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Paynesville Press - November 24, 2004

U of M reps discuss health care shortages

By Michael Jacobson

Getting more health care professionals to return to rural Minnesota was the topic of discussion between a local panel and three representatives of the University of Minnesota last week. The trio from the Minne-sota Academic Health Center toured the Paynesville Area Health Care System on Wednesday, Nov. 17, and then led a 90-minute panel discussion at the Paynesville Area Center.

In all, two dozen people took part in the panel discussion, which was the 12th held in rural Minnesota this year by the Minnesota Academic Health Center.

The message across the state, according to Barbara Brandt, Ph.D., assistant vice president for education and director of the Minnesota Area Health Education, is that getting health care professionals to come to rural areas is reaching crisis proportions.

According to the Minnesota Area Health Education Center, 60 percent of dentists in the state may retire in the next 20 years, there are 259 pharmacy vacancies in the state, and every 100,000 rural Minnesotans are served by 110 physicians while every 100,000 urban Minnesotans are served by 300 physicians.

Demographics is not going to help the health care professional shortage, as more Baby Boomers retire they will leave the workforce and add to the aging population.

The loss of health care professionals usually impacts rural communities more than suburban and urban areas. The loss of one doctor or one pharmacist in Paynesville is a much greater percentage than the loss of one in St. Cloud or St. Louis Park.

The goal of the tour, and the panel discussion, was to promote a partnership between the University of Minnesota and rural Minnesota. The U of M needs rural Minnesota to send its students to the University of Minnesota, and the University needs to send these students back to rural Minnesota.

Rural students are more likely to return to rural Minnesota. So the University of Minnesota needs to be a good steward with the youth of rural Minnesota, said Brandt, educating them well but encouraging them to return to rural areas.

Unfortunately, due to budget cuts and problems, the University faces some hurdles. For instance, the Minnesota Academic Health Center wanted $16 million in the bonding bill from the state for classroom expansion and more space for the pharmacy program in Duluth. That still has not passed the Minnesota Legislature.

And, due to budget cuts, the University of Minnesota has suspended applications to its occupational therapy program, said Brandt. This is being done solely for financial reasons, since a need exists for occupational therapists in the state. The status of the medical technology program at the U of M is also uncertain, despite its being the only medical technology program in the state, added Brandt.

The University of Minnesota is looking at partnerships with other states to insure that needed medical training programs are at least offered in the region, if not the state, said Brandt.

The Rural Health School, which sent a number of students to PAHCS, has also been cut, though not entirely for financial reasons. The goal of the Rural Health School was to expose students to rural health care and to try and get them to want to move to rural Minnesota, but the program mainly involved rural students who already knew they wanted to go back to a rural area. Kris Cervin, a Pharm.D. at PAHCS, was the exception in being a Rural Health School participant from the metro area who has settled in outstate Minnesota.

One job for the University of Minnesota is to better integrate its curriculum so switching between majors becomes easier. Anatomy classes, for instance, should be transferable whether a student decides to study nursing or pharmacy. That would make it easier for students to switch medical majors.

All students need a Plan B - need to have a second choice for a medical career - since many programs have highly competitive applications.

While medical school, nursing, and pharmacy are very competitive, mental health, public health, and nursing education typically have openings, said Linda Lindeke, Ph.D., R.N., C.N.P., an associate professor in the School of Nursing. A message to students is that they need to take their studies seriously and get good grades and relevant experiences to help their applications in competitive programs, but they also need to look at all their options if they aren't accepted to their first-choice program.

People are amazingly ingenious, said Lindeke. The University of Minnesota can accommodate busy schedules, even of nontraditional students. She cited a nurse from International Falls, pursuing her Ph.D. at the University, as an example. Or two health care professionals from Benson who carpooled, studied in the car on trips to and from the Twin Cities, and got the best grades in their master's class.

But rural towns need to be more inviting to professionals, too, and not just to health care professionals, but to all professionals, the U of M representatives said. Typically, health care professionals have spouses who are also professionals. Job opportunities - and social opportunities - for professionals may not be as readily available in rural areas.

The Minnesota Academic Health Center includes the School of Dentistry (573 students as of fall 2003); the School of Medicine (2,479 students); the School of Nursing (797 students); the College of Pharmacy (647 students); the School of Public Health (610 students); and the College of Veterinary Medicine (430 students).

Local representatives on the panel discussion included: pharmacist Bert Stanley; superintendent Todd Burlingame; city administrator Steve Helget; Dr. Allan Solum; Todd Lemke, Pharm.D.; Cervin; Tom Kooiman, COO and long-term care administrator for PAHCS; Paulette Hagen, staff development for PAHCS; board members Vickie Ruegemer of Richmond and Rich Philabaum of Roscoe; and Dr. Ray Lindeman.

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