A middle-aged woman draped in a hospital gownsits on an examining table grasping her midsection, complaining of acute abdominal pain. A fresh-faced man in a white lab coat enters the room, introduces himself with an outstretched hand and proceeds to review the patient’s chart, inquiring about her history and symptoms. Then he will begin an abdominal examination. It will be his first.
This scenario is being replayed half a dozen times in identical examination rooms down a long corridor. But this is no ordinary clinic. The patients are perfectly healthy actors who have been specially trained to present certain symptoms. And the men and women conducting the examinations are not doctors, at least not yet. They are first-year medical students at the Lakewood Ranch campus of the Lake Erie College of Osteopathic Medicine (LECOM), and they are participating in the medical school’s hands-on, problem-based learning pathway. This week happens to be gastrointestinal distress week.
The examinations are being monitored across the hall via closed-circuit television, and the tapes will be reviewed by professors who will critique the students on medical protocols and bedside manner.
Some of these students will move on to treating actual patients at Manatee Memorial Hospital in the region’s first residency program when they receive their medical degrees. Announced this year, the program—which begins next summer—aims to keep many of the school’s new primary care doctors in Manatee and Sarasota.
LECOM opened its campus in 2004 in Lakewood Ranch to 150 medical students. Today the college is training 600 medical students and 400 pharmacy students a year and employing 73 full-time faculty and staff in an impressive 110,000-square-foot, modern concrete and glass building. Headquartered in Erie, Pa., LECOM is now the largest medical school in the nation.
A matter of pride to Lakewood Ranch and regional residents, the school has made a point of connecting to community. LECOM students and staff work closely with the Community Pharmacy of Sarasota County, a nonprofit organization that provides free medication and pharmaceutical care to the uninsured and working poor. They staff the free clinic at the Bradenton-based Bill Galvano One-Stop Center homeless shelter, and they act as mentors for an after-school tutoring program at the Manatee County Sheriff’s Youth Ranch. Most significantly, LECOM is seen as an important example of the talent and investment that the region attracts and is touted widely by Manatee and Sarasota economic development and elected officials.
“Anybody in the medical technology business would do well to look at our area,” says Schroeder-Manatee Ranch CEO Rex Jensen.
The medical degree conferred at LECOM is the Doctor of Osteopathic Medicine, a discipline known for its emphasis on preventive healthcare and a “whole person” approach to medicine; the college trains doctors to be primary care physicians.
LECOM students must not only learn to be qualified physicians from a scientific perspective, but they are also required to develop their patient rapport skills, says Dr. Robert George, LECOM associate dean of academic affairs—hence the importance of using actors in simulated clinics.
“D.O.s are first-line physicians,” he explains. “They are the doctors you see at your point of entry into medical care. While they are eligible to enter any specialty, 63 percent of D.O.s choose to practice internal medicine, pediatrics, family medicine or obstetrics and gynecology. That’s why our students are trained in humanistic approaches to patient care along with medical knowledge.”
D.O.s practice much the same as physicians holding M.D. degrees, referred to as allopathic physicians, George says. They hold the same medical licenses, take the same certifications and work in the same environments as M.D.s. However, Doctors of Osteopathy also use osteopathic manipulative treatment (OMT), a form of hands-on care that consists of using stretching, gentle pressure and resistance techniques to move muscles and joints. OMT is used to aid the doctors in the diagnosis, treatment or prevention of illness or injury.
Manatee Memorial’s residency program couldn’t come at a better time. According to a recent Florida Department of Health report, fewer physicians are opening practices in Florida; those who do are not choosing primary care. Most go into specialties that don’t require emergency room duties or extended hours. Add the fact that 60 percent of Florida doctors are over 45 years old and that 13 percent reported plans to close their practices by 2013. Healthcare experts know it is imperative that Florida attract more physicians to the state, especially a state that has such a high percentage of older residents.
In addition to improving patient care, experts say that increasing the number of primary care physicians in a community can aid its ability to meet rising healthcare costs. According to research published in the American Journal of Medicine earlier this year, a mere 15 percent increase in primary care doctors in a given metropolitan area would cut emergency department visits by 10.9 percent, cut the number of surgeries by 7.2 percent, cut inpatient admissions by 5.5 percent and cut outpatient visits by 5 percent.
Up until now, LECOM’s medical students have had to do four years of coursework and clinical rotations in the community before graduating and were then sent off to spend three or more years in medical residency programs around the country, because no hospitals in Manatee or Sarasota counties offered such programs. (A residency is usually a requirement if an M.D. or a D.O. wants to practice medicine in the United States, and usually requires three to five years of work under the supervision of licensed medical doctors, most often in a hospital.) That meant that very few of LECOM’s doctors have set up practice in the area.
“Physicians like to stay in the area where they finish their residencies,” says Manatee Memorial Hospital CEO Kevin DiLallo. “Until now LECOM graduates had to leave Manatee County.”
Beginning with the graduating class of 2011, Manatee Memorial Hospital will be offering LECOM graduates 25 residencies—12 in
primary care and 12 in internal medicine and one rotating internship (a post-graduate year of training for a physician who is entering a specialty practice).
“The hospital and medical staff are very excited about these residencies,” DiLallo says. “With the shortage of physicians in Florida and the need for more primary care doctors in our area, keeping these residents here will bring a huge benefit to our community.”
LECOM in a Nutshell
Seton Hill in Greensburg, Pa., in 2009; and Lakewood Ranch, 2004
Number of Lakewood Ranch students
1,000 (includes 600 medical and 400 pharmacy)
Number of staff
Year LECOM became nation’s largest medical school
Lakewood Ranch Campus Growth plans
Beginning in the fall of 2011, the medical school will increase its freshman class size from 150 to 183
Number of applicants to Lakewood Ranch campus
More than 3,000 for the Class of 2014