Dorothy Hughes’ Award-Winning Essay

Our seventh winning essay comes from Dorothy Hughes of the University of Kansas School of Medicine:

Eradicating Health Disparities by Getting Creative with Workforce Solutions and Inter-Disciplinary Education

To eradicate health disparities, starting with the rural/urban divide makes sense. For those who suffer health disparities due to other reasons, being in a rural area layers on an additional barrier to accessing health care. If we can address this geographic barrier, we have a greater chance at successfully eliminating other barriers as well.

Immediately, we need to think creatively about how to distribute health care professionals, for example, the creation of job-sharing arrangements. Now and into the future, inter-disciplinary health professional education programs need to be encouraged and grown exponentially. Inter-disciplinary education must be the orientation of all health professional training programs because only through innovation and collaboration can we hope to eradicate health disparities.

In rural areas, physicians are scarce, and burnout runs rampant. Recently, I interviewed a surgeon who covers three rural towns. He has a quasi-partner, a surgeon who comes to town from a larger city once a week and acts as a release valve, doing elective cases and taking the pressure off the primary surgeon. In a frontier setting I visited, a surgeon was hired to work three days a week. She lived more than four hours away, commuting to her hospital in the middle of the week and lodging in a local bed and breakfast two nights per week. This allowed the hospital to gain surgical revenue, allowed the surgeon to manage her workload and call schedule, and most importantly, allowed this small town to retain access to surgical services.

In Kansas, some of our most admired medical communities are in rural areas where administrator and physician collaborations have built relationships with specialists around the region. The specialists travel to the rural areas a few times a month to see patients. These collaborations have also established telemedicine links with the state’s academic medical center, connecting patients to quaternary-level expertise. By thinking creatively about scheduling and staffing, they have managed to increase access to care for rural residents, thereby working to eliminate rural/urban health disparities, while also providing a unique practice experience for clinicians. These job-sharing and part-time arrangements are only the beginning. We should continue to pursue outside-the-box solutions.

It sounds simplistic, but putting future administrators and future clinicians in the same room during their education is crucial. In a joint DO/MBA program where I serve as adjunct faculty, the interactions are incredible between medical students – who come to class directly from clinical rotations – and the students who come from jobs as health IT consultants, rehab administrators, marketing directors, and more. Students bring their professional knowledge and personal perspectives, expanding the diversity of backgrounds in the classroom. This exposure to diverse perspectives pushes students to think about disparities and how they can be part of the solution, not by themselves, but as a team of future health professionals.

If eradication of health disparities is going to happen, it will be through innovative workforce solutions and inter-disciplinary education.

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