>> M.D., D.O., P.A., NURSE PRACTITIONER, R.N., PHYSICAL
THERAPIST, PHARMACIST, THE LIST GOES ON AND ON.
OPPORTUNITIES FOR WORKING IN THE HEALTH PROFESSIONS,
TONIGHT, "ON CALL WITH THE PRAIRIE DOC."
>> GOOD EVENING, AND WELCOME TO "ON CALL WITH THE PRAIRIE DOC."
THE PRACTICE OF MODERN MEDICINE INCLUDES A WIDE VARIETY OF
PROFESSIONAL OCCUPATIONS, A VIRTUAL HALO OF ASSISTANCE
AROUND THE PATIENT TO COVER ALL ASPECTS OF THEIR TREATMENT.
FIRST, LET'S TAKE A LOOK AT THIS WEEK'S PRAIRIE DOC QUIZ QUESTION.
BY THE YEAR 2025, AS THE BOOMERS GRADUATE INTO OLD AGE
AND AS THE NEEDS FOR HEALTH CARE IN THIS GROUP INCREASE IN
THE U.S., IT IS ESTIMATED THAT THERE WILL BE A CRITICAL SHORTAGE OF PHYSICIANS.
HOW MANY PHYSICIANS WOULD BE NEEDED TO MAKE UP THAT SHORTFALL?
A: 25,000
B: 50,000
OR C: 90,000?
WE WILL SHARE THE ANSWER AT THE END OF THE PROGRAM.
JOINING US TONIGHT IS DR. MARY NETTLEMAN, DEAN OF THE
U.S.D. SANFORD SCHOOL OF MEDICINE.
AND DR. BROCK ROPS, EDUCATION COORDINATOR WITHIN THE
DEPARTMENT OF FAMILY MEDICINE AT THE U.S.D. SANFORD SCHOOL OF MEDICINE.
THANK YOU BOTH FOR BEING HERE.
>> THANK YOU FOR HAVING US.
>> A GREAT OPPORTUNITY.
SO WE'RE GOING TO TALK ABOUT, REALLY, THE TRAINING AND ALSO
ALL ASPECTS OF HEALTH CARE PROFESSIONS.
AND, YOU KNOW, WHAT YOU NEED TO DO TO GET IN AND WHY WOULD YOU
WANT TO DO SUCH A THING AND ALL OF THAT.
BUT BEFORE WE GET INTO THAT, BROCK, I WOULD LIKE TO HEAR A
LITTLE BIT MORE ABOUT YOU.
>> WELL, I'M SOUTH DAKOTA-BORN AND RAISED SO I KNOW A LOT ABOUT THE PRAIRIE.
>> YOU GREW UP IN?
>> I GREW UP IN LENNOX, SOUTH DAKOTA, AND I'M LIVING NOW BACK
THERE IN WHAT I WOULD CALL A LITTLE BIT OF RURAL AMERICA.
AND SO WE JUST -- WE LOVE THAT LIFESTYLE.
>> THE LENNOX TIGER, ISN'T IT?
>> LENNOX ORIOLES, IT'S ORANGE AND BLACK --
>> YEAH, ORANGE AND BLACK.
>> THAT'S EXACTLY RIGHT.
SO I GREW UP THERE, GOT INTO -- WITH THE COLLEGE AT USD AND
MOUNT MARTY COLLEGE MAJORING IN BIOLOGY AND SECONDARY EDUCATION, GRADUATED
AND TAUGHT, YOU KNOW, FIVE DIFFERENT LAB SITES AT THE HIGH
SCHOOL LEVEL BEFORE MOVING INTO THE AHEC AS AN EDUCATION
COORDINATOR POSITION AND HAVE BEEN THERE FOR SIX YEARS.
>> AND WE'LL TALK MORE ABOUT YOUR PROJECT WITH
PRE-PROFESSIONALS AND THE SORT OF THE FFA ORGANIZATION OF
PREPROFESSIONALS BUT WE'LL TURN TO YOU FIRST, MARY.
SO YOU'RE NOT ORIGINALLY FROM SOUTH DAKOTA.
>> NO, BUT I GOT HERE AS SOON AS I COULD
[Laughter]
>> GREAT ANSWER.
>> THAT'S WHAT MY BUMPER STICKER SAYS.
>> GOT HERE JUST AS SOON AS I COULD.
SO YOU'RE ORIGINALLY FROM --
>> MICHIGAN.
>> MICHIGAN.
>> BORN AND RAISED IN MICHIGAN.
MEDICAL SCHOOL IN VANDERBILT, WHICH IS IN NASHVILLE.
I DID MY RESIDENCY AND FELLOWSHIP TRAINING IN INDIANA
UNIVERSITY AND THEN TEN YEARS AT THE UNIVERSITY OF IOWA, TEN
YEARS AT VIRGINIA COMMONWEALTH UNIVERSITY, TEN YEARS AT
MICHIGAN STATE AND HERE I AM.
>> SO, YOU'RE AN INFECTIOUS DISEASE SPECIALIST.
>> THAT'S MY SPECIALTY.
>> YOU KEEP THAT BUT, OF COURSE, YOU'RE THE DEAN OF THE
MEDICAL SCHOOL, THAT'S KIND OF A HUGE JOB.
>> IT IS.
IT'S A VERY CONSUMING JOB BUT I HAVE GREAT PEOPLE TO WORK WITH
SO IT MAKES IT REALLY EASY.
>> AND YOU'RE MARRIED TO A HANDSOME AND WONDERFUL MAN.
>> YES, HE IS.
YES, INDEED HE IS.
>> I TOTALLY AGREE WITH THAT.
AND YOU'VE BEEN HERE FOR HOW LONG NOW, MARY?
>> ALMOST SIX YEARS.
>> SO WHAT'S SPECIAL ABOUT SOUTH DAKOTA SCHOOL OF MEDICINE?
>> WELL, THERE ARE A LOT OF THINGS THAT ARE SPECIAL ABOUT IT.
ONE IS, FIRST OF ALL, WE'RE SMALL COMPARED TO MOST MEDICAL SCHOOLS.
WE TAKE 71 STUDENTS PER CLASS AND OUR CURRICULUM IS SLIGHTLY DIFFERENT.
WE GET PEOPLE IN FRONT OF PATIENTS SOONER THAN MOST SCHOOLS DO.
WE INTEGRATE ALL OF OUR CLINICAL SCIENCES SO A LOT OF
PLACES YOU DO SIX WEEKS OF PEDIATRICS AND SIX WEEKS OF
SURGERY AND WHEN YOU'RE DOING CLINICALS, AND WE TRY TO
INTEGRATE IT SO YOU'RE DOING EVERYTHING EVERY WEEK AS A
MEDICAL STUDENT SO THAT YOU REALLY -- YOU CAN'T FORGET IT,
YOU CAN'T JUST LIKE BINGE LEARN ONE FIELD AND THEN JUST FORGET
IT AND MOVE ON TO THE NEXT BECAUSE IT'S IMPORTANT TO
REMEMBER THINGS IN MEDICAL SCHOOL.
>> YES, IT IS.
SO IT'S ALL OF THEM ARE BLENDING.
>> YES, THEY'RE ALL BLENDED TOGETHER.
>> I REMEMBER TWO YEARS OF MEDICAL SCHOOL THAT ALL I DID
WAS SIT AND DO MEMORIZATION, MEMORIZATION, MEMORIZATION, AND
THEN THE SECOND TWO YEARS, I HAD TO LEAVE SOUTH DAKOTA AND GO TO ATLANTA.
>> RIGHT, YOU WERE PART OF A --
>> OH, TWO YEARS AGO, YEAH.
>> BECAUSE WE ONLY HAD A TWO-YEAR SCHOOL AT THE TIME AND
THEN YOU GOT YOUR CLINICAL FEET WET WHICH I THOUGHT WAS A WONDERFUL PARTS.
>> BUT NOW WE DO IT SLIGHTLY DIFFERENTLY.
FIRST OF ALL, THERE'S NO MORE THAN 17 HOURS OF LECTURE A WEEK
AND USUALLY NO MORE THAN THAT, BY DESIGN.
THERE ARE TWO AND A HALF DAYS THAT ARE NOT SCHEDULED TO
STUDENTS HAVE TIME TO SCHEDULE WITHIN THE WORK WEEK AND ALL
THE DIFFERENT LEARNING IS DESIGNED TO TRY TO EMBED IT IN
PEOPLE'S DEEP MEMORY, DEEP, DEEP IN THEIR MEMORY SO THEY
CAN'T JUST FORGET IT AND DUMP IT OUT AGAIN BUT THEY HAVE TO
THINK ABOUT HEPATITIS, THEY CAN TURN IN -- PULL THAT OUT OF
THEIR MEMORY AND USE IT.
>> SO THIS KIND OF INDIVIDUAL BLENDED EDUCATION KIND OF
STARTED IN YANKTON, SOUTH DAKOTA.
>> YES, IT DID.
>> PARTLY BECAUSE OF NECESSITY, THAT'S WHAT THEY HAD.
>> PARTLY, ALTHOUGH THEY COULD HAVE DONE THE OLD-FASHIONED MODEL.
I THINK THEY WERE JUST INNOVATIVE AND IT IS CALLED --
ITS OFFICIAL WORD IS THE LONGITUDINAL INTEGRATED
CURRICULUM BUT NATIONALLY IT'S REFERRED TO AS THE YANKTON MODEL.
IN FACT, INTERNATIONALLY IT'S REFERRED TO AS THE YANKTON
MODEL AND MOST MEDICAL SCHOOLS HAVE SOME VARIATION OF THAT ON
AT LEAST ONE OF THEIR CAMPUSES NOW.
>> THE HARVARD PEOPLE ARE TRYING TO CALL IT THE HARVARD METHOD.
>> YES, IT'S REFERRED TO HARVARD AS THE YANKTON OF THE EAST.
[Laughter]
>> YES, I KNOW.
BUT IT WAS THE YANKTON GROUP THAT STARTED IT AND HARVARD
CAME IN -- IN FACT, A LARGE PROPORTION OF THE MEDICAL
SCHOOLS IN THE COUNTRY HAVE ACTUALLY VISITED YANKTON, SOUTH
DAKOTA, TO SEE HOW IT'S DONE. DR. LORIE HANSEN, OUR
CAMPUS DEAN, LEADS THAT EFFORT THERE.
