Comstock's magazine 1217 - December 2017 | Page 82

HEALTH CARE
“As technology expands, medical knowledge expands. And
those bodies of knowledge are multiplying exponentially.”
-DR. STEPHEN LOCKHART, CHIEF MEDICAL OFFICER, SUTTER HEALTH
“He never even had to leave the fa-
cility and it was all done in less than an
hour,” says Trish Rodriguez, senior vice
president and area manager for Kaiser
Permanente in South Sacramento and Elk
Grove, and Artagnan’s spouse.
Leveraging sophisticated technology
tools and collaborative access to digital
health records is a game changer for the
health care industry and impacting the
way specialty care is delivered.
“The days of an adult family medicine
physician knowing all the latest technolo-
gy, the latest medications and the latest
treatments for so many different disease
processes is virtually impossible,” says
Dr. Robert Azevedo, physician-in-chief
for Kaiser Permanente Sacramento
Medical Center.
With continued advancements in
health care, some providers now offer
upwards of 100 different specialty and
subspecialty services for their patients.
But balancing the demand for great-
er specialization with coordination and
continuity of care through primary care
doctors, as well as watching their bottom
line, is a priority for health care providers.
And so is forecasting what patient needs
are going to be for primary and specialty
care in the future.
In the last 20 years, specialization in
health care has exploded. According to
Dr. Stephen Lockhart, chief medical offi-
cer with Sutter Health, there are two rea-
sons behind the catalyst for this growth.
The first is the advances in technology,
and with that, the ability for medical pro-
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fessionals to understand and treat issues
that were previously impossible to ad-
dress. The second is patient education.
“As technology expands, medical knowl-
edge expands,” says Lockhart. “And those
bodies of knowledge are multiplying ex-
ponentially.” Greater access to informa-
tion has led to patients more interested
and engaged in trying to understand all
the options available to them, and de-
manding better access to those options.
“It’s our responsibility as a profession
to make sure the access is not unfettered,
but is based upon a true understanding of
what the clinica l needs are and whether
those interventions will enhance the pa-
tient’s health and life,” Lockhart says.
Ideally, the primary care provider
is meant to serve as an imperative first
stop for patients, where all of their care
is coordinated. The goal is to keep peo-
ple healthy as opposed to managing ill-
ness. But the shine on pursuing primary
care medicine has worn off for some of
today’s future doctors, who are pursu-
ing specialization — which generally is
higher paying and more focused — in
greater numbers.
Some of the top specialties that the
current crop of med students are pursu-
ing at UC Davis’ School of Medicine are
genomics, emerging imaging technolo-
gies, pain management, oncology and
minimally invasive surgeries. “It’s much
more comfortable to be a specialist,”
says Dr. Mark Servis, vice dean for med-
ical education at the UC Davis School of
Medicine. “You can have certainty and
there’s not as much ambiguity for you as
a clinician.”
But that creates a challenge for pri-
mary care. According to data from the
Public Health Institute, the state is fac-
ing a primary care provider shortage.
Twenty-three of California’s 58 counties
fall below the minimum required primary
care physician-to-population ratio, and
at current utilization, California will need
more than 8,200 additional primary care
physicians by 2030.
The Central Valley was identified as
one of the regions that will experience
the worst shortages, in UC San Francis-
co’s recent study on projections around
the primary care workforce for the state.
“That was further incentive for us to
make sure we continue to train an ade-
quate number of primary care doctors,”
says Servis.
To take steps, the UC Davis School
of Medicine has placed an emphasis on
training primary care doctors and im-
plemented a program to incentivize and
retain students who are interested in
primary care. The accelerated training
program, called Accelerated Compe-
tency Based Education in Primary Care
(ACE-PC) was launched by UC Davis
in collaboration with Kaiser Permanen-
te. For students committed to a prima-
ry care identity, the program shaves off
one year of medical school, decreasing a
student’s debt and getting them through
school and into a primary care residency
more quickly. The program has been very
successful, with UC Davis graduating its