OCR Text |
Show , Medex-aides for busy rural doctors i By LID1A WASOWICZ Managing Editor Alone, over-worked, with few, if any, temporary substitutes at j vacation time and fewer perman ent replacements, the country doctor risks a community health-care crisis each time he i decides to take even a few days off from work. Plausible threats of becoming overwhelmed by the number of patients calling for his services and the wide geographical area he would have to cover discourage discour-age the young physician from opening a practice in rural areas. As a result, the percentage of rural physicians over 45 (pres ently 70 percent nationally) rises steadily. The difficulty of finding a doctor over a weekend or at night, the long delays and waits in doctors' offices and clinics and all the other problems prob-lems resulting from the shortage of available medical personnel increase rapidly. In the meantime, thousands of medical corpsmen, discharged from the services each year, having hav-ing little access into the healthcare health-care field, are going into completely com-pletely unrelated fields in civilian civil-ian life. Many of the former military "medics" who, in the service, have treated people in crisis situations, situ-ations, amputating legs, treating severe gunshot wounds and performing per-forming many other complicated medical procedures, end up as truck drivers or mechanics, wasting wast-ing their years of military medical medi-cal training, obtained at a cost to the U.S. taxpayer of up to S20,000 per man. In response to some of the needs in these two problematic areas, an experimental, federally funded program- MEDEX -has been established in six states. The Utah MEDEX Demonstration Demon-stration Project is patterned after the MEDEX projects currently cur-rently underway in Seattle, Washington; Los Angeles, California; Cali-fornia; Grand Forks, North Dakota; Birmingham, Alabama; and Dartmouth, New Hampshire. Hamp-shire. Utah MEDEX is a joint effort sponsored by the Department of Community and Family Medicine, Medi-cine, the Intermountain Regional Region-al Medical Program and the Utah State Medical Association. "Utah MEDEX will start training in September carefully selected former military corps-men corps-men for utilization within the private practice of medicine under the supervision of physicians physi-cians providing primary health care," said William M. Wilson, deputy director of the project. Mr. Wilson explained that the program will utilize former military mili-tary medical corpsmen, many with thousands of hours of formal medical training and on-the-job experience, as physicians' physi-cians' assistants. "The Medex (corpsman) will supplement, not replace, the overworked practitioner. He will perform specified tasks under the supervision of his physician-preceptor, physician-preceptor, who in turn will have more time to devote to more seriously ill patients and to continuing education and community com-munity health problems. At the same time, greater numbers of patients will receive health care and medical services," commented com-mented Mr. Wilson. "The program gives the practicing practi-cing doctor an opportunity to train tailor-made assistants whom he will eventually employ in his practice," said Mr. Wilson. The Medex will perform various vari-ous duties which do not demand a physician's extensive training and will help untie the hands of doctors to work on more serious cases, noted the project deputy director. Twenty-four corpsmen will be trained at the University Medical Center during the next twoyears They will participate in a 15-month 15-month program, after which they will be certified by the Utah State Medical Association. The MEDEX program will be divided into two phases: a three-month phase within the University Medical Center which emphasizes the transition from military to civilian medical practice prac-tice and the acquisition of skills not acquired in' the armed services; ser-vices; and 12 months of practical, practi-cal, on-the-job training under the guidance of a preceptor and faculty affiliated with the College Col-lege of Medicine. "Initially, the Medex will learn and apply medical care skills under the supervision of his preceptor. Eventually, the Medex will become adept in extending his physician's capacity capa-city in numerous ways," said Mr. Wilson. Possible duties delegated by the physician to the Medex will include performing parts of physical examinations, taking patient histories, treating minor injuries, changing dressings, administering ad-ministering injections, handling casts, suturing, screening patients pa-tients in the office, assisting with house calls, taking emergency calls, assisting at surgery, performing per-forming laboratory test, providing pro-viding follow-up and patient erl- (Continued on page 8, col. 1) Former corpsmen stay in medicine (Continued from page 4) ucation and completing other taskes designated by the physician. physi-cian. Two groups of 12 practitioners practi-tioners from the Intermountain Region will act as teacher-trainers for two classes of 12 Medex trainees. Preceptors will be expected to hire the Medex upon the successful success-ful completion of his training. "We don't intend to prepare the Medex for jobs that don't exist," said Mr. Wilson. Former military corpsemen will be selected for the program from the various branches of the armed services through an inten-sive inten-sive interview- selection process. All Medex candidates will have either served on independent duty or will have received advanced ad-vanced training qualifying them for independent duty. Their formal military training will range from 640 to 2,000 hours. Their practical experience will range from two to twenty-plus twenty-plus years in the provision of direct primary medical care within the military's medical system. The 12 corpsmen for the first class in Utah will be selected from 1,200 applicants from the Intermountain Region. Nationwide, Nation-wide, 16,000 corpsman have applied for the program. "Corpsmen will be matched up with physician's in rural areas, with emphasis on age similarities and previous background. We don't want to match relatively young men with older physicians who will be retiring in a few years, but with those who will likely stay where they are if given additional help. "We definitely wouldn't take a corpsman, regardless of his ability, who would not be satisfied satis-fied with life in a rural commun- and balance system between i themselves," reflected Steve Turnipseed, a Medex from Seattle, Seat-tle, Washington. The Seattle MEDEX project, which has been in, operation longer than any of the other five programs, has been successful in eradicating some of the prob-lems prob-lems of the over-worked physician physi-cian and the unused former mili-tary mili-tary medical corpsman. "MEDEX is certainly not the answer to all the medical prob. lems, but it is a workable approach to the physician short-age; short-age; it is an answer to the returned return-ed corpsman whose medical training, for which the army spent thousands of dollars of the taxpayers' money is wasted when he is forced to enter an unrelated field in civilan life; it is an answer to the population's need for better, more readily available medical care," expressed express-ed Mr. Turnipseed. ity. Previous experience in Washington Wash-ington (the MEDEX program there) has proven that young men reared in the country can relate better with the rural population," popu-lation," said Mr. Wilson. To ensure compatibility, the selected preceptors and corpsmen will rank each other from one to three in order of preference as working mates. The physician and former medic who rank each other "1" will be matched as a team. "Mutual acceptance is essential essen-tial in this program since the preceptor and the Medex will work together 24 hours a day and hopefully until they retire," said Mr. Wilson. "The relationship developed in the program is like that in a marriage. It's a one-to-one relationship, rela-tionship, with both partners close to each other in order to maintain a continuity with the patients and a type of checks |