>> AND IT WAS A LOT OF LORIE'S CREATIVITY THAT BROUGHT IT TO --
>> IT WAS, YEAH.
>> IT REALLY WAS.
>> YEAH, IT WAS, AND NOW THE WHOLE SCHOOL IS ON THAT TYPE OF CURRICULUM.
>> WE ARE REALLY -- THEY CALL IT THE THREE PILLARS NOW.
>> WE CALL IT THREE PILLARS, INSTEAD OF FOUR YEARS.
THE FIRST PILLAR IS FOUNDATIONAL SCIENCES, DO YOU
UNDERSTAND,UP, THE FOUNDATION OF MEDICINE.
AND THE SECOND ONE IS REALLY GETTING MEDICAL -- MORE MEDICAL
KNOWLEDGE, AND THEN YOU GET INTO MORE ADVANCED SKILLS WHERE
YOU ARE LEARNING SUBSPECIALTIES, YOU'RE DELVING
MORE INTO AN AREA YOU THINK YOU WANT TO SPEND YOUR LIFE IN SO
CURRICULUM ALLOWS STUDENTS TO GET EXPERIENCES BEFORE THEY
HAVE TO ACTUALLY DECIDE WHAT THEY WANT TO DO, WHETHER TO BE
A SURGEON OR A FAMILY PHYSICIAN OR SOMETHING ELSE.
>> OR AN INTERNIST.
>> OR AN INTERNIST.
>> LIKE YOU AND I.
>> YES.
BUT AN INTERNIST IS AN ADULT MEDICINE SPECIALIST.
>> DOCTORS FOR ADULTS IS --
>> DOCTORS FOR ADULTS, YES.
>> SO, BROCK, YOUR TRAINING HAS BEEN IN BIOLOGY AND YOU WERE
HIRED TO BE A COORDINATOR OF WHAT KIND OF -- WHAT WAS GOING
ON IN FAMILY PRACTICE IN SIOUX FALLS?
>> SO I WAS HIRED THROUGH AN AHEC, AN AREA HEALTH EDUCATION
CENTER WHICH IS A FEDERALLY FUNDED PROGRAM THAT REALLY
LOOKS TO REACH OUT INTO COMMUNITIES HAVE THE OUR FOCUS
REALLY IS TO GET HEALTH CARE PROFESSIONALS TO WORK IN RURAL COMMUNITIES.
AND SOMETHING THAT WE HAD COME ACROSS AND IN MY HIRE WAS THE
FUTURE HEALTH PROFESSIONALS PROGRAM THAT'S A NATION-WIDE
PROGRAM AND OUR STATE WAS NOT
AFFILIATED WITH THAT, SO WE FOUND OUT FROM OUR STATE
DEPARTMENT OF EDUCATION JUST HOW INTERESTED -- HOW MUCH
INTEREST IS THERE FROM STUDENTS IN THAT HEALTH SCIENCE FIELD
AND FOUND THAT IT'S THE SECOND LARGEST CAREER CLUSTER INTEREST.
AND, THEREFORE, WE THOUGHT WE NEEDED TO PURSUE GETTING THIS
STARTED IN THE STATE OF SOUTH DAKOTA, AND SO WE STARTED IT --
WE'VE GOT OUR CHARTER IN 2012, 2013.
>> SO THIS HOSTED THING IS TALKING ABOUT -- IT'S SORT OF
LIKE FFA IN HIGH SCHOOLS BUT IT CAN BE IN COLLEGES, TOO.
>> SURE.
>> AND THE PRE-MEDICAL HEALTH PROFESSIONS OF ANY KIND.
>> OF ANY KIND.
WHEN I TRAVEL AROUND OUR STATE, AND WE'VE GOT 30 CHAPTERS
STATEWIDE, OUR SMALLEST CHAPTER IS 13 IN HOVAN, SOUTH DAKOTA,
OR 15 IN IROQUIOS AND THEN WE'LL HAVE CHAPTERS AS LARGE AS
100 IN HARRISBURG AND 70 IN DAKOTA VALLEY.
BUT, REALLY, WE'RE TRYING TO GET STUDENTS TO UNDERSTAND JUST
CAREER AWARENESS, NUMBER ONE. WHAT IS ALL OUT THERE, BECAUSE
MOST STUDENTS THINK HEALTH CARE AND THEY THINK PHYSICIAN,
PHARMACY, NURSE, AND THAT'S THE END OF IT.
>> RIGHT.
>> SO TRYING TO GET OUT THERE, JUST THE ENTIRE SPECTRUM OF
HEALTH CARE CAREERS IS NUMBER ONE.
AND THEN NUMBER TWO, TRYING TO BASICALLY KNOCK DOWN THESE
WALLS THAT I HAVE TO BE A 4.0, THAT'S NOT TRUE.
OR I FEEL I DON'T HAVE THE RESOURCES HERE IN THIS SMALL
COMMUNITY AND THAT'S JUST NOT TRUE.
AND SO TRYING TO REALLY BUILD CONFIDENCE IN THESE STUDENTS TO
PURSUE WHATEVER CAREER PATH THAT THEY CHOOSE, HEALTH-WISE.
>> IF YOU'RE FROM HOVAN OR DESMET, WHERE I'M FROM,
YOU -- AND LET'S LOOK AT THE PICTURES.
TELL ME A LITTLE BUILT MORE ABOUT THIS.
>> SO, EVERY YEAR WE HAVE AN ANNUAL STATE LEADERSHIP
CONFERENCE HEALED IN SIOUX FALLS.
>> THESE LOOK LIKE BABIES.
THESE ARE BABIES.
>> NO, NO.
NO, THEY'RE YOUNG ADULTS.
>> THEY'RE SO YOUNG.
[Overlapping Conversation]
>> YOUR PERSPECTIVE, RICK.
>> KEEP GETTING YOUNGER AND SO THIS IS A PICTURE OF US AT THE
SANFORD PENTAGON WHO HOSTED THE EVENT. STUDENTS COME TO COMPETE IN
OVER 50 DIFFERENT EVENTS THAT ARE HEALTH CARE SLANTED.
>> SO WE HAD IT IN SIOUX FALLS?
>> YES.
>> THE NATIONAL MEETING.
>> THIS IS JUST FOR THE STATE.
>> THIS IS OUR STATE MEETING.
[Overlapping Conversation]
>> AND HERE THEY ARE EXAMINING A FUNNY LOOKING DUDE.
>> THAT'S RIGHT, THAT'S THE ASSIMILATION SEPTEMBER AT THE SCHOOL OF MEDICINE.
>> SO, YOU KNOW, I SENSE THAT IF YOU'RE GOING TO BRING
SOMEBODY TO DESMET TO PRACTICE MEDICINE OR TO BE A
NURSE OR TO BE A FLOW BOTH MISS OR TO DO HEALTH CARE OF ANY
KIND OF FORM OR SHAPE, YOU REALLY NEED TO COME FROM
DESMET OR YOU HAVE A WHOLE LOT HIGHER CHANCE OF COMING
BACK TO DESMET IF YOU STARTED THERE.
>> I PERSONALLY BELIEVE THAT.
I FEEL IF THE STUDENT FEELS THEY GAINED THEIR CONFIDENCE OR
THEIR START, WHETHER 15, 16, 17 YEARS OLD, THEY KNOW THAT
COMMUNITY BEST AND I FEEL THAT THEY FEEL THEY'VE GOT A REALLY
GOOD START THERE AS A HIGH SCHOOL STUDENT, THAT THE
LIKELIHOOD OF THEM RETURNING TO THAT COMMUNITY TO RAISE A
FAMILY AND TO PRACTICE THERE INCREASES.
>> YOUR RESPONSE TO THOSE COMMENTS ABOUT WHERE PEOPLE GO TO PRACTICE.
IF WE'RE GOING TO PRACTICE RURAL HEALTH CARE, HOW
IMPORTANT IS IT THAT WE DRAW FROM THE RURAL --
>> I THINK IT'S VERY IMPORTANT, I THINK IT'S NOT JUST EVEN
DRAWING FROM THE RURAL AREAS, I THINK IT'S TRAINING PEOPLE IN
THE RURAL AREA TO THE EXTENT THAT WE CAN BECAUSE MEDICINE IN
A RURAL COMMUNITY IS A LOT OF FUN BUT IT'S A SLIGHTLY
DIFFERENT THING THAN IT IS IN THE CITY WHERE YOU MIGHT HAVE
SPECIALISTS ALL AROUND YOU AND SO GETTING THAT CONFIDENCE IS
REALLY IMPORTANT SO WE HAVE -- WE CONSCIOUSLY PROVIDE
OPPORTUNITIES FOR OUR STUDENTS TO TRAIN IN RURAL AREAS.
IN FACT, THE ENTIRE CLASS HAS TO DO A REQUIRED RURAL
EXPERIENCE IN FAMILY MEDICINE.
>> THAT'S -- WE SHOULD GET INTO THAT AND WE WILL IN A LITTLE BIT.
BUT LET'S DO THIS FIRST.
BEGINNING IN THE MID 1960S, A NEW PROGRAM WAS DEVELOPED TO
TAKE ADVANTAGE OF THE FIELD TRAINING AND EXPERIENCE OF
FORMER MILITARY CORPSMEN AND EDUCATE THEM AS PHYSICIAN'S
ASSISTANTS TO FILL A SHORTAGE OF PRIMARY CARE PHYSICIANS.
IN 1993, THE SANFORD SCHOOL OF MEDICINE ADDED A PHYSICIAN'S
ASSISTANTS PROGRAM TO THEIR OFFERINGS.
WHAT DOES THIS MEAN FOR THE FUTURE OF MEDICINE IN SOUTH
DAKOTA, BOTH RURAL AND URBAN?
>> SO I THINK THE EASIEST WAY TO DESCRIBE PHYSICIAN'S
ASSISTANT AND WHAT THEY DO IS TO SAY P.A.s PRACTICE
MEDICINE, AND P.A.s PRACTICE MEDICINE AND A WHOLE HOST OF
AREAS WITHIN THE HEALTH CARE FIELD, RIGHT?
