HARLINGEN — The 21st century world of medicine is a fast moving place, and the University of Texas System is poised to lead a shift in medical education that can fortify team-based outpatient care.
Students enrolled in the UT–Rio Grande Valley School of Medicine will be taught with a team-based care foundation along with peers in other medical fields, participate in modular courses and will work with patients from the very beginning of their medical education.
The Valley medical school will also place a major emphasis in involving the community in the ambulatory arena by working with not only hospitals, but also federally qualified health centers and in South Texas’ impoverished colonias.
The school’s inaugural dean, Dr. Francisco Fernandez, said he plans to not only advance Hispanic health initiatives regarding obesity, nutrition and diabetes, but to do so with inherently Hispanic values.
“There isn’t a field that isn’t touched by those three elements as they occur and are critical to the future of the health of the Hispanic community, particularly the Mexican American community,” Fernandez said.
“But it’s how to provide care, also, with compassion and I have a very strong feeling about the ability to build for this school to lead in that area,” Fernandez said. “Corazon, respeto y dignidad. Those are the values of Mexican- American families and Hispanic families, just think of it. You can’t get away from corazon, respeto y dignidad.”
21st CENTURY MEDICINE AND THE
“Twenty-first century medicine is a team sport,” Dr. Kenneth Shine, special adviser to the UT System chancellor, said.
As primary care physicians struggle to keep up with growing populations with longer life expectancy, acute medical issues, chronic disease, preventative care and end of life care, all while dealing with insurance companies and other bureaucratic demands, experts said 21st century medical delivery will largely depend on increased communication and collaboration.
Dr. Sue Bornstein, executive director of the Texas Medical Home Initiative based in Dallas, works with physicians and their practices to help them transform their practices into medical homes, health homes models where they can implement improved coordination of care, access to care, and information technology.
Bornstein said team-based care is more common within hospitals than in outpatient medicine, but the health home concept — which has been around since the 1960s — has taken off within the past six or seven years in private practices.
Under the health home model, rather than patients navigating the medical system and finding specialists themselves, they would have a centralized team to provide care.
“Now the primary care physician is really the guide. They are going to guide you through the medical system, because especially older folks that have a lot of medical problems, they can see 10 or 12 medical specialists frequently and that care is not coordinated,” Bornstein said.
Primary care physicians, particularly in the private practice realm, have traditionally been trained to work independently. However, experts said as medical care grows more complex, it is important for physicians to work and communicate with an interdisciplinary team to provide the best care possible to patients.
While it may be difficult for many older and already established physicians to make the transition, experts said, with the establishment of the South Texas medical school and the Dell School of Medicine in Austin, the UT System will train the future medical workforce with a foundation for interdisciplinary cooperation.
“Medical schools around the country are all undergoing change, and there is a general agreement about what those changes ought to be. But they are very slow to occur in existing institutions where you have already established departments and people,” Shine said.
“This is one of the reasons that the new deans for these two new schools are so excited; they have an opportunity to do things that are very modern,” Shine said.
A TALE OF TWO MEDICAL SCHOOLS
“We are the only system of higher education in America that is embarking on two medical schools at the same time,” UT System Chancellor Francisco Cigarroa said. “They both have to be focused on innovation and how we educate students in the future. So we are both learning from each other and so you have two founding deans that are going to be talking to each other and comparing notes, which is going to make the Dell School of Medicine better, and it’s going to make the South Texas School of Medicine better.”
The University of Texas – Rio Grande Valley School of Medicine, and the Dell School of Medicine in Austin, will be the first UT System medical schools built on academic campuses.
Unique to the Valley medical school, though, is the concurrent establishment of one regional university. “Its perfect because it’ll be a part of one university. It’s going to synergize the new UT-RGV,” Cigarroa said.
The UT System currently has four schools of medicine, all of which are integrated as part of health science campuses.
The health science campus model dates back to the 1870s when Texas voters chose to establish the University of Texas in Austin, and its medical school, the University of Texas Medical Branch, in Galveston, Shine said.
“Texas is unique. It was an accident of history that the medical schools in Texas were separated from the academic campuses. Throughout the United States that’s quite unusual,” Shine said. “When the subsequent medical schools were built, they were all built as part of health campuses. So this is the first time for the University of Texas that the medical schools will be a part of the university.”
While they remain independent of one another, both institutions share the same ambition of providing 21st century education, which allows for curriculum planners and school leadership to work together to solve problems and share ideas.
However, financing and planning for the medical schools are being conducted independently, and neither institution will divert resources away from their corresponding academic campuses.
With the Regional Academic Health Center’s approximate $15.8 million in funding per year, the regent’s $10 million per year commitment, a $1 million per year contribution from Hidalgo County and four municipalities — totaling $15 million — there is about $25.8 million in available funding for the establishment of the UT – RGV School of Medicine, Shine said.
The overall total could be a little more than $30 million, Shine said. “That’s a substantial amount of money to begin the medical school,” Shine said. “It’s not going to be the long term budget, but certainly for the couple of years at least it provides the resources to start the medical school, to support the new dean, to allow the dean to recruit new faculty and so forth.”