Many are concerned about the looming physician shortage, particularly in primary care. It may become worse as a result of the goal of the health care reform bill to provide health insurance for the currently uninsured. The July 2010 issue of Physicians News Digest highlighted the upcoming need for physicians in our region. Patricia Costante, CEO of MD Advantage and writer of that article, clearly proposed numerous viable possibilities of addressing this shortage. We suggest that another way to address the physician shortage is to return inactive physicians to clinical practice.
Returning a non-practicing physician to clinical medicine is appealing. First, it is significantly less expensive to re-train an inactive physician than to train a new one. Second, one can re-train physicians much faster than one can train new physicians, so more physicians would be available in less time. Also, in the current economic climate, many retired physicians are looking to return to medicine.
However, re-entry also has its limitations. Physicians wanting to return to clinical medicine face numerous challenges: low self-confidence in their skills, lack of professional networking possibilities, limited resources for gaining up-to-date skills and knowledge, and cumbersome regulations from licensing and credentialing bodies or employers. Of equal concern, programs offering reentry face financial and (educational) resource challenges.
Across the United States, a number of organizations (the American Medical Association, the American Academy of Pediatrics, the Federation of State Medical Boards) are working together to address these challenges. Though sparse in number, several programs address physicians’ assessment and educational needs. Regionally, the Drexel Medicine Physician Refresher/Re-Entry Course of Drexel University College of Medicine has served the physician communities’ needs since the program was originally developed in 1968 by Women’s Medical College of Pennsylvania.
Please allow a minor digression to explain the history. The Female Medical College of Pennsylvania was founded in 1850 as the first medical school for women. It was renamed Medical College of Pennsylvania (MCP) in 1969. It then merged with Hahnemann University in 1998 to become MCP Hahnemann University School of Medicine. In 2002, the latter became Drexel University College of Medicine (DUCOM).
In 2006, the reentry program was enhanced using MCP’s experience, DUCOM’s instructional technology resources, and the program’s excellence in medical education to create innovative curricular strategies for physicians around the world to access resources designed to enhance their professional and clinical skills. The Drexel Program has several courses that physicians may take independently or sequentially to refresh and enhance their skills. Thus, the Drexel Program helps physicians in need of remediation or refresher courses for reentry. A few have taken the courses for retraining, as well. Physicians from overseas wanting acculturation to the American medical system have also taken advantage of the courses.
The Drexel Program currently offers several educational opportunities online and on-site. The goal of the online program is to allow physicians anywhere in the world to access the courses according to their own schedules. The on-site courses are given in Philadelphia at DUCOM’s university hospitals. Preceptorships are offered in internal medicine, obstetrics-gynecology, surgery, pediatrics, and subspecialties—as needed. Furthermore, focused training is available on specific topics such as medical documentation. In addition to traditional learning experiences, the Drexel Program offers a novel online technology that allows live WebEncounters between trainees and selected standardized patients (actor-patients). This new learning format features online practice, assessment, mentoring, and assignment of learning tasks in addition to the mere learning of the knowledge (see http://webcampus.drexelmed.edu/webosce/).
In addition to excellent educational resources, the Drexel Program offers a comprehensive approach to re-entry, remediation, or re-training because the ultimate goal of the physician is to return to clinical practice. DUCOM’s full faculty and staff offer help in becoming up to date in various “newer skills” pertinent to a practicing physician, such as electronic medical records, medical documentation changes, computer or research skills, medical errors, and health policy changes. Equally important, the Drexel Program staff guides physicians in the maze of career counseling and regulations before they take any of the courses (to determine the best way of achieving the individual physician’s goals) and long after they finish.
From 1968 to 1993, 412 physicians went through the MCP Physician Refresher Program. From November 2006 through spring 2010, about 50 physicians completed the Drexel Medicine Physician Refresher/Re-Entry course. Though most physician trainees are from the local area, others have come from all over the United States and the world. Physicians who have completed the program have stayed in touch with us, seeking guidance with letters and credentialing and reporting on their progress. All participant evaluations of the program have been excellent, with some making comments such as “Participating in your program really helped my self-confidence,” “Nothing short of remarkable,” “I will never forget this learning experience at Drexel.” As such, the Drexel Medicine Physician Refresher/Re-Entry course is another way of returning physicians to clinical practice and a way of addressing the physician shortage in our region.
Nielufar Varjavand, MD, is Program Director, Drexel Medicine® Physician Refresher/Re-Entry Course. For more information, please visit http://webcampus.drexelmed.edu/refresher/ or call 215-762-2580.
Exactly as Dr. Vajravand mentioned, it applies to a lot of female physicians even today. A whole bunch of us answer to that calling to bringing up the kids, only that, some of us had to choose one or the other- a family or a career. This is an awesome concept that could be considered by all medical schools and residency programs. The re-training in a structured environment should be all encompassing and not myopic in its scope. (There are US settled/citizens but foreign trained who clear the board exams but still get turned away from residency training every year)
Through this all: Life, Liberty and Pursuit of Happiness
I really enjoyed the article and applaud Dr. Varjavand’s efforts to highlight physician re-entry, this is an issue that will not resolve itself. We at NeoVocatus contribute to the solution by working with 10-15 percent of physicians who have had or will have issues with drugs or alcohol. We assist and empower physicians who are in “Good Recovery” to seek and secure new physician employment opportunities. NeoVocatus means “New Calling” and we find recovering physicians embrace their new calling with vigor and compassion.
And day in and day out I continue to quietly successfully operate a private NP clinic. Four towns’ worth of satisfied patients, quality minor emergency health care and chronic disease management; and the best idea is a retired physician….incredibly astounding.
Interesting…but how does this program address the reasons YOUNGER “non-practicing” physicians left clinical practice in the first place, often finding administrative jobs? Out-of-control frivolous lawsuits, unreasonably high cost of malpractice insurance, low pay, long hours/poor quality of life given the lawsuits and low reimbursement, noncompliant patients despite all educational attempts, patients’ arrogant sense of entitlement and demanding attitudes, oppressive regulations and micromanagement by third party payors as well as state and federal government, etc., etc., etc.