SO THE COMMON ONE THAT HISTORICALLY STARTED THE
PROFESSION WAS REALLY ABOUT PRIMARY CARE AND GETTING
P.A.s INTO PRIMARY CARE TO PRACTICE MEDICINE IN A PRIMARY CARE SETTING.
BUT CLEARLY P.A.s WORK IN PRIMARY CARE AND P.A.s WORK
IN MULTIPLE SPECIALTIES ACROSS THE SPECTRUM, AS WELL.
SO IT'S DIFFERENT FROM BEING A PHYSICIAN IN THAT THE TRAINING IS LESS.
A P.A. PROFESSION OR PROGRAMS ARE SOMEWHERE BETWEEN 24 AND 28
MONTHS IN LENGTH KIND OF ON THE AVERAGE, AND SO STUDENTS COME
IN WITH A -- TYPICALLY THEY COME IN WITH AN UNDERGRADUATE
DEGREE, TYPICALLY THAT MEANS A BIOLOGY DEGREE OR A HEALTH
SCIENCES DEGREE, AND THEY ALL HAVE SOME LEVEL OF EXPERIENCE BEFOREHAND.
EVERY P.A. PROGRAM IN THE COUNTRY IS MODELED AFTER THE
MEDICAL MODEL, WHICH KIND OF -- WHICH PRIMARILY MEANS THE FIRST
PHASE OR THE FIRST HALF OF THE PROGRAM IS THE DIDACTIC PHASE
OR KIND OF THE BASIC SCIENCE FOUNDATIONAL COURSE WORK THAT
THEY NEED, SOME GROSS ANATOMY, PHYSIOLOGY, PHARMACOLOGY,
CLINICAL MEDICINE, THOSE KINDS OF THINGS, AND THEN THE LAST
HALF OF THE PROGRAM IS ALL ABOUT CLINICAL ROTATIONS OR THE
SUPERVISED PRACTICE OF MEDICINE SO THEY SPEND 12 MONTHS MINIMUM
OF 2,000 HOURS OVER THAT 12 MONTHS PRACTICING IN A VARIETY
OF -- PRACTICING UNDER SUPERVISION IN A VARIETY OF
MEDICAL SETTINGS AND THEN AFTER THAT 12 MOMENTS, THEY GRADUATE.
P.A.s DON'T DO A RESIDENCY PROGRAM AND THE OTHER
DIFFERENCE IS THAT P.A.s ALWAYS WORK WITH PHYSICIANS,
RIGHT, SO P.A.s HAVE COLLABORATING PHYSICIANS THAT THEY WORK FOR AND WITH.
THE INTERESTING THING IS RIGHT NOW WE'RE DEALING WITH THE
HEALTH CARE PROVIDER SHORTAGE BUT 50 YEARS AGO WHEN THE
P.A. PROFESSION STARTED, IT STARTED BECAUSE THERE WAS A
HEALTH CARE PROVIDER SHORTAGE.
THAT'S WHY THE PROGRAM EXISTS, WHEN IT STARTED IN THE FIRST
CLASS ENROLLED IN 1993.
WE WERE ESTABLISHED BECAUSE THERE WAS A HEALTH CARE
PROVIDER SHORTAGE, ESPECIALLY FELT IN SMALL UNDERSERVED
COMMUNITIES WITHIN THE STATE.
THAT'S OUR MISSION, THAT'S WHY WE'RE HERE, THAT'S WHY WE EXIST.
AND SO THAT'S THE NICHE THAT WE TRY TO HELP -- WE TRY TO HELP
FULFILL AND FILL THAT NICHE WITHIN THAT RURAL PRIMARY CARE
SETTING AS WELL AS THE NEEDS OF THE ENTIRE STATE.
AND THERE WAS A RURAL HEALTH EDUCATION STUDY THAT WAS DONE A
COUPLE OF YEARS AGO THAT LOOKED AT THE PROPORTION OF P.A.s
PRACTICING IN RURAL AREAS, AND WHERE THOSE STUDENTS ACTUALLY
COME FROM, OR THOSE PRACTICING P.A.s, WHERE THEY CAME FROM
HAVE THE AND SOUTH DAKOTA RANKED 12th IN THE COUNTRY
IN PRODUCTION OF P.A.s IN RURAL COMMUNITIES.
CLEARLY, THAT'S OUR MISSION, CLEARLY THAT'S WHERE THE NEEDS AT
AND THAT'S WHERE WE WANT TO PRODUCE P.A.s.
>> SO P.A. SCHOOL IS WITHIN THE SCHOOL OF MEDICINE?
>> THE SCHOOL OF SCIENCES, YES, ON THE CAMPUS.
YES.
>> IT'S ON THE CAMPUS HIM AND HIS COMMENTS ABOUT HISTORY AND
ROLES AND SO ON, SO FORTH, WHAT WOULD YOU REFLECT AS AN
IMPORTANT POINT TO UNDERLINE?
>> WELL, I THINK IT'S A TEAM APPROACH.
YOU BEGAN BY SAYING THAT THERE IS A SHORTAGE OF PHYSICIANS AND
THERE IS A NEED FOR MORE THAN JUST PHYSICIANS AND MORE THAN
JUST WHAT PHYSICIANS DO, AND P.A.s PLAY A VERY IMPORTANT
ROLE IN DOING THAT.
THEY WORK ALONGSIDE PHYSICIANS, THEY SEE PATIENTS.
WHEN YOU GO TO YOUR DOCTOR'S OFFICE, YOU MIGHT BE SEEN BY A
P.A. FOR SOME THINGS, FOR EXAMPLE, OR A NURSE
PRACTITIONER HAVE THE AND SO THAT IS -- I THINK THE MODERN
WAY AND PROBABLY MOST PEOPLE IN YOUR AUDIENCE HAVE BEEN SEEN
BY -- HAVE GONE INTO A DOCTOR'S OFFICE AND SEEN SOMEBODY IN ONE
OF THOSE TWO PROFESSIONS.
>> RIGHT.
ANY COMMENT -- YOU'RE PART OF THE FAMILY PRACTICE.
>> WELL, I MEAN, I THINK THAT, YOU KNOW, OUT IN RURAL SOUTH
DAKOTA, YOU'VE GOT ISSUES THAT ARE GOING TO HAVE TO BE FILLED
AND YOU MENTIONED BEFORE ABOUT THE BABY-BOOMER POPULATION AND
SOMETHING WITH -- IT'S A DOUBLE-WHAMMY IN HEALTH CARE
BECAUSE NOT ONLY ARE THESE P.A.s OR NURSE PRACTITIONERS
OR PHYSICIANS RETIRING AS THEY GET OLDER BUT THEY'RE ALSO
GOING TO NEED MORE HEALTH CARE, WHICH IS JUST A -- IT'S JUST A
BIG VACUUM AND SO WE'VE GOT TO HAVE THESE FUTURE HEALTH
PROFESSIONALS AVAILABLE TO FILL THIS VOID.
>> AND IT IS A -- IT'S KIND OF SCARY, YOU KNOW, OF COURSE, AS
A RETIRING PHYSICIAN AT THIS PHASE OF MY LIFE, I'VE GOT TO
HAVE SOMEBODY TAKE CARE OF ME.
WHO'S GOING TO DO THAT?
>> RIGHT.
RIGHT.
>> IT'S NOT GOING TO BE ME.
>> AND PEOPLE AREN'T GOING TO GO TO P.A. SCHOOL IF THEY DON'T
KNOW WHAT A PHYSICIAN ASSISTANT IS AND THAT'S WHERE I THINK HOSA COMES IN.
>> WHAT ABOUT THE IDEA OF TRAINING OF P.A.s?
HE SAID THE MEDICAL MODEL.
>> YES.
>> WHAT DOES HE MEAN BY THAT?
>> OH, HE MEANS IT STARTS WITH A FOUNDATIONAL OF SCIENCES,
LEARNING ABOUT MEDICINES, LEARNING ABOUT MEDICATION,
LEARNING ABOUT THE FUNCTION OF THE HUMAN BODY AND HOW THAT ALL
WORKS TOGETHER AND -- ALTHOUGH THEY ALSO HAVE CLINICAL
EXPERIENCES EARLY, BUT THEN MOVING STRONGLY INTO THE
CLINICAL EXPERIENCES TOWARD THE LATTER PART OF THE TRAINING.
SO THAT'S SIMILAR TO THE MEDICAL MODEL OF ONE -- FIRST
GETTING YOUR FEET ON THE GROUND AND THEN LEARNING AND
PRACTICING YOUR SKILLS, IF YOU WILL.
>> AND OF COURSE THAT'S -- YOU KNOW, I THINK THE PART OF MY
TRAINING THAT I THINK ABOUT WAS THE MENTORSHIP.
>> YES.
>> THE TIME THAT I'M HANGING WITH SOMEBODY AND I LEARN BY
EXAMPLE, AND I KIND OF -- I REMEMBER SAYING TO MYSELF AFTER
FIVE OR TEN YEARS OF PRACTICE, I WISH I COULD GO BACK AND
SHADOW FIVE OR TEN DOCTORS AGAIN AND SEE WHAT I'M DOING RIGHT OR WRONG.
I MEAN, I'VE GOT STUDENTS SHADOWING ME, I HOPE I'M DOING THE RIGHT THING.
I'M HOPING THAT I'M DOING THE RIGHT THING.
>> I AM POSITIVE YOU'RE DOING THE RIGHT THING.
>> I -- I MADE EVERY EFFORT TO TRY TO DO THE RIGHT THING AND
PART OF IT IS BECAUSE YOU ARE HELPING SOMEONE WHO IS IN NEED.
>> RIGHT.
>> YOU JUST HAVE TO BE THE VERY BEST YOU CAN BE.
>> RIGHT, AND OUR SCHOOL TAKES ONLY PEOPLE WHO ARE FROM SOUTH
DAKOTA OR WHO HAVE INCREDIBLY STRONG SOUTH DAKOTA ROOTS SO, I
MEAN, THE PEOPLE WHO ARE PRACTICING FROM OUR SCHOOL
WORKED WITH PEOPLE, YOU KNOW, AND NOW WHEN -- WHEN THEY WERE
TRAINING AND NOW FEEL THEY CAN GIVE BACK, AND IN THIS STATE,
IT'S LIKELY TO THEIR NEIGHBOR'S SON OR THEIR COUSIN'S WIFE'S
NEPHEW OR SOMETHING LIKE THAT SO IT'S DEFINITELY A -- WE RELY
VERY HEAVILY ON THE REST OF THE STATE TO SUPPORT US, AND THEY CERTAINLY DO.
