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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

The Future of Medical Education in a Time of Health Care Questions

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Health care policy has come back into public discussion in a big way, and we want to add your voice to the conversation. Over the coming months, we’ll be featuring interviews with health care providers, experts and everyday Missourians about their health hopes, needs and concerns moving forward.

Let us know what questions you have about the future of health care: @besables, sablesmithb@missouri.edu

Among the many questions facing American health care right now is how to deal with a looming physician shortage. The Association of American Medical Colleges projects a shortage of between 61,700 and 94,700 physicians by 2025. The shortfall includes as many as 31,100 primary care doctors alone. At the same time, the cost of medical education is on the rise pushing more medical students into higher paying specialties; this despite the Affordable Care Act’s emphasis on primary care.

To find out how the medical educators are responding to these challenges and to potential changes in health care policy, KBIA spoke with Dr. Margaret Wilson, Dean of the Kirksville College of Osteopathic Medicine.

Q: When I think of osteopathic medicine I think of an emphasis on primary care. If the Affordable Care Act also had an emphasis on primary care did that shape the number of people who were interested in coming out to Kirksville to learn medicine?

I guess it's hard to say you know I don't know what drives applicants in terms of their perspective of the affordable Care Act. I think probably student do seek [osteopathic] schools out because they have a strong interest in primary care. They know our history that we have an emphasis there, although we do certainly produce many specialist as well. So I hope that as we continue to look at the needs of the nation that we understand the need for primary care physicians. They are the core to providing good, cost effective health care. I hope that my school and my profession can continue to contribute to that effort. The other part of that is medical school is very, very expensive and I think, unfortunately, because primary care I typically less financially rewarding at the end of the day sometimes that drives students into specialties because I I look at our student debt quite frankly.

Q: Do you think there's room in the national conversation to address the high price tag on medical education or to encourage more students to go into primary care?

Yes, I think there's lots of room. Things like scholarship and we're looking at ways to reduce debt for students, and ways of enhancing reimbursement for primary care physicians that, at the end of the day, make it more attractive or at least make it more feasible for them to pay off student debt if they are going to primary care. There's lots of ways to look at that, certainly a lot of groups at the national level have been and continue to look at that. But it’s time to step up to the plate in and put some money towards that to really improve that situation, I believe.

Q: In an ideal world, if you, Dr. Wilson, were called to Congress and they took all you recommendations and turned it into federal policy, what would happen? 

My core belief is that we need to continue to produce the best possible physicians to take care of patients across the spectrum. We definitely need more rural and primary care physicians particularly in our state, in the state of Missouri. I would ask Congress how can they better support us, and how can they fund progress to get physicians to where they're needed most?

A curious Columbia, Mo. native, Bram Sable-Smith has documented mbira musicians in Zimbabwe, mining protests in Chile, and the St. Louis airport's tumultuous relationship with the Chinese cargo business. His reporting from Ferguson, Mo. was part of a KBIA documentary honored by the Missouri Broadcasters Association and winner of a national Edward R. Murrow Award. He comes to KBIA most recently from the Salt Institute for Documentary Studies in Portland, Maine.
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