Limited to Georgia and you have to be physically present to participate. www.Medical-Mastermind-Community.com

  43. Efforts to Remedy the Imbalance • AOA • What are you doing? • Go Dr. Bowman! www.Medical-Mastermind-Community.com

  44. Efforts to Remedy the Imbalance • ACGME: • Have nothing to do with such issues. • Perhaps the most ideal entity of all. • They focus on 7 core competencies of physicians and all research has shown that residency graduates perform equally well regardless of their individual background. www.Medical-Mastermind-Community.com

  45. Efforts to Remedy the Imbalance • Student Organizations • Student National Medical Association • Good because they are web-based and community organization, therefore they reach a broader audience. • Only serve people “of color”. www.Medical-Mastermind-Community.com

  46. Efforts to Remedy the Imbalance • Student Organizations • Student National Medical Association • Good because they are web-based and community organization, therefore they reach a broader audience. • Only serve people “of color”. Not ideal www.Medical-Mastermind-Community.com

  47. Efforts to Remedy the Imbalance • Are we part of the solution here? • What about Gantz vs. Bollinger? Not ideal www.Medical-Mastermind-Community.com

  48. Efforts to Remedy the Imbalance • Great program, but white people drink over there… www.Medical-Mastermind-Community.com

  49. Efforts to Remedy the Imbalance • AMA • Funds scholarships • Health Care Reform lobbying www.Medical-Mastermind-Community.com

  50. Efforts to Remedy the Imbalance • AMSA • Health Care Reform lobbying • Diversity Education • AMSA Foundation funds programs www.Medical-Mastermind-Community.com

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