>> THEY DO, DON'T THEY?
>> UH-HUH, THEY DO.
>> SO, LET'S TALK ABOUT THIS ORGANIZATION, THE HOSA, A LITTLE BIT MORE.
I KIND OF WANT TO GET INTO THAT.
SO WE WERE ABOUT THE LATEST --
>> YES, THERE'S 48 STATES ACTUALLY, A COUPLE THAT STILL
AREN'T ON BOARD AND WE BECAME THE 47th AND NORTH DAKOTA BECAME THE
48th STATE AND REALLY TRYING TO GET STUDENTS TO
UNDERSTAND -- LIKE WHEN THEY HEAR P.A., THEY THINK
P.A. SYSTEM OR THEY THINK --
[Laughter]
[Overlapping Conversation]
>> THAT'S EXACTLY RIGHT, OR WHEN THEY HEAR PHYSICIAN
ASSISTANTS, THEY THINK I DON'T WANT TO BE AN ASSISTANT, I WANT
TO BE MY OWN -- THEY'RE JUST THIS MISCOMMUNICATION ON WHAT
ACTUAL CAREERS ARE AND EVEN TO GET INTO THE CONVERSATION ABOUT CAREERS AVAILABLE.
WHEN WE START LOOKING AT GENETICS AND START LOOKING AT
CAREERS THIS AREN'T EVEN HERE YET AND WHAT'S ON THE HORIZON
AND REALLY PERSONALIZED MEMBERS AND THOSE TYPES OF THINGS, IT'S
JUST AN EXCITING TIME FOR A HIGH SCHOOL STUDENT TO GET
INVOLVED AND KIND OF GET THEIR FOOT IN THE DOOR AND UNDERSTAND
BEFORE THEY GRADUATE FROM HIGH SCHOOL, WHICH WILL SAVE THEM
TIME AND MONEY LATER ON IN THEIR ACADEMIC JOURNEY, JUST TO
BETTER UNDERSTAND WHAT'S AVAILABLE TO THEM.
>> RIGHT.
SO, NOW, YOU'VE GOTTEN INVOLVED WITH THE ORGANIZATION ITSELF.
TELL US A LITTLE BIT MORE ABOUT THAT.
>> YES, SO I WAS FORTUNATE ENOUGH, I WAS ASKED TO APPLY TO
GET ON THE BOARD JUST ONE YEAR IN AND --
>> THE NATIONAL BOARD.
>> THE NATIONAL BOARD OF --
>> WHICH IS RUN OUT OF DALLAS, TEXAS.
>> AND HOSA STANDS FOR --
>> HEALTH OCCUPATION, STUDENTS OF AMERICA, BUT BECAUSE WE'VE
GROWN SO MUCH WE'RE IN CANADA AND WE'RE IN MEXICO AND WE'RE
IN GERMANY AND SO THEY HAD TO CHANGE KIND OF THAT -- HAD TO
CHANGE THEIR BRAND TO -- THEIR BRAND TO BASICALLY REFLECT
HOSA BECAUSE PEOPLE WANTED TO ADD ON TO THE HISTORY
AND THEN ADDED THE FUTURE PROFESSIONALS
WHICH SIGNIFIES WHAT WE'RE TRYING TO DO IS TO CREATE AND JUST
BUILD A BETTER CANDIDATE FOR WHATEVER CAREER PATH THEY DECIDE TO GO INTO.
>> SO YOU WERE ON THE BOARD FOR A YEAR?
>> ON THE BOARD FOR A YEAR AND KIND OF HOW IT WORKS, I MOVED
INTO A SECRETARY OF THE BOARD AND THEN INTO -- NOT THE CHAIR
ROLE -- AS A CHAIR AND THEN I'LL GO IMMEDIATE PAST CHAIR STARTING IN JANUARY.
>> HE RAN THE PLACE.
HE RAN IT.
>> YOU RAN IT, THAT'S KIND OF NEAT.
>> IT'S BIG SHOES TO FILL AND THERE IS A LOT OF GOINGS ON AND, OBVIOUSLY, WHEN YOU
OVERSEE AN ORGANIZATION OF OVER 200,000 MEMBERS, THAT'S A BIG BUSINESS.
>> DO PEOPLE FROM LENNOX REALLY REALIZE WHAT'S HAPPENED --
>> WELL, I DON'T KNOW --
>> WE'RE PROUD.
>> WELL, WE ARE PROUD.
>> I CERTAINLY AM EXCITED ABOUT THE ROLE I PLAY AND JUST THE
VISION, I'M A VISIONARY, I TRY TO BE INNOVATIVE IN WHAT WE DO
AND EVERY YEAR WE'RE TRYING TO TWEAK LIKE WHAT CAN WE DO
BETTER, AS JUST THE HOSA ORGANIZATION AND DO I SELFISHLY
LOOK OUT FOR OUR KIDS FIRST AND WHAT SOUTH DAKOTA HOSA MEANS
AND THE MISSIONS AND VALUES OF WHAT WE HAVE HERE, JUST LIKE
EVERY STATE IS GOING TO BE DIFFERENT.
WHAT STUDENTS CAN -- WHAT'S REALLY EXCITING IS WATCHING
REPRESENTATIVES FROM THE STATE OF SOUTH DAKOTA GO AND COMPETE
AND ATTEND INTERNATIONAL LEADERSHIP CONFERENCE AND BEING
ABLE TO BE WITH PEERS FROM REALLY ACROSS THE UNITED STATES
AND EVEN BEYOND THAT AND TO MEET KIDS WITH THE SAME CAREER
GOALS, YOU KNOW, SOMEBODY FROM ALABAMA, SOMEBODY FROM HAWAII,
SOMEBODY FROM GERMANY, THAT EXPERIENCE, IT JUST LIFTS THEM
TO A WHOLE NEW LEVEL HAVE THE AND THEN ANOTHER THING IS IT'S
GLOBAL, I MEAN, IT'S -- YOU'RE GROWING TO COMPETE GLOBALLY NOT
ONLY TO GO TO COLLEGE BUT IN A CAREER JUST FOR A JOB AND SO
YOU NEED TO JUST GET THE BEST EDUCATION THEY CAN.
>> THERE IT IS.
>> I WAS DOING SOME PREPARATION FOR THIS SHOW AND I WAS LOOKING
AT RURAL VERSUS URBAN AND I KNOW THAT URBAN IS A TOWN
GREATER THAN 2,500, AND SMALLER THAN -- YOU KNOW, FROM 2,000 TO
50,000, 2500 PEOPLE IN A TOWN TO 50,000 IS KIND OF A
BORDERLINE MICRO URBAN AREA.
LESS THAN 2500 IS URBAN, YOU'RE OUT IN THE COUNTRY OR --
>> YOU MEAN, IT'S NOT URBAN --
>> IT'S RURAL, RIGHT.
>> SO YOU'RE RURAL IF YOU'RE IN A TOWN LIKE DeSMET AT 1600 OR
YOU'RE OUT IN THE COUNTRY.
SO YOU LOOK AT THE COUNTRY, THE UNITED STATES OF AMERICA, WE
HAVE 85% OF THE LAND IS RURAL AND 15% IS URBAN.
15% IS URBAN, RIGHT?
BUT OF THE PEOPLE IN THE UNITED STATES, 85% ARE URBAN AND 15% ARE RURAL.
BUT IF WE GO TO SOUTH DAKOTA --
>> THAT'S A DIFFERENT THING, YES.
>> 50% ARE URBAN, 50% ARE RURAL.
>> UH-HUH.
>> WE'VE GOT VERY HIGH PERCENTAGE OF RURAL, HIGHER
PERCENTAGE THAN ALMOST ANY PLACE, MAYBE A COUPLE THAT ARE MORE RURAL THAN WE ARE.
BUT IT'S IMPORTANT, IF WE'RE GOING TO PROVIDE ACCESS TO
HEALTH CARE IN OUR RURAL AREA, WE'VE GOT TO DRAW OUR STUDENTS
FROM THAT RURAL AREA.
>> ABSOLUTELY.
>> THERE IT IS.
AND THAT'S WHAT YOU'RE DOING.
>> ABSOLUTELY.
AND SOMETHING THAT -- WE'RE TRYING TO GET STUDENTS TO GET
CERTIFICATIONS, WHICH AS A HIGH SCHOOL STUDENT, WHAT CAN YOU
DO, YOU CAN BECOME A CNA OR AN EMT, BECAUSE THE
E.M.T. SHORTAGES IN OUR STATE, IT'S JUST AWFUL AND TRYING TO
GET A HIGH SCHOOL STUDENT AT 18 YEARS OLD TO GET THEIR
E.M.T. IS SOMETHING THAT'S GOING TO BODE WELL FOR THEM
DOWN THE ROAD, AND SO THERE ARE THINGS IN PLACE THAT WE'RE
DOING TO ALLEVIATE SOME OF THOSE ISSUES.
>> THEY DIDN'T HAVE E.M.T.s -- I REMEMBER TRYING
TO GET A JOB ON AN AMBULANCE CREW, SO WHAT EXPERIENCE HAVE YOU HAD?
WELL, I'VE NOT RUN AN AMBULANCE CREW BUT I HAD NO ACCESS, I
DIDN'T HAVE ANY WAY TO GET INTO THAT.
LET'S TALK ABOUT OUR SCHOOL OF MEDICINE, THOUGH.
>> ALL RIGHT.
>> I KNOW THAT WE HAVE -- I'M A REAL FAN, I MEAN, I'VE BEEN --
>> FROM THE BEGINNING.
>> A BIG SUPPORTER.
>> YES.
AND SO WHAT ARE THE INTERESTING THINGS WE CAN SAY ABOUT OUR RURAL COMMITMENT.
HOW DO WE DO ON TRAINING PEOPLE TO BE IN RURAL?
>> SO, FIRST WE DRAW FROM RURAL AREAS, 44% OF ALL OF OUR STUDENTS
ARE FROM RURAL AREAS, WHICH FOR US IS A TOWN OF LESS THAN 10,000.
