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UIW to give primary care a boost
June 21, 2014

UIW President Lou Agnese (left) and Brooks City Base President and CEO Leo Gomez sign an accord on housing the osteopathic medical school.

By Peggy O'Hare, San Antonio Express-News

The University of the Incarnate Word's quest to open what would be San Antonio's second medical school likely will bring more attention to a type of health care that's growing rapidly - osteopathic medicine.

The venture, if approved by the required accrediting bodies, would be the second osteopathic medical school to open its doors in Texas.

The first - Texas College of Osteopathic Medicine, which opened in Fort Worth in 1970 - has more than 900 students and about 200 graduates a year.

UIW expects to wrap up a required feasibility study by next month for the national Commission on Osteopathic College Accreditation, with hopes of getting credentialed for up to 150 students when the medical school opens at Brooks City Base in summer 2016.

If the university succeeds, the new school ultimately will bring more doctors to San Antonio and the South Texas region, which is grappling with a shortage of primary care physicians like the rest of the country.

Consumers in the local market will benefit, Texas A&M University-San Antonio assistant Professor Alan Preston predicts.

"Patients that are indigent and don't have health insurance . . . can have yet another place, another option that they can go to and seek care," said Preston, who specializes in epidemiology and health care policy.

Another health care expert agreed consumers will reap the rewards of increased competition if San Antonio becomes home to two medical schools.

"If we're graduating more doctors and they stay in the region, there's going to be better access for the patients and presumably lower costs," said Dana Forgione, chair of the University of Texas at San Antonio's business of health program and an adjunct professor at the local area's other medical school, the University of Texas Health Science Center at San Antonio.

Osteopathic medicine, known for taking a holistic approach to patients, has a long history, but its popularity has markedly increased in recent years.

The number of osteopathic physicians nationwide has jumped exponentially in the past 50 years, soaring to more than 82,000 last year - six times the number seen in 1960, according to the American Osteopathic Association. More than 73,000 of those doctors are engaged in active medical practice, the group said.

That growth is expected to continue, with at least 5,000 osteopathic medical students graduating annually, a more than tenfold increase from numbers seen nearly 80 years ago.

Reaching out
Many osteopathic medical schools have established missions to provide health care to underserved and rural populations.

Almost all of the UIW medical school's designated service area - spanning South Texas and extending westward to include San Angelo, north toward Abilene, and eastward to encompass Killeen and Austin - is medically underserved, statistics show.

While "traditional" medical schools for allopathic physicians or MDs emphasize research and specialized types of medical care, osteopathic medical schools focus more on primary care, internal medicine and prevention, Forgione said.

MDs might be apt to treat symptoms with medications or surgeries, but osteopathic physicians - known as DOs subscribe to a philosophy that the human body has an innate ability to heal itself. However, osteopathic doctors also can prescribe medications, perform surgeries and can have admitting privileges at nonosteopathic hospitals.

They may also venture into medical specialties, such as gastroenterology, cardiology and pulmonology.

Additionally, they receive 200 hours of training in osteopathic manipulative treatment, hands-on techniques to improve body function and relieve discomfort.

Medicare treats both types of physicians equally, paying them the same amount per procedure, Forgione said.

Osteopathic physician Melissa Walker, who has practiced family medicine in San Antonio for 10 years, supports UIW's plans to open a new medical school here.

"I think that there is room for another program, whether it's osteopathic or allopathic," Walker said. "I'm actually very excited that it's osteopathic, because I don't think there's anything like osteopathic medicine. I think (UIW President Louis Agnese Jr.) is a brilliant man to even go after such a pursuit."

The academic training is nearly identical at both types of medical schools. Both institutions offer four-year programs with similar curriculums that include anatomy, physiology, biochemistry, microbiology, epidemiology and clinical skills. Graduates go on to residency programs lasting three to eight years.

Because of osteopathic medicine's focus on primary care, prevention and community outreach, UIW plans to look for students with significant life experiences - candidates who have persevered or overcome hardships, demonstrate compassion and show a commitment to social responsibility, said the medical school's founding dean, Dr. Robyn Phillips-Madson.

Prospective students also must have a bachelor's degree, take the Medical College Admission Test, undergo extensive interviews and show an ability to handle the rigor of a medical education program, she said.

Accountability to society will be part of the school's mission.

"You want to inspire them to become a physician who's working at a community health center or in a rural area that's underserved - or even doing little things, like a couple of weeks of outreach to a particular community, whether it's here in the United States or abroad," Phillips-Madson said.

UIW's program would offer medical students another option besides the UT Health Science Center's School of Medicine, an allopathic program that admitted its first students in 1966.

Phillips-Madson doesn't see UIW competing for space in the same hospitals where UTHSC's medical students do their rotations. Osteopathic medical students tend to work in free clinics, community health centers or community-based hospitals rather than large tertiary care centers, she said.

"Our intent is to go to places that haven't had students to a large extent before or where there's excess capacity," she said. "For example, at University Health System, I know that a lot of (UTHSC) students rotate there. So I would never imagine that being a primary site to have our students.

Nor does Phillips-Madson expect to cull faculty from the health science center.

"I won't poach faculty from other institutions," she said. "I'm not actively recruiting people from the area."

It wouldn't be a surprise, however, if some faculty members at the health science center's medical school end up teaching at UIW's osteopathic medical school as well, said Dr. Stephen Shannon, president of the American Association of Colleges of Osteopathic Medicine.

"It's very usual for faculty with certain types of expertise to be shared with other academic institutions," Shannon said. "But I have no doubt that (UIW) will also be recruiting for new faculty nationally to complete their curriculum."

UIW plans for its medical school to have around 45 faculty members by the program's fourth year.

Potential partnerships with health care systems might allow UIW to share faculty with a medical practice, which would allow physicians to see patients three or four days a week and teach medical students one or two days a week.

Phillips-Madson has begun discussions with several health care systems exploring such an arrangement.

 

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