Dean of University of Tennessee College of Medicine at Chattanooga addresses health-care challenges

By Susan Pierce

Dr. David Seaberg says the opportunity to guide the strategic vision of a college of medicine campus drew him from the University of Florida College of Medicine to the Scenic City.

In June 2007, Dr. Seaberg accepted an appointment as the first dean of the University of Tennessee College of Medicine at Chattanooga.

Although a college of medicine has been based in Erlanger for more than 30 years, the Chattanooga campus is now recognized as one of three UT Health Science Centers, a UT College of Medicine in its own right instead of a satellite of the UT Memphis medical school.

“The campus designation has not only meant more recognition for Chattanooga within the University of Tennessee statewide system of medical education, but it also means that more resources will be placed into the Chattanooga-based academic medical center,� Dr. Seaberg said.

In addition to overseeing nine residency programs, Dr. Seaberg continues to actively practice medicine by working shifts in the emergency department at Erlanger.

What are the residency programs of the UT College of Medicine at Chattanooga?

We now have nine Residency programs: family medicine, internal medicine, emergency medicine, pediatrics, general surgery, plastic surgery, orthopedic surgery, obstetrics and gynecology and transitional year.

We also will have five fellowships next year: geriatrics, vascular surgery, surgical critical care, trauma orthopedic surgery and hospice and palliative care medicine.

How does UTCOMC’s change of status affect its residents and programs?

As a campus, we are able to better determine the growth of our training programs and we may also receive more resources, particularly in terms of funding, for our programs.

What are your goals over the next five years?

I would like to continue to enhance the sense of community that our faculty and staff feel within the University of Tennessee. We have excellent academic partners in Erlanger and UTC, which should allow us to grow the academic medical center in terms of productivity and respect in our areas of focus: clinical service, education, research and community service.

What do you believe is the biggest issue (i.e. insurance, patient obesity, staying abreast of technology, etc.) current residents will face and why?

I believe we must face the problem of providing quality medical care for all Americans. Should we do this, we will need to train more physicians as we will face a physician shortage. We also need to solve the medical liability environment to allow our physicians to practice the best medicine.

What do you believe can be done to streamline emergency department efficiency, address overcrowding and reduce waiting time?

I want to make one point clear. The overcrowding of emergency departments is not due to the influx of non-emergent patients. We are now putting mid-level providers (physician assistants and nurse practitioners) out in our triage area to take care of these individuals so that they never even make it back into an ED room.

We are also developing Fast Track areas where these less-acute patients can be seen more efficiently.

The real issue with overcrowding is that we have a lot of sick patients who need to be admitted and can’t get a hospital bed because the hospital is full. This boarding is the real culprit as to why EDs are full. If you have 10 sick, admitted patients taking up beds and nursing time in the ED, then you have a situation where you can’t bring other sick patients back to a room. Hence they wait in the waiting room and cause overcrowding.

We are working with the hospital to reduce overcrowding by such measures as smoothing out the surgery schedule and discharging patients earlier in the day.

Would you address statistical claims that 45 million Americans don’t have health insurance, forcing them to use the emergency department, and how that affects consumers?

I read recently that the number is now 47 million and climbing. Emergency departments had over 115 million visits last year; that is one in every three Americans.

Overcrowding of emergency departments, which is due to boarding affects everyone. Many people think that this just affects uninsured individuals, but the vast majority of patients who use the ED are insured. In fact, the largest single group of patients who use the ED are those with commercial insurance.

Your inaugural class of residents in the UTCOM’s newest program, the Emergency Medicine Residency, starts this summer. Will you please describe this new teaching program? What is the importance of such ED and trauma care to the well-being of Americans?

Emergency medicine is the medical specialty with the principal mission of evaluating, managing, treating and preventing unexpected illness and injury. The new program in Chattanooga will be the first and only emergency medicine residency program in the University of Tennessee system.

Tennessee ranks near the bottom in terms of number of board-certified emergency physicians per 100,000 population. This new training program, which will eventually train a total of 18 residents over a 36-month training period, will help improve the emergency care that Tennesseans receive.

It will also allow excellent medical students at the University of Tennessee who want to go into emergency medicine a place to train in Tennessee. Previously these students had to leave the state to get training. Our hope is that once they train in our new program, the majority of them will stay in the state for their career.

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