NOT NEAR AN URBAN CENTER, AND WE ALSO TRACK -- THEY TRACK
NATIONALLY WHERE PEOPLE ULTIMATELY PRACTICE AND SO WE
ARE AT THE 98TH PERCENTILE, ALMOST TOP IN THE COUNTRY FOR THE PROPORTION
OF OUR GRADUATES THAT ACTUALLY DO PRACTICE IN RURAL AREAS.
>> WOW.
>> AND SOMETIMES WE'RE NUMBER ONE IN THE COUNTRY.
I DON'T KNOW WHO WE'RE COMPETING AGAINST, BUT, ANYWAY,
SO WE HAVE A BIG EMPHASIS ON THAT, SO WE DRAW FROM THOSE
POPULATIONS, AS YOU SAY, AND WE ALSO TRY TO TRAIN STUDENTS IN
THIS IN RURAL AREAS AND AS I SAID, 100% OF THEM HAVE SOME RURAL EXPERIENCE --
>> LET'S TALK ABOUT THE TRAINING.
WE HAVE A FARM PROGRAM.
>> WE DO
>> WHEN WE SAY FARM IN THE MEDICAL SCHOOL, WE MEAN THE
FRONTIER AND RURAL MEDICINE PROGRAM AND THIS IS WHERE A
STUDENT CAN SPEND NINE MONTHS OF THAT VERY IMPORTANT FIRST
CLINICAL YEAR IN A SMALLER TOWN IN SOUTH DAKOTA.
SO MILLBANK, MOBRIDGE, PARKSTON, WINNER, VERMILLION,
SPEARFISH, PIERRE -- GEE, I HOPE I DIDN'T FORGET ONE.
SO THOSE ARE THE TRAINING SITES AND THEY TRAIN WITH THE PHYSICIANS WHO ARE THERE.
THEY ARE EMBEDDED IN THEIR COMMUNITIES, THEY DO COMMUNITY PROJECTS AND
THEY LEARN RURAL MEDICINE FROM THE GROUND UP
AND THEY DO REALLY WELL, REALLY WELL ON
THEIR BOARDS, THEY GET EXCELLENT TRAINING.
IT'S BEEN A VERY SUCCESSFUL PROGRAM AND IT'S VERY POPULAR.
WE HAVE MORE --
>> PEOPLE WANTING --
>> MORE PEOPLE WANTING TO DO IT THAN WE HAVE SPOTS.
>> BUT THE INTERESTING THING THAT YOU'RE TELLING ME IS THEY
DO WELL ON THE BOARDS.
[Overlapping Conversation]
>> IT PROVES THEY'RE NOT GETTING LESSER TRAINING.
>> NOT AT ALL.
>> THEY'RE GETTING A LOT MORE HANDS-ON, AREN'T THEY?
>> THEY ARE GETTING VERY MUCH HANDS-ON TRAINING.
>> WE HAD THREE YEARS OF FAMILY PHYSICIAN RESIDENCE AT THE
BROOKINGS CLINIC BACK 15, OH, YEARS AGO, SOMETHING LIKE THAT.
>> UH-HUH.
>> AND THEY ALL STAYED IN RURAL AREAS -- ONE STAYED WITH US AND SHE'S WONDERFUL.
SO -- BUT WE LOST IT BECAUSE THE MONEY FOR THE SUPPORT FOR THAT WENT AWAY.
>> SO WE HAVE SOMETHING NEW, SOMETHING BRAND-NEW, AS FUNDED
BY THE LEGISLATURE ON THE RECOMMENDATION OF THE GOVERNOR
AND THE PERMANENT CARE TASK FORCE, THERE WILL BE A RURAL
FAMILY MEDICINE TRACK IN PIERRE, SOUTH DAKOTA, SO
THEY'LL DO ONE YEAR IN SIOUX FALLS WITH THE SIOUX FALLS
FAMILY MEDICINE RESIDENCY AND TWO YEARS IN PIERRE, SOUTH DAKOTA.
>> THAT'S REALLY NEEDED.
>> WE'RE SO EXCITED.
>> SOME OF MY BUDDIES FROM PIERRE ARE JUST THRILLED ABOUT IT.
>> YEAH.
>> WE'LL TALK ABOUT IT A LITTLE BIT MORE.
I WANT TO TALK ABOUT THAT AWARD THAT WE HAVE.
WE'LL DO THAT IN A MINUTE.
WITH ALL THE VARIOUS OPPORTUNITIES, IT MAY BE
DIFFICULT TO DECIDE IN WHICH AREA YOU WOULD LIKE TO WORK.
THE SOUTH DAKOTA STATE UNIVERSITY COLLEGE OF NURSING
CAN HELP YOU RESEARCH POSSIBLE FIELDS OF STUDY.
>> THERE IS A LOT GOING ON AT SDSU.
OF COURSE, WE HAVE NURSING, WHICH IS REALLY A COLLEGE OF
NURSING, THAT'S WHAT WE DO AND WE DO IT WELL.
BUT WE ALSO HAVE COLLEGE OF PHARMACY AND ALLIED HEALTH
PROFESSIONS, THAT INCLUDES NOT ONLY PHARMACY AND THE PHARM D,
BUT MEDICAL LABORATORY SCIENCE AS WELL AS A MASTER IN PUBLIC
HEALTH PROGRAM THAT IS COLLABORATIVE WITH THE
UNIVERSITY OF SOUTH DAKOTA, AND WE HAVE DIETETICS, EXERCISE SCIENCE,
ATHLETIC TRAINING, SO WE HAVE MULTIPLE HEALTH PROFESSIONS THAT WE PREPARE.
>> SO THERE'S BEEN A CONCERN OFF AND ON OVER THOSE 30 YEARS,
35 YEARS I'VE BEEN PRACTICING IN BROOKINGS ABOUT ENOUGH
NURSES BEING TRAINED AND SOME YEARS, OH, MY GOODNESS, WE'RE
WAY BEHIND AND THEN SOME YEARS, WE'VE GOT ENOUGH.
I'M WONDERING WHERE WE'RE AT RIGHT NOW.
>> WELL, IF YOU THINK ABOUT THE POPULATION DEMOGRAPHIC THAT'S
GROWING THE FASTEST, THOSE WHO ARE 85 YEARS AND OLDER, AND
THAT WON'T CHANGE FOR AT LEAST TWO DECADES, WE KNOW THAT
NURSES ARE GOING TO BE VERY MUCH IN DEMAND.
I DID RECEIVE INFORMATION FROM A NATIONAL STUDY THAT'S DONE
EVERY FIVE YEARS AT A RECENT CONFERENCE, IT'S NOT OUT YET
BUT THERE IS A TIDAL WAVE COMING
AND, IN FACT, IT'S ALREADY THERE, THE SHORTAGE.
>> SO TALK ABOUT THE DIFFERENT ADVANCED PRACTICE NURSING
ROLES, WHAT ARE THEY?
>> ADVANCED PRACTICE REGISTERED NURSES ARE GRADUATE PREPARED
WITH A GRADUATE DEGREE, EITHER A MASTER'S OR A DOCTORAL DEGREE.
THERE ARE FOUR ROLES FOR ADVANCED PRACTICE REGISTERED
NURSES, A NURSE PRACTITIONER, THE ONE THAT'S MOST FAMILIAR TO PEOPLE.
AND THERE ARE MULTIPLE SPECIALIZATIONS.
AND THEN CLINICAL NURSE SPECIALIST, THAT WAS SUCH A
GREAT ROLE FOR THE ACUTE CARE SYSTEM AND FOR TRANSITIONS TO
PRIMARY CARE, STARTED,UP, IN THE '70s, ADVANCED PRACTICE
NURSES WHO ARE CNSs ARE INTEGRATED INTO PRIMARILY
LARGER HEALTH SYSTEMS AND ACUTE CARE SETTINGS, AND THEN THERE
ARE CERTIFIED REGISTER NURSE ANESTHETIST NOW PREPARED AT THE
DOCTORAL LEVEL AND OF COURSE CERTIFIED NURSE MIDWIVES.
IN TERMS OF RESEARCH, NURSE SCIENTISTS HAVE BEEN AROUND FOR ABOUT 60 YEARS.
>> OKAY, SO THERE'S THE SCIENTIST NURSE, THERE'S AN
EDUCATION NURSE, TOO, IS THERE NOT?
>> UH-HUH.
>> EXPLAIN THAT.
>> WELL, WE CAN'T HAVE A HEALTH CARE WORKFORCE WITHOUT THE EDUCATORS WHO PREPARE THEM.
THINK OF ALL THE HEALTH CARE PROFESSIONS, NURSING HAS LEADS
THE WAY WITH PREPARING HEALTH PROFESSIONS' EDUCATORS BECAUSE
WE'VE NEEDED TO BUT SOUTH DAKOTA CODIFIED LAW ACTUALLY
SPECIFIES THAT IN ORDER TO BE AN INSTRUCTOR OR FACULTY MEMBER
IN NURSING, YOU HAVE TO HAVE A MASTER'S DEGREE OR A GRADUATE DEGREE IN THE DISCIPLINE.
WE ALSO HAVE ONLINE OPTIONS THAT ARE ACCESSIBLE FROM A
DISTANCE IN THIS VAST RURAL STATE.
THE HEALTH CARE WORKFORCE IN NURSING CANNOT MEET DEMANDS IF
WE DON'T PREPARE ENOUGH NURSE EDUCATORS AND NURSE EDUCATORS
AND THE ADMINISTRATORS IN NURSING ARE AT THE FOREFRONT OF
A NATIONAL SHORTAGE, AS WELL, SO IT'S SYNERGISTIC.
>> SO ISN'T SHE A GREAT LADY?
THANK YOU, NANCY, FOR THAT.
BROCK, LET'S TALK ABOUT NURSING, TRAINING FOR NURSING
OR THE ENTHUSIASM THAT YOU HEAR OUT THERE IN THE HIGH SCHOOLS
ABOUT NURSING.
>> WELL, A LOT OF STUDENTS, THEY UNDERSTAND NURSING AND THAT'S THE END OF IT.
THE FACT THAT YOU CAN WORK IN SO MANY DIFFERENT AREAS OF
NURSING IS A SURPRISE TO A LOT OF STUDENTS.
