UAMS Mulls M.D. Residencies

By Ben Boulden

Two Fort Smith hospitals could become homes to physician residency programs in the future if some financial and bureaucratic obstacles are cleared, Dr. Peter Kohler said Tuesday.

Kohler, vice chancellor on the northwest Arkansas campus of the University of Arkansas for Medical Sciences, spoke to and answered questions from the House and Senate Interim Committees on Public Health, Welfare and Labor of the Arkansas General Assembly during its meeting Tuesday morning in Van Buren.

Both the morning session and another on Monday afternoon in Fort Smith were concerned with area and statewide shortages of physicians and nurses.

Kohler and others who testified before the committees said they think increasing the number of new nurses and medical doctors coming out of medical colleges is key to solving the shortfall problem.

More physician residencies — the clinical training of doctors after graduating from medical colleges — are an important part of increasing those numbers locally and statewide, Kohler said.

By fall 2009, UAMS plans to begin taking students at its satellite campus in Fayetteville, he said.

Those students will need placement later in residency programs, and Fort Smith hospitals — Sparks Regional Medical Center and St. Edward Mercy Medical Center — would be good places to host one in internal medicine.

Ted Woodrell, Sparks chief executive, said Tuesday he had talked with Kohler about the possibility.

“There is an interest,â€? he said. “It’s just a matter of funding. Residencies require a line of funding that goes beyond our ability to do it as a community service. While we’re very interested in doing it and have further discussion, it comes down to whether it can be funded appropriately. … You don’t want to start and stop a program.â€?

Based on his earlier experience in hospital administration in Mississippi, he believes it would take at least $2.5 million annually to fund a residency program, Woodrell said.

In addition to internal medicine, he and Kohler discussed possible programs in obstetrics and general surgery.

A federal cap effectively blocking a residency program directly administered by the hospitals would have to be lifted and funding secured before anything could be started up, Kohler said.

St. Edward also has had discussions with Kohler and UAMS officials about the future possibility of a residency program in internal medicine.

“I can’t imagine anything that would do a better job that would solve the shortage of internal medicine in Fort Smith,� said Larry Pearce, St. Edward vice president of medical affairs.

He said if volunteer faculty are used instead of full-time, salaried faculty, then the cost of a residency program could be held to about $70,000 per resident annually.

In other testimony, Kohler said Arkansas is short at least 200 medical doctors.

“That’s a conservative estimate,� he said.

District 64 state Rep. Jim Medley, R-Fort Smith, said the state’s shortage of nurses numbers about 1,000.

Between 100 and 150 more physicians could practice in the Fort Smith region, Woodrell said in 2007.

With no changes to increase the number of physicians practicing, the United States will fall 85,000 to 200,000 doctors short of its need, Kohler said.

By training more doctors and nurses in the state in Little Rock and Fayetteville, then placing them in residency programs in Arkansas cities and towns, more will be retained in Arkansas, he said.

Larry Bates, western region chairman for Simmons First National Bank and chairman of the Health Care Council at the Fort Smith Regional Chamber of Commerce, said four physicians who finished a six-physician, three-year residency program locally through the Area Health Education Center in Fort Smith were retained.

Many residents tend to stay where they finish their programs, he said.

Bates and Jason Green, vice president for human resources at Fort Smith-based Baldor Electric Co., also spoke to the legislative panel.

The Fort Smith chamber formed the council that Bates heads up to investigate and address the issues contributing to the physician and nursing shortage.

To fill the shortfall, more funding and other support is needed for training programs at the University of Arkansas at Fort Smith, AHEC and the new UAMS satellite campus in Fayetteville, Bates said.

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