A recent report by the California Future Health Workforce Commission said that to avoid a looming health care crisis, California will need to ensure the state has enough doctors, physician assistants, nurses and home care workers in the coming years — a situation Western University of Health Sciences is uniquely positioned to address.
According to the report, a $3 billion plan is needed to avoid the looming crisis, and it will need the support of California’s new governor, legislators, and a broad spectrum of stakeholders in the public and private sectors. The core challenge is that California does not have enough of the right types of health workers in the right places to meet the needs of its growing, aging, and increasingly diverse population.
California has historically underfunded residency positions in medicine and other professions, according to the report. California ranks No. 32in the nation. From 1997 to 2012, the annual number of physicians graduating from primary care residencies in California has steadily declined. California will need to increase the number of graduates by 30% to alleviate current and projected shortages, according to the report.
More residencies must be established and funded in California to ensure more doctors and psychiatrists stay here, which will benefit the future health of Californians, said WesternU President Daniel R. Wilson, MD, PhD.
About 75% of California resident physicians stay in the state to practice, according to data from the Society of Teachers of Family Medicine.
Wilson said California has myriad health care and health sciences educational institutions available to help meet this demand. Nurses, nurse practitioners and physician assistants are “priority professions” that warrant special attention because of the broad range of health care services they provide.
“Like its nonprofit counterparts throughout the state, WesternU is training the next generation of health care providers using state-of-the-art innovative educational strategies to prepare them for the changing landscape of future primary health care delivery, all without direct public support,” Wilson said. “WesternU and its educational brethren throughout California will continue to serve key roles in powerful public-private partnerships needed to fill – most efficiently and cost-effectively – the growing shortage of health professionals, even as we help ensure high-quality, accessible health care for the well-being of all.”
WesternU’s College of Osteopathic Medicine of the Pacific (COMP) has graduated nearly 6,000 physicians since 1982 – with more than 2,000 staying to live and practice in the Inland Empire and other parts of Southern California, according to COMP Dean Paula Crone, DO ’92,
She said the escalating need for health care in underserved communities and the predicted shortage of physicians by 2030 are driving a list of targeted strategies for COMP.
“The emerging physician shortage is a complex problem that is compounded by an inadequate supply of residency programs,” Crone said. “The number of physicians who are retiring each year is greater than the number of new physicians who are graduating from residency. One of our primary goals is to expand residency opportunities in partnership with hospitals and health care systems.”
COMP is leveraging programs such as its Longitudinal Tracks, community service learning and community health initiatives to improve community health, immerse students in population-based care, and cultivate relationships among academic, clinical and community partners.
The College also is strengthening the diversity of the future workforce and providing culturally competent care to diverse populations through WesternU’s Master of Science in Medical Sciences (MSMS) program, Crone said.
Graduate College of Biomedical Sciences Professor and Associate Dean of Academic Affairs Christina Goode, PhD, said WesternU’s 12-month Master of Science in Medical Sciences (MSMS) program helps prepare underrepresented and diverse students for careers in health professions by helping them gain acceptance to professional schools, with an ultimate goal of increasing the number of health professionals in underserved areas.
Since the inception of the program, more than 160 MSMS students have transitioned to COMP, with more than two-thirds of them considered diverse or underrepresented in medicine, said Goode.
“MSMS alumni that transition to COMP are leaders and have spearheaded efforts such as the Latino Medical Student Association and the Student National Medical Association, medical Spanish classes and community health clinics,” Goode said. “MSMS alumni that have now graduated from COMP are largely practicing in primary care and serving in health shortage areas.”
Physician assistants (PAs) are referenced with nurse practitioners (NPs) throughout the report. With more than 11,500 PAs in California, the profession is also one of the fastest-growing occupations in the nation. A survey from the California Office of Statewide Health Planning and Development indicated that WesternU’s PA program has provided the most PAs from any program who enter California’s PA workforce.
“PAs are medical professionals that diagnose disease states, develop, initiate, and manage treatment plans, and prescribe and follow up on medications,” said WesternU College of Health Sciences Department of Physician Assistant Education Chair Roy Guizado, MS, PA. “PAs serve as a patient’s primary provider and increase a patient’s access to health care. Through all these actions, PAs have, are, and will be a viable solution to the health care shortage.”
Another proposal in the report recommends allowing nurse practitioners (NP) to work independently of doctors.
College of Graduate Nursing Dean Mary Lopez, PhD, RN, said the NP primary care workforce is outpacing the growth of the primary care physician labor force. NPs provide primary care of equal quality compared to physicians, are more likely to work in rural areas, and are more likely to serve poor and vulnerable Americans, who already need more primary care providers. NP services also cost less.
“Scope-of-practice restrictions are being lifted in states across the country, and health care administrators are allowing NPs to take on expanded roles in primary care settings,” Lopez said. “NPs continue to provide primary care to more Americans, improving health across the United States. The Family Nurse Practitioner (FNP) program at the College of Graduate Nursing at WesternU was recently awarded as a top FNP program in California. We continue to strive to meet the needs of vulnerable populations within Southern California and across the nation.”
WesternU is committed to implementing or assisting opportunities for Pomona community empowerment though Pomona Health Career Ladder (HCL), community-based oral health centers and the Promoter program, said Associate Vice Provost for Academic Development Elizabeth Rega, PhD.
CGN helped plan and implement Pomona’s Health Promoters, a group of health workers who provide education and resources to the community. Spanish-speaking Promoters have been trained in basic adult education techniques, communication, leadership, and being community resources. Promoters have received training in Community Emergency Response Training (CERT) and do outreach throughout the community.
The Pomona Health Career Ladder is entering its 10th year as a multi-institutional formal alliance of WesternU with Cal Poly Pomona and the Pomona Unified School District. During each academic year, local students at the middle and high school levels attend six monthly Saturday workshops, where more than 100 WesternU student volunteers from most of the nine colleges teach students various elements of the health care professions.
American Indian Health Career Ladder began in 2011 to help California Native American students overcome social and institutional barriers preventing them from becoming health practitioners in their communities.
“HCL is fostering a uniquely Pomona-driven program empowering students and parents to become health professionals ‘from our community, for our community,’ as well as to promote healthy lifestyles in a population with epidemic levels of lifestyle-related diseases,” Rega said. “Our collaborative has created a network and pathways to assist parents and students in becoming physicians, dentists, nurses, physical therapists, pharmacists, physician assistants, veterinarians, foot and ankle surgeons, optometrists and a range of other health professionals.”