AND WHERE THEY WANT TO WORK, MOST STUDENTS, WELL, I WANT TO
WORK WHERE I CAN DELIVER BABIES OR I CAN WORK IN -- NOT JUST
DELIVERING BUT BEING IN THE SUITE THERE, AND I GIVE THEM
THE REALITY OF, LIKE, YOU DO UNDERSTAND IT DOESN'T ALWAYS
COME OUT RIGHT AND ARE YOU ABLE TO HANDLE THAT EMOTIONALLY?
ANOTHER THING IS JUST THAT NURSING AS A PLATFORM TO LAUNCH
INTO A DIFFERENT CAREER IS JUST SUCH A WONDERFUL PLACE TO
START, WHETHER YOU'RE GOING TO BE A NURSE ANESTHETIST OR MOVE
INTO NURSE PRACTITIONER OR WHATEVER THE CASE MIGHT BE.
>> OR SOMETIMES GO TO MED SCHOOL.
>> ABSOLUTELY.
>> SOME DO.
>> AND A LOT OF STUDENTS DON'T UNDERSTAND THAT PATHWAY AND
WE'RE JUST TRYING TO ENLIGHTEN THEM TO THAT.
>> SO, I HAVE A SON WHO'S A NURSE AND A WIFE WHO IS A NURSE AND A NURSE PRACTITIONER.
I'M SURROUNDED BY NURSES AT MY HOUSE.
>> YOU'RE BLESSED
>> I AM BLESSED.
I JUST THINK ABOUT THE TIMES IN THE NIGHT WHEN THE NURSE WOULD
CALL AND SAY, WE'RE IN TROUBLE, I NEED YOU HERE.
>> YEP.
>> OR THE NURSE WOULD CALL AND SAY, YOU KNOW, THINGS ARE FINE
BUT I NEED THIS AND I CAN'T DO IT WITHOUT WAKING YOU UP AND
I'M SORRY BUT, WE NEED -- AND I NEEDED TO MAKE ABSOLUTELY SURE
THAT THEY KNEW THEY COULD WAKE ME.
>> YES, HAVE TO DO THAT, ABSOLUTELY.
>> SO -- BUT THEY'RE THE ONES THAT ARE WITH THE PATIENT AND
KNEW THE MOST AND I LEANED ON THEM MY WHOLE CAREER, NO QUESTION ABOUT IT.
>> BEING MARRIED TO A NURSE, SHE GIVES ME PLENTY OF ADVICE AND I --
>> OH, DOES SHE?
>> AND I AM NOT A VERY GOOD PATIENT AND SHE LETS ME KNOW ABOUT IT.
I TELL YOU WHAT, SHE'S CERTAINLY RIGHT MORE OFTEN THAN SHE'S WRONG.
>> RIGHT.
SO LET'S TALK ABOUT THE AWARD.
>> OH, YES.
>> SO THE AAMC IS WHAT ORGANIZATION?
>> IT'S THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES.
>> SO IT'S YOUR CLUB.
>> IT'S -- ALL THE...
[Overlapping Conversation]
IN THE COUNTRY BELONG TO THIS -- IT'S AN ORGANIZATION.
>> AND WHAT DOES -- IF THEY BELONG, DO THEY GETS ACCREDITED BY THEM OR.
>> NO, THEY BELONG BECAUSE IT IS THE GROUP OF EVERYONE SO WE ALL
GET TOGETHER AT DIFFERENT MEETINGS, I MEAN, ALL THE DEANS
GET TOGETHER AND WE HAVE THE COUNCIL OF DEANS.
THERE ARE A LOT OF FUNCTIONS, THEY RUN THE MATCH, THEY ARE
PART OF THE PEOPLE THAT DO ACCREDIT MEDICAL SCHOOLS BUT,
NO, IF YOU BELONG, YOU ALSO GET ACCESS TO A BUNCH OF DATA, SOME
OF THE DATA I'VE BEEN TALKING ABOUT COMES TO US FROM THE AAMC.
>> SO THE AAMC IS SORT OF LIKE YOUR AMERICAN COLLEGE OF
PHYSICIANS, THE INTERNIST CLUB.
BUT THIS IS THE DEANS AND MED SCHOOL...
[Overlapping Conversation]
>> SO THEY GIVE OUT AWARDS --
>> THEY GIVE OUT DIFFERENT AWARDS, YES.
>> AND WHAT'S HAPPENED WITH SOUTH DAKOTA?
>> SO WE GOT -- THEY ONLY GIVE ONE AWARD EACH YEAR TO A MEDICAL SCHOOL.
THEY GIVE INDIVIDUAL AWARDS BUT THEY ONLY GIVE ONE TO A
MEDICAL SCHOOL AND THEY CONSIDER IT -- MANY DO CONSIDER
IT THE TOP AWARD THAT A MEDICAL SCHOOL CAN RECEIVE, IT'S CALLED
THE SPENCER FOREMAN AWARD FOR OUTSTANDING COMMUNITY SERVICE
AND RECOGNIZES A MEDICAL SCHOOL THAT IS FULFILLING ITS MISSION
TO ITS CONSTITUENCIES, THAT ITS COMMUNITIES -- THE COMMUNITIES
ARE GIVING BACK TO THE SCHOOL WHICH THEY CERTAINLY ARE HERE,
AND THIS YEAR WE WON IT.
AND WE ARE SO EXCITED.
>> YOU WON THE AWARDS.
>> YES.
>> SO CONGRATULATIONS ON THAT.
>> WELL, THANK YOU, IT WAS DEFINITELY A TEAM EFFORT.
>> RIGHT.
AND HERE IS -- WHAT IS THIS PICTURE?
>> THAT'S US ACCEPTING THE AWARD IN BOSTON AND, OH, THERE
ARE 7,000 PEOPLE AT THIS MEETING.
THIS IS THE BLACK TIE DINNER THAT GOES WITH IT AND THESE ARE
OUR SOUTH DAKOTA FRIENDS AND DR. MARSHA RAPLY, DEAN MARSHA
RAPLY IS PRESENTING THE AWARD -- I SHOULD SAY VICE PRESIDENT MARSHA RAPLY IS
PRESENTING THE AWARD.
SHE IS A PHYSICIAN AND WAS ORIGINALLY A NURSE.
>> THERE WE GO.
>> AND SHE RUNS -- SHE'S THE HEAD OF THAT ORGANIZATION RIGHT NOW.
>> SO WE'LL PUT THAT IN THE CASE AND STICK IT OUT FOR EVERYBODY TO SEE.
>> WE'RE SO EXCITED.
>> HOW PROUD YOU MUST BE FOR THAT.
>> YOU'LL SEE SOME BILLBOARDS GOING UP THANKING THE COMMUNITIES, BECAUSE WE ARE
VERY SMALL.
WE CONSIDER THE WHOLE STATE TO BE OUR COMMUNITY AND THE WHOLE
STATE TURNS OUT TO SUPPORT THIS MEDICAL SCHOOL.
WE COULDN'T DO IT WITHOUT THE SUPPORT THAT WE GET FROM
EVERYBODY IN THIS STATE.
>> WELL, IT'S AN ENDEAVOR THAT IS DONE AS A GROUP, STARTED AS A GROUP THING.
I REMEMBER WHEN I WAS AT THE END OF MY SOPHOMORE YEAR,
BEFORE I GRADUATED TO GO TO EMERY AND FINISH THE SCHOOL OF
MEDICINE AT THAT TIME, I ONLY HAD TWO YEARS OF SCHOOL.
I SPENT A WEEK IN MADISON WITH DR. MUGLEY AND THAT WAS THE
MOST ENLIGHTENING, SHOCKING, UNBELIEVABLE CLINICAL
EXPERIENCE, BUT THOSE DOCTORS IN THAT COMMUNITY TEACHING ME WHAT MEDICINE WAS LIKE.
>> YES, EXACTLY.
THAT'S REAL MEDICINE.
>> AND THEY CONTINUE TO DO THAT KIND OF A THING.
THEY CONTINUE TO DO THAT AND OUR STUDENTS EXCEL BECAUSE
FIRST OF ALL WE TAKE SOUTH DAKOTANS ONLY OR PEOPLE WITH
STRONG SOUTH DAKOTA ROOTS AND THOSE ARE GREAT STUDENTS BUT
ALSO BECAUSE THEY HAVE FABULOUS MENTORSHEP AND TEACHERS.
>> YEAH.
>> SO ANY OTHER ISSUES THAT WE WANT TO MAKE SURE THAT WE TALK
ABOUT ON THE SCHOOL OF MEDICINE?
THE HELMSLY AWARD -- THE HELMSLY RESEARCH THAT'S
RECENTLY COME OUT, WE NEED TO TALK ABOUT THAT.
>> OKAY.
>> BUT I JUST -- I DO THINK THAT THERE ARE A LOT OF THINGS
THAT WE CAN TALK ABOUT THE SCHOOL OF MEDICINE AND WHAT IT
DOES, IN PARTICULAR, I THINK YOUR PRESENTATION AT THE STATE
MEDICAL ASSOCIATION, YOU TALKED ABOUT WHERE STUDENTS WERE AT
THE END OF TWO YEARS, AT THE ENDS OF FOUR YEARS AND AT THE BEGINNING.
>> RIGHT
>> AND WHAT'S HAPPENED, WHAT'S HAPPENED WITH THEIR PROGRESS?
>> THERE IS A LOT OF PROGRESS THAT GETS MADE OVER THE TIME.
THERE ARE SOME WAYS OUR STUDENTS TAKE BOARDS LIKE EVERY
BOARD EXAMINATIONS LIKE EVERYBODY ELSE AND OUR STUDENTS
RIGHT NOW, 95% TO 100% PASS ON THE FIRST TRY, DEPENDING ON THE
BOARD, OUR BOARD PASS RATES ARE ALL AT OR ABOVE THE NATIONAL
AVERAGE, OUR BOARD SCORES ARE AT OR ABOVE THE NATIONAL
AVERAGE AND WERE TAKING, REMEMBER, 44% OF THE CLASS GREW
UP IN A TOWN OF LESS THAN 10,000 IN SOUTH DAKOTA.
SO THESE ARE -- WHEN YOU SAID PEOPLE WHO GROW UP IN SMALL
TOWNS SHOULDN'T FEEL ASHAMED OF IT, THAT'S WHERE WE'RE GETTING
A LOT OF OUR TALENT.
