Approved on October 21, 2008
Minutes of Audio-Conference Meeting,
September 15, 2008
Advisory Committee Members
Present
Lolita M. McDavid, MD, MPA, Chair
Perri Morgan, PhD, PA-C, Vice Chair
Lauren L. Patton, DDS, Vice Chair
Nathaniel B. Beers, MD, MPA
James F. Cawley, MPH, PA-C
Kevin J. Donly, DDS, MS
Mary B. Duke, MD
Katherine A. Flores, MD
Stephanie L. Janson, PA-C
Desiree Lie, MD, MSEd
Eugene Mochan, DO, PhD
Charles P. Mouton, MD, MS
Stephen C. Shannon, DO, MPH
Harry Strothers III, MD, MMM
James A. Thomas, PhD
Surendra K. Varma, MD
Others Present
Jerilyn K. Glass, MD, PhD, Acting Executive Secretary, Advisory Committee
Sanford J. Fenton, DDS, MDS, Retired Member
Joseph L. Price, PhD, Retired Member
Claire Wilson, Contract Writer, Insight Policy Research, Inc.
Monday, September 15, 2008
The Advisory Committee on Training
in Primary Care Medicine and Dentistry (Advisory Committee) convened its audio-conference
meeting at 10:00 a.m. Eastern Time. Lolita M. McDavid, MD, Chair, began the
meeting by having new members, current members, and guest retired members introduce
themselves.
Dr. McDavid introduced Ms. Brenda
Williamson, Chief, Primary Care Medical Education Branch in HRSA’s Division
of Medicine and Dentistry, who provided an update on the most recent Title VII,
section 747 grant cycle. She provided data on the number of grant applications
received, number that met eligibility requirements, number that were funded
by grant category, and the amount of money awarded.
The Advisory Committee discussed
plans for its 8th report on the redesign of primary care and consequent
implications for training and plans for the November 17-18 face-to-face meeting.
Surendra K. Varma, M.D. mentioned that the American Board of Pediatrics and
the Accreditation Council for Graduate Medical Education have developed an R3
project allowing for a variety of activities within a pediatric residency.
Dr. Varma will provide some background materials on the project and give a review
of it at the next meeting.
Challenges for the future of health
care include the transition of large numbers of children with chronic conditions
who when they reach adulthood will need to be cared for in adult practices.
Dr. Varma pointed out as another issue the number of conditions now being seen
in the pediatric population that were previously diseases of adults, like hypertension
and type II diabetes. Perri Morgan, Ph.D., PA-C underscored the increased complexity
of patients in primary care and the need for collaboration with specialists.
Dr. McDavid discussed the need for
children with chronic and special needs to get access to pediatric dentistry.
Mary Duke, M.D., felt that the medical-dental home concept cannot be explored
without addressing the shortage of residents wanting to enter the primary care
workforce.
Dr. Morgan suggested that report
recommendations be written to focus on inter-professional education and team
communication. Eugene Mochan, D.O., Ph.D., said that the issues could be brought
together with a training model such as the Wagner Chronic Care Model. Dr. Mochan
will provide information to the membership about the model and will lead discussion
on it at the next meeting.
James F. Cawley, M.P.H., PA-C, said
that the decreasing number of physicians and physician assistants going into
primary care can be directly tied to students’ rising debt levels. One report
recommendation might be to restructure the system such that educational subsidies
can be given to reduce student debt. The situation is especially critical because
physician assistants are no longer coming to the rescue in terms of providing
primary care; they, too, are following the same kinds of specialty distribution
trends as graduating medical students. Dr. Morgan is finishing a paper on this
topic and will share the data at the November meeting. Mr. Cawley will supply
the latest data from the American Association of Physician Assistants and help
lead the discussion in November.
Kevin J. Donly, D.D.S., M.S., said
that dentistry is facing many of the same problems as medicine. Especially
critical is the extreme need for dental faculty. Last year there were 357 unfilled
positions in dental education. The average age of a dental educator right now
is 57-1/2 years. One report recommendation might be for Title VII, section
747 to award faculty development grants in general and pediatric dentistry.
The Advisory Committee discussed
possible speakers for the November meeting. The members who volunteered previously
for the 8th Report Writing Group were: Dr. Morgan, Dr. Varma, Dr.
Mochan, Katherine A. Flores, M.D., William A, Curry, M.D., and Sheila H. Koh,
D.D.S., R.N. New members to the Advisory Committee were invited to join the
Writing Group.
The agenda turned to the finalization
of the 7th report on primary care serving as a medical-dental home
for patients and communities. The Advisory Committee discussed which of two
titles they wanted for the report. A vote will be taken electronically to select
the title before the next meeting.
Dr. Donly led the discussion about
the 7th report. He led the members section by section through the
Report and explained what changes were made and why. The Committee approved
the report text and its recommendations. The next steps are sending it out
for public comment to constituent groups and getting it edited.
Prior to meeting adjournment, there
was time allotted for public comment. There were no public comments.