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VOL. 8 | NO. 40 | Saturday, September 26, 2015

Resurrection Health's Donlon: Expanding Primary Care is Paramount

By Andy Meek

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Expanding a base of primary physician care – in Memphis and elsewhere – is increasingly seen as a compelling answer to fixing some of the things that are broken about health care.

Yes, money continues to flow to the industry’s high-dollar fringes. Innovations and breakthroughs lead to expensive new technologies, which come with big price tags and costs that get passed down to the end user. And who can blame medical students, who’ve gone through very expensive medical school, for choosing to specialize in a specific corner of medicine that certainly pays a lot more than a primary care doctor’s salary?

Making quality primary care more accessible, though, is about realigning some of the incentives in health care. People most frequently tend to think about their health care when something’s wrong and needs to be fixed. You go to the hospital or to a specialist, where the office or facility is festooned with state-of-the-art equipment, and the cost is commensurate with the quality.

Resurrection Health CEO Rick Donlon tells The Memphis News editorial board the city has a greater need for primary care doctors.

(Memphis News/Andrew J. Breig)

Memphis-based Resurrection Health, meanwhile, is going the other way. It’s a faith-based health service organization on a mission of addressing health disparities in Memphis. One way it’s doing that - training residents along multiple disciplines along the family medicine and primary care spectrum.

In recent weeks, Resurrection Health acquired a nationally recognized family medicine residency program formerly hosted through Christ Community Health Services. That came less than a year after Resurrection opened its first health center.

The three-year residency program, called Resurrection Family Medicine, was one of a select few programs in the U.S. funded through the Teaching Health Center Graduate Medical Education program. That’s a $230 million, five-year initiative as part of the Affordable Care Act that was created to increase the number of primary care residents trained in community-based settings.

Resurrection Family Medicine has the capacity to train 24 residents each year, at three area teaching hospitals and health care providers, including Regional One Health, Baptist Memorial Health Care and Delta Medical Center. The residency program’s base will be at Resurrection Health’s current space at Delta Medical Center.

Resurrection CEO Rick Donlon and Delta Medical Center CEO James Hahn stopped by The Daily News to talk about what they’re doing and why. This is an abridged selection of their comments.

On why expanding a base of primary care is important:

Donlon: “For generations, medical students have realized specialists enjoy higher incomes. And they move toward market realities. The world of so-called primary care is at the bottom of the totem pole.

“That wouldn’t really matter, except there’s absolutely overwhelmingly convincing evidence that communities that have more specialists and fewer primary care doctors and have a system dominated by specialists with a disregard for primary care – those systems deliver worse health outcomes that are much more expensive.”

Memphis, he continued, is one such place and why Resurrection exists.

Donlon: “Memphis is a specialty driven culture. Primary care is given at best a nod. There are every year lamentations about how few of the graduates from medical schools choose primary care, and the numbers in Memphis are as bad or worse than the national numbers.

HAHN

“That’s why we have the residency program and have been drawing eager young minds from around the country. These are bright young minds eager to attack the health care disparities and injustices they see.”

Hahn: “In the health care business, success is defined by your ability to provide access to health care at a good cost and with convincing quality. When you’re in the ZIP code that Delta is, it becomes a unique challenge. We’re dealing with a group of people that are disadvantaged, that have incredible health needs that are often extreme.”

How do you go about changing that and steering things more toward primary care?

Donlon: “I think you could have four more Christ Community Health Services, four more Resurrections, four more Church Health Centers, and you still wouldn’t meet all that primary care need. And there’s steady pressure for students to pursue specialties and prestige.

“But it’s like Luke and Leia (from Star Wars) – they’re our only hope. We’ve got to develop the younger people who are going to take on this mantle and go forward.

“We’re building expensive cancer centers and high tech this and that. They look great and serve a relatively small number of people, and we’ve left a large number of our neighbors without basic health services. People are used to going to the emergency room instead of going to a pediatrician or regular doctor’s office.

“It’s just going to take time and some amount of altering economic incentives to change that. But it can and must change.”

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