IT'S REALLY, REALLY GOOD. SO THERE'S A BIG MATURATION THAT GOES ON.
PEOPLE HAVE TO LEARN NOT TO JUST MEMORIZE THE FACTS, SPIT
IT OUT AND FORGET IT BECAUSE YOU'RE SUPPOSED TO REMEMBER THAT STUFF.
YOU WANT YOUR DOCTOR TO KNOW SOMETHING ABOUT THE LIVER AND
NOT TO HAVE FORGOTTEN IT IN THE FIRST YEAR OF MEDICAL SCHOOL SO
IT'S A DIFFERENT PROCESS ALMOST A TRANSFORMATION THAT OCCURS
AMONG THE MEDICAL STUDENTS AND IT'S HARD TO DO THAT.
IT'S HARD TO TRANSITION FROM BEING A MEDICAL STUDENT -- A
COLLEGE STUDENT TO A MEDICAL STUDENT.
>> I WAS SORT OF LIKE, OKAY, NOW I'M GOING TO DEDICATE MY
LIFE TO THIS ONE THING, I'M NOT GOING TO HAVE ANY OTHER LIFE
AND I STUDIED MY HEAD OFF, I REALLY DID
>> WE ARE WORKING HARD NOW, AT STUDENT WELLNESS.
PHYSICIANS HAVE A HIGH SUICIDE RATE.
WHAT IS IT, THREE OR FOUR MEDICAL SCHOOL GRADUATING
CLASSES, LARGE MEDICAL SCHOOL GRADUATING CLASSES HAVE TO
GRADUATE TO REPLACE PHYSICIANS WHO COMMIT SUICIDE EVERY YEAR.
>> WE NEED TO TALK ABOUT WHY THAT IS.
>> SO WE'RE TRYING TO NOT CREATE BURNOUT BY THE TIME THE
STUDENTS GRADUATE, SO THE STUDENTS THEMSELVES ARE VERY
MUCH PARTICIPATING IN THIS, DR. PAT MANZARA HELPED
ESTABLISH THIS PROGRAM AND THERE IS A LOT GOING ON WITH
THE WELLNESS PROGRAM AND WE INTENTIONALLY ALLOW WHITE SPACE AND SCHEDULED TIME.
I CAN'T MAKE MEDICAL SCHOOL EASY BUT I LIKE TO MAKE IT
SOMETHING YOU CAN GET BETTER, SO YOU CAN GET OUT AND SEE.
>> AND BE A WELL-ROUNDED PERSON.
>> RIGHT.
OUR STUDENTS ARE TWICE AS LIKELY TO GET MARRIED AND TWICE
AS LIKELY TO HAVE CHILDREN AS THE REST OF THE COUNTRY.
>> OH, THAT'S INTERESTING.
>> YEAH, I MEAN, IT'S THEIR LOT -- THEY'RE -- OVER HALF
THE CLASS IS USUALLY MARRIED OR ABOUT TO GET MARRIED BY
GRADUATION, AND OVER A QUARTER HAVE AT LEAST ONE CHILD.
SO A LOT ON THEIR PLATE.
>> THERE IS A LOT ON THEIR PLATE.
>> AND THEY ARE DOING VERY WELL ON THE NATIONAL BOARDS.
>> BROCK, TELL US -- RESPOND TO THAT COMMENT ABOUT SUICIDE BEING HIGH IN PHYSICIANS.
THAT'S A LITTLE BIT SCARY TO THINK ABOUT THAT.
>> IT IS.
I MEAN, JUST TO SPEAK AT THE SECONDARY LEVEL AND WHAT
STUDENTS ARE GOING THROUGH, SOMETHING THAT WE FEEL WE CAN
FILL JUST FROM A COUNSELOR ROLE IS, IN A UTOPIAN SOCIETY,
A SCHOOL IS GOING TO HAVE A COUNSELOR FOR CAREER PLANNING
AND A COUNSELOR FOR THE PERSONAL ISSUES THAT GO ON IN THE STUDENT'S LIFE.
WELL, THAT DOESN'T EXIST IN VERY MANY PLACES AND SO THE
CAREER COUNSELING KIND OF GETS PUSHED TO THE BACK BURNER
BECAUSE THE PERSONAL COUNSELING HAS TO TAKE PRECEDENCE
AND THAT MAKES COMPLETE SENSE, AND THAT'S WHAT HAS TO HAPPEN.
AND WE'RE JUST HOPING TO BECOME JUST AS A HOSA PROGRAM IS
TRYING TO LESSEN THE BURDEN ON SOME OF THESE COUNSELORS WHO
HAVE TO DO BOTH OF THESE VERY IMPORTANT JOBS AND KIND OF
BEING -- IF YOU HAVE SOMEONE WHO WALKS IN YOUR DOOR, A
STUDENT WHO WALKS IN THE DOOR INTERESTED IN HEALTH CARE X, Y,
Z, OR CAREER X, Y, Z, RELATED TO HEALTH, SEND THEM OUR WAY
AND WE CAN HELP YOU DO THAT.
>> I THINK ABOUT THE STRESSES IN MEDICAL SCHOOL AND THE HOURS
AND THE WORK LOAD AND THE STRESSES OUT IN PRACTICE, BUT I
HAVE TO THINK THAT A GUY COULDN'T HAVE A BETTER JOB.
>> NO, I WOULD AGREE WITH YOU.
ME TOO.
>> IT'S BEEN A WONDERFUL JOB THAT I'VE HAD AND I CAN'T
IMAGINE -- I THINK IT HAD TO DO WITH THE SELECTION OF THE
PEOPLE GOING INTO MEDICINE MORE THAN IT IS MEDICINE ITSELF THAT
WOULD BRING ON THAT SUICIDE RATE.
>> ALSO, PEOPLE DON'T FEEL THEY HAVE A CHOICE, THEY FEEL LIKE
THEY'RE WORKING WAY TOO HARD, THE HOURS ARE TOO LONG AND THEY
DON'T FEEL THAT...
[Overlapping Conversation]
>> I GET IT, I UNDERSTAND WHY THAT WOULD HAPPEN, I MEAN,
THERE ARE A LOT OF, AS YOU SAY, STRESSES ON PHYSICIANES, JUST
LIKE THERE ARE A LOT OF STRESSES EVERYWHERE BUT THE
PHYSICIAN RATE IS HIGHER THAN THE NATIONAL AVERAGE.
>> I THINK THAT THE -- THERE ARE CERTAIN KINDS OF PEOPLE,
THOUGH, SOMETIMES COULD BE DRAWN TO THE FIELD OF MEDICINE
AND SOME OF THAT, THE O.C.D. KIND OF PEOPLE THAT ARE
SO TIGHTLY WOUND AND THAT MIGHT LEND ITSELF TO STRESSES THAT ARE INAPPROPRIATE.
I HAVE OFTEN THOUGHT THAT THE ACCEPTANCE OF PEOPLE IN THE
MEDICAL SCHOOL HAS BEEN TOO LOOKING AT THE GRADES AND NOT
ENOUGH LOOKING AT THAT WELL-ROUNDED, BALANCED BEDSIDE
MANNER KIND OF PERSON.
>> IT'S HARD TO PREDICT BECAUSE MANY OF THEM HAVEN'T BEEN UNDER
THAT KIND OF STRESS.
IT'S PARTLY THE ABILITY TO FORGIVE YOURSELF.
YOURSELF IS THE HARDEST PERSON TO FORGIVE, RIGHT?
BUT YOU'RE GOING TO SCREW UP AND SOMETIMES IF YOU'RE IN
MEDICINE, THAT'S GOING TO MAKE A DIFFERENCE AND SO YOU HAVE TO
BE ABLE TO MOVE ON, IT'S NOT, YOU KNOW, SOMETHING THAT WILL
STAY WITH YOU BUT TO BE ABLE TO FIND A WAY OUT, TO BE ABLE TO
STEP BACK, THOSE THINGS ARE SKILLS THAT WE'RE TRYING TO AT
LEAST GIVE SOME FOUNDATION FOR OUR MEDICAL STUDENTS.
>> I HAD A DATE WITH A GIRL WHEN I WAS IN -- WAY BEFORE MY WIFE.
>> GOOD.
>> AND I HAD A DATE WITH THIS GIRL AND SHE SAID, OH, FOR A
MED SCHOOL STUDENT, YOU'RE NOT QUITE AS, UM, OUT OF BALANCE, OUT OF SYNC.
THAT'S WHAT HER WORDS WERE. OUT OF SYNC, YOU'RE NOT QUITE
AS OUT OF SYNC AS THE REST OF THEM.
SHE WAS A NURSE AND DATED A BUNCH OF MED STUDENTS AND THE
POINT IS THAT I THINK TO TRY TO BE IN SYNC WITH, YOU KNOW, THIS
HUMANITY OF IT ALL IS SOMETHING THAT WE THREE TO TRY TO --
>> WELL, IT'S SO IMPORTANT TO HAVE -- IT'S WORK-LIFE BALANCE
AND A LOT OF TIMES I CAN -- I MEAN, I HAVEN'T BEEN IN THAT
SITUATION IN TERMS OF A MEDICAL STUDENT BUT JUST TO UNDERSTAND
YOUR PRIORITIES AND TRYING TO KEEP THAT IN BALANCE AND SO
WHEN THAT GETS OUT OF WHACK, I'M SURE THE STRESS CAN REALLY PILE ON.
>> SOMETIMES THINGS ARE OUT OF YOUR CONTROL.
YOU HAVE A TEST COMING, IF YOU'RE A STUDENT, YOU HAVE A
TEST COMING AND THIS HAPPENS AND THAT HAPPENED AND IT DOES,
IT ALL COMPRESSES DOWN INTO TIME AND IT'S DIFFICULT.
WHEN I FOUND OUT THAT OUR STUDENTS WERE MORE LIKELY TO
HAVE CHILDREN, I FOUND THAT THEY WEREN'T ASKING FOR
MATERNITY OR PATERNITY LEAVE AND I SAID, WHY NOT.
THEY SAID WE DIDN'T KNOW WE COULD.
