NEOUCOM’s unique, vital place in medical education is abandoned

NEOUCOM’s unique, vital place in medical education is abandoned

An essay in laSt Sunday’s Vin- dicator, “Medical research is good for the health of Ohioans,” was of special interest to me as a retired family physician and medical educator. It was signed by the presidents of numerous northeastern Ohio universities, led by Jay Gerson DDS, PhD of Northeast Ohio Medical University (formerly Northeastern Ohio Universities College of Medicine, or NEOUCOM). Its primary message is that the represented institutions are all involved in biomedical research, and that their work is beneficial to Ohioans in terms of both useful new information and dollars infused into the local economy.

This is all good, but it appears to represent the final nail in the coffin of a key promise made decades ago at the time of NEOUCOM’s founding: that the school would focus on correcting the area’s (and our nation’s) long-standing shortage of primary physicians (internists, pediatricians and family physicians). The intent was that NEOUCOM students would have educational opportunities that would lead at least half of them to choose primary care careers, where they are most needed. This goal has been achieved only by claiming, when doing the arithmetic, that obstetrics-gynecology is one of the primary care specialties.

Why is this important? The purpose of primary care, as an old slogan puts it, to provide “uncommonly good care of common health problems.” This includes preventive care and management of frequently seen illnesses in a “one stop” setting where doctors and patients know and respect each other. People are referred to subspecialists when appropriate, with the primary doctor coordinating the care. It’s well documented that this approach, recently named “the medical home,” improves quality of care while restraining costs.

It has been clear since my medical school days in the 1950s that medical school graduates are being enticed into other fields by multiple factors, notably higher incomes, more academic prestige, and being exposed mostly to subspecialists during their training. Many recent graduates have heavy education debt to pay off, and this inevitably influences their choices. There are also some persistent myths at work, including (take your choice) that primary care is either simple and boring or that it is incredibly demanding.

This situation opens the door to numerous problems. One is excessive focus on high technology diagnostic and treatment methods, which can deter professionals from managing small medical problems effectively before they become huge problems. Another is inadequate coordination among the multiple professionals treating a particular patient, leading to unnecessary overlaps, duplications and conflicting tests and treatments.

As the medical system focuses on biomedical research, it continues to ignore the question that has a staggering impact on our nation’s long-term wellbeing: why is U. S. health care so expensive, when other industrial nations get equal or better “outcomes” for a quarter or a third less money, in relation to their size and economic factors? Throwing money at American patients has not given us better overall health than is achieved elsewhere. Primary care’s low status in our nation isn’t the whole answer, but it’s an important factor that has been swept under the rug for decades.

Robert D. Gillette MD, Poland

Look at socialism’s ugly underbelly

Just imagine, The Vindicator, writing a favorable story about socialism (Sept. 25). Smiling, happy faces in the accompanying photo. Andrew Porter is the national organizer of the Young Democratic Socialists, and he would like young Americans to believe that his concept of socialism is “different.”

Our country, the greatest this earth has ever seen, was founded on and developed through free market capitalism, not socialism. The People’s Republic of China (Communist China) believes in Marxist socialism, like President Obama. But Communist China would still be struggling to feed its people if it hadn’t done what? It embraced capitalism to realize economic advancement! Not more socialism. Watching Hong Kong prosper for the 99 years of United Kingdom control, they must have thought, “Oh, they grow rich! Maybe that’s something we can try?” The Soviet Union never did that, and collapsed.

Proponents of socialism often point to the “benevolent” socialist state of Sweden. They would like to transform the USA into such a country. Benevolent, you say? Google “Sweden sterilization” or “Sweden lobotomy” and read about these forced programs. There are ways a government can deal with problems other than sending people to Gulags, as in the Union of Soviet Socialist Republics (USSR), or outright murder.

Proponents of socialism, like Mr. Porter, would like you to believe that their model of socialism would be different; ideal, harmonious, happy. But socialism breeds dependence upon the government, destroys ambition and incentive, and makes us all worker bees stuck on minimum effort. That is, unless you are in the government itself; the Politburo, the Party, (the Union?). Yes, the leaders always live better. Do you think Hillary Clinton would give up her millions and live like the common people? Did Edward Kennedy leave half his wealth to the poor, who he championed throughout his political career? Dream on, proletariat.

I’m glad I’m 64 when I consider how our country is “changing” under Obama. If it turns socialist, I won’t have to suffer the consequences for long. But I fear for the future of my children and grandchildren.

Since the era of President Franklin D. Roosevelt (my lifetime), the USA has been slowly, gradually accepting socialism. I call it “creeping communism,” and both of our political parties are at fault because of the concept of “compromise.” The Republicans have gone along with government access to Social Security funds, welfare, Medicare, food stamps, etc., and now we are a bankrupt Nation, kicking the reality can down the road with every increase in our national debt limit.

Donald K. Allen, DVM, Youngstown

GM retirees take it on the chin

We think the new GM con- tract IS the biggest slap in the face ever for the people who made GM what it is today. I’m talking about the retirees.

The thought of them taking away the $700 holiday bonus with no pension raise is unbelievable. GM gave the working people a bonus, and $1,000 a year for three years. Don’t they think the retirees need extra money at holiday time? I’m sure a lot of us used it to cover extra expenses if buying gifts for our families.

We wish they would have to live on a fixed income for a year. We’re sure it would be a little different. We talked to our friends that are retired. Everybody swears, no more buying GM cars. If they don’t care about the retirees, why should we be helping them make more money?

The retirees gave up the same benefits as the working person, but nothing was given back to us. Instead of gaining something back, we lost more. Something is wrong with this picture.

It’s a disgrace what the union officials let happen. I hope they all remember this contract when it’s time for them to retire. The union should have fought more for the retirees’ benefits.

Russ and Helen Garrett, Austintown

Never in my 96 years ...

The letter in the Sept. 23 Vin- dicator that discussed the need to honor and respect the office of the president should be printed in large letters and put on your front page.

I am 96 years old, and I have never seen or heard so much disrespect for the president of the United States.

Josephine Hartman, Youngstown