IT WAS THEIR IDEA THAT THEY SHOULD KEEP WORKING AND THAT
WAS OUR FAULT, THAT'S ON US, WE SHOULD HAVE MADE IT CLEAR THAT
NOT ONLY SHOULD THEY BUT COULD -- CAN THEY BUT THEY
SHOULD AND WE CAN ARRANGE IT SO IT DOESN'T EXTEND THEIR MEDICAL
TRAINING ALMOST, YOU KNOW, ALMOST IN ANY WAY.
SO PART OF IT IS ON US.
>> THOSE WORDS, THOUGH, WOULD HAVE DRIVEN ME TO FIND A GIRL, GET A BABY...
[Laughter]
>> REALLY.
[Laughter]
>> JUST KIDDING.
SO, LET'S TALK ABOUT OTHER HEALTH PROFESSIONS.
NANCY TALKED ABOUT NURSE PRACTITIONERS.
>> YES.
>> LET ME HAVE YOUR TAKE ON A LITTLE BIT OF THE BLOW-BACK
FROM THE RECENT LEGISLATION THAT ALLOWED THEIR INDEPENDENT
PRACTICE VERSUS THE WAY IT WAS BEFORE.
>> SO, NURSE PRACTITIONERS -- P.A.s WORK IN COLLABORATION
WITH A PHYSICIAN, AS WE SAID. NURSE PRACTITIONERS NOW HAVE
THE ABILITY TO SET UP INDEPENDENT PRACTICE AS, YOU
KNOW, PRIMARY CARE PROVIDERS WITHOUT HAVING A PHYSICIAN'S SUPERVISION PRESENT.
SO THAT IS A DIFFERENT WAY OF DOING IT.
IT'S NOT UNCOMMON THROUGHOUT THE COUNTRY AND SOUTH DAKOTA
HAS DONE THAT, AND IT IS SOMETHING THAT IS GOING TO MOVE
FORWARD, AND I HAVE THE GREATEST RESPECT FOR NURSE
PRACTITIONERS, SO I THINK THAT THIS IS SOMETHING THAT
OBVIOUSLY ANY PRACTICE OF MEDICINE NEEDS OVERSIGHT AND
NEEDS GOOD OVERSIGHT AND GOOD DATA, JUST LIKE WE HAVE FOR ALL
THE MEDICAL PROFESSIONALS IN THIS STATE.
>> YOU KNOW, THAT'S MY TAKE, TOO, IS THAT PHYSICIANS NEED TO
HAVE COLLABORATION, NURSE PRACTITIONERS AND P.A.s NEED
TO COLLABORATE, WE ALL NEED TO BE CONSTANTLY COLLABORATING.
>> AND THAT IS HAPPENING.
YES, CERTAINLY WE DON'T WANT SILOS BECAUSE THAT TURNS OUT TO BE REALLY BAD.
WHEN THE TEAM DOESN'T COMMUNICATE WITH EACH OTHER, OR
COMMUNICATES IN A DYSFUNCTIONAL FASHION, IT'S REALLY HARD TO GIVE --
>> AND WHEN A PHYSICIAN IS IN A SILO, THAT'S A BAD THING.
TEN SECONDS, BROCK, LAST WORDS.
>> I JUST THANK YOU FOR THE OPPORTUNITY FOR BEING ON THE
SHOW AND THINK THE HOSA PROGRAM IS A WONDERFUL PROGRAM TO GET
INVOLVED IN, ESPECIALLY IF WE'RE THINKING A HEALTH CARE CAREER.
MOST SMALL COMMUNITIES HAVE STUDENTS INVOLVED IN EVERYTHING
AND THAT'S KIND OF THE PUSHBACK I GET BUT IF IT'S A CAREER
THING, I THINK IT SHOULD TAKE PRECEDENTS OVER SOME OTHER THINGS.
>> THANK YOU BOTH SO MUCH.
AND NOW FOR THE ANSWER TO TONIGHT'S PRAIRIE DOC QUIZ QUESTION.
BY THE YEAR 2025, AS THE BOOMERS GRADUATE INTO OLD AGE
AND AS THE NEEDS FOR HEALTH CARE IN THIS GROUP INCREASES IN
THE U.S., IT IS ESTIMATED THAT THERE WILL BE A CRITICAL SHORTAGE OF PHYSICIANS.
HOW MANY PHYSICIANS WOULD BE NEEDED TO MAKE UP THAT SHORTFALL?
THE ANSWER IS C: GREATER THAN 90,000
SO, ENCOURAGE SOMEONE TO ATTEND MEDICAL SCHOOL!
WE'LL NEED ALL THE HELP WE CAN GET.
WE'LL BE RIGHT BACK AFTER THIS.
>> BECAUSE THEY WANT YOU TO BE THERE FOR THE MANY MILESTONES
YET TO COME, BECAUSE YOU DON'T WANT TO MISS OUT ON THE LITTLE
THINGS, THERE ARE MANY REASONS TO GET LIFE-SAVING CANCER
SCREENINGS, ONE IN EIGHT WOMEN WILL BE DIAGNOSED WITH BREAST CANCER IN HER LIFETIME.
BUT REGULAR SELF-EXAMS AND MAMMOGRAMS CAN CATCH IT
EARLY WHEN IT'S MOST TREATABLE.
>> PROMISE?
>> PROMISE.
>> MAKE THE PROMISE TO GET SCREENED.
DO IT FOR THE PEOPLE YOU LOVE.
FOR MORE INFORMATION ABOUT LIFE-SAVING SCREENINGS OR
AVAILABLE FINANCIAL ASSISTANCE, VISIT GETSCREENEDSD.ORG.
>> AS PART OF OUR PRAIRIE DOC VOLUNTEER WORK TO SPREAD
SCIENCE-BASED PUBLIC HEALTH INFORMATION, WE HAVE GATHERED A
GROUP OF PRE-PROFESSIONAL COLLEGE WOMEN AND MEN TO HELP US.
ALMOST EVERY THURSDAY NIGHT AT 7:00 P.M., 6:00 P.M. MOUNTAIN
TIME, THESE YOUNG PRAIRIE DOC ASSISTANTS ANSWER TELEPHONE
CALL-IN QUESTIONS FOR OUR TV SHOW ON PBS.
THIS CHANGING GROUP, INITIATED BY OUR FRIEND AND ADVISOR MR.
JUDGE KELLEY, HAS BEEN HELPING US FOR MORE THAN FOUR YEARS.
THESE KIDS NOT ONLY HELP ANSWER PHONE CALLS DURING LIVE SHOWS
BUT THEY HELP RESEARCH MEDICAL TOPICS, AND EVEN HELP OTHERS
DURING MEDICAL MISSION TRIPS.
IN RETURN, WE GIVE THEM THE OPPORTUNITY TO MEET OUR MEDICAL
GUESTS FOR 30 MINUTES BEFORE THE SHOW, AND WE HELP THEM FIND
SHADOWING EXPERIENCES WITH PHYSICIANS.
THEY NEED TO EXPERIENCE A TASTE OF WHAT IT WOULD BE LIKE IN MED
SCHOOL AND IN THE REAL WORLD AFTER STARTING PRACTICE, BEFORE THEY COMMIT TO IT.
THE FIRST TWO YEARS OF MEDICAL SCHOOL, FOR ME BACK IN THE
'70S, REQUIRED PUTTING MY NOSE INTO BOOKS, MEMORIZING HOW THE
NORMAL HUMAN BODY WORKS, AND UNDERSTANDING WHAT CAN HAPPEN WHEN ILLNESS STRIKES.
THE SECOND TWO YEARS, AND THE INTERNSHIP AND RESIDENCY THAT
FOLLOWED, WAS LEARNING FROM AN OLDER AND EXPERIENCED MASTER WHO TAUGHT BY EXAMPLE.
THIS MENTORING-TYPE TEACHING IS A LOT LIKE THE MEDIEVAL WAY OF
LEARNING, LIKE BEING A SILVERSMITH'S APPRENTICE WITH
AN ARTISAN WHO KNOWS WHAT HE'S DOING, AND WHO GUIDES YOU IN
MAKING YOUR FIRST SILVER TEA SERVICE.
IN MEDICINE, I THINK THE HANDS-ON, ONE-ON-ONE MENTORING
EXPERIENCE IS WHAT MATTERS THE MOST, BUT THE BOOK-LEARNING PART IS STILL NECESSARY.
NOW, MED SCHOOLS ARE MIXING TOGETHER THE BOOK-LEARNING AND
THE MENTORING THROUGHOUT THE FOUR YEARS, WHICH IS A BETTER DEAL.
DURING MY LIFE OF MEDICAL PRACTICE, I HAVE HAD MANY
APPRENTICE NURSE PRACTITIONER STUDENTS, P.A. STUDENTS,
MEDICAL STUDENTS, AND MEDICAL RESIDENTS, ALL WHILE I WAS CARING FOR PATIENTS.
I ASKED THE PATIENT PERMISSION FIRST AND VERY RARELY HAD
ANYONE SAY NO TO HAVING A STUDENT IN THE ROOM.
HOW ELSE ARE THEY TO LEARN HOW TO LISTEN, EXAMINE, AND THINK
IN THEIR QUEST TO BECOME A HIGH-QUALITY CARE GIVER?
BESIDES, HAVING A STUDENT WATCHING CAN ONLY MAKE A DOCTOR TRY HARDER AND BE BETTER.
NOW, I FIND MYSELF ENCOURAGING COLLEGE STUDENTS INTO THE
GLORIOUS AND REWARDING FIELD OF MEDICINE.
INDEED, WHAT AN HONOR IT HAS BEEN TO HAVE A TREASURE CHEST
OF KNOWLEDGE THAT CAN BE USED TO HELP OTHERS!
>> A BIG THANK YOU TO OUR GUESTS, DR. MARY NETTLEMAN AND
DR. BROCK ROPS WITH THE U.S.D. SANFORD SCHOOL OF MEDICINE FOR
TRAVELING TO OUR STUDIO IN BROOKINGS.
THEIR EXPERIENCE BROUGHT GREAT DEPTH TO OUR DISCUSSION THIS EVENING.
THAT DOES IT FOR TONIGHT.
FROM ALL OF US HERE AT "ON CALL WITH THE PRAIRIE DOC," UNTIL
NEXT TIME, STAY HEALTHY OUT THERE PEOPLE.
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