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How many HBCU medical schools are there? Do hospitals pay for medical school? How bad is the doctor shortage? Is Xavier University getting a medical school?
Leonardo Seoane, MD, founding dean of the Xavier Ochsner College of Medicine and executive vice president and chief academic officer at Ochsner Health discusses making medical school more affordable, the importance of diversity in medicine, major challenges for health care system in rural areas and incentives for doctors to work in rural areas. AMA Chief Experience Officer Todd Unger hosts.
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- Ochsner Physician Scholars Program for LSU Health Shreveport School of Medicine and University of Queensland Medical School New Orleans.
- Wondering when will Xavier medical school open? Find out more on Xavier Ochsner College of Medicine at Xavier University of Louisiana.
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- Reforming Medicare payment
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Speaker
- Leonardo Seoane, MD, founding dean, Xavier Ochsner College of Medicine; executive vice president and chief academic officer, Ochsner Health
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. Today, we're talking about how Ochsner Health is taking an innovative approach to address the physician shortage that we're seeing across medicine. Our guest is Dr. Leonardo Seoane, founding dean of the Xavier Ochsner College of Medicine, and executive vice president and chief academic officer at Ochsner Health in New Orleans. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Seoane, thanks for joining us today.
Dr. Seoane: Well, thank you for having me, Todd. And I want to thank the AMA. I'm grateful for the time they're giving us to speak on this important topic.
Unger: Indeed, the physician shortage is one of the biggest issues that we face in medicine today, and it impacts nearly every practice in the country. But before we talk about your efforts to address that problem, why don't we just start by getting a little bit of background about how your organization has been impacted by this issue?
Dr. Seoane: Well, as you know, Todd, the AAMC has predicted up to 86,000 positions short by 2036. And they do their report every two years, and that was their latest report. But that does not universally felt throughout the U.S. It is a heterogeneous effect. And places like the Gulf South, which Ochsner is in, and rural communities, they feel that impact even greater. And so, it impacts patient access when we're trying to get our physician and our wait times go up. We felt that as it impacts competition for physicians, and when we post a position, we're finding it's taking a lot longer to fill that position.
Unger: Well, that's a really interesting point, because we do hear that kind of global figure at 86,000. And as you point out, that varies regionally. So let's talk about what you can do to overcome this particular physician shortage. Tell us about, first, your Ochsner Physician Scholars Program and other kind of tuition reimbursement programs for physicians.
Dr. Seoane: So, we started the Physician Scholars Program in 2021, right in the heart of the pandemic. And in Louisiana, there's a couple of things that we acutely feel when it comes to physician shortage. One is in primary care. I know in a lot of places across the United States feel that impact. And the other is psychiatry.
And actually, a 2030 report says that Mississippi will have the worst physician shortage by 2030. And Louisiana will have the third worst. So, our area is particularly hit hard by these shortages.
So, the Physician Scholars Program is in partnership with our two medical school partners, one, LSU Health Sciences in Shreveport and the other with the University of Queensland, where we have the Ochsner Clinical School, where we take American kids. They do spend their first two years of medical school in Brisbane, Australia, and return to do all of their clinical training years three and four at Ochsner in New Orleans. So, students from either of those medical schools, we will reimburse their tuition in return for work commitment if they practice in primary care or psychiatry anywhere within the Ochsner Health System. So that includes Mississippi and Louisiana.
The program has been very successful to date. In fact, in July, we hired our first physician from that program, Dr. Mary Curet, who finished her family medicine residency, and has returned to practice in a rural setting in southwest Louisiana. So very excited for her.
Unger: Wow. What a fantastic opportunity for med students, and also of course, a huge benefit to the community as well. Tell us a little bit more about the results that you've seen from the program so far.
Dr. Seoane: Well, we have currently eight students enrolled in the program, and there are some are in medical school, some are doing their residency program. As I said, we had Mary Curet, who has joined us in a rural area. So, we are seeing the students appreciate that we eliminate that financial barrier.
And as you know, the average medical student in the U.S. graduates with about $250,000 worth of medical debt. That is compounded by compounding interest. So, the ability to come out of med school with no debt and then be able to practice in an area you want to practice, that is a win-win.
Unger: Well, that work has clearly been a success. And now, you're taking it to the next level and opening up your own medical school. So, tell us a little bit about that and what you're hoping to achieve.
Dr. Seoane: Todd, this is extremely exciting. This is a transformational project. This I would say, this is a once in a lifetime project, as this will be transformational for our partners, Xavier University, which is one of the premier HBCU universities throughout the United States. And they have a long history. They're coming up on their 100th anniversary of being excellent at STEM, and one of the leaders of placing African Americans into medical school. That's our partner on the university side.
And of course, Ochsner Health, and maybe many of your listeners are very familiar with Ochsner Health, the largest health system in the Gulf South, an academic medical center, with 33 ACGME accredited residencies and fellowships. We train over 360 residents and fellows. Coming together allows us and aligns us to start this new medical school for the United States.
And it's really needed. And it's needed on a couple of points. If you look at this year's Match, the 2024 match, 25% of our incoming interns attended medical school outside of the United States. So, we need more U.S. medical graduates.
It's also needed because Xavier being an HBCU, when we established this med school and taking our first class, will only be the fifth HBCU medical school in the United States. And then as we look at diversity throughout the U.S. among physicians, we see that although about 14% of the population is African American, only 5.7% of physicians are African American.
And if you look at Hispanics, we make up 19% of the population. We're the largest growing minority population in the United States. We only make up 6.9% of the physicians. So having an HBCU dedicated to training more Black and Brown physicians is essential for our diversity pathways for physicians in the United States. So, we're extremely excited about it.
It's going to be in downtown New Orleans next to the iconic Superdome in our Bio District. So, it'll be, as I like to say, it'll be transformational for New Orleans, transformation for Xavier and Ochsner, but transformational for our country of having a pathway for Black and Brown students to become physicians.
Unger: Wow, that is incredible creativity and effort to build that pipeline yourself, and so many benefits. We're going to talk a little bit more about medical student costs. But the diversity that you are building through the HBCUs, as well as the IMG contingent, which needs more opportunities as well.
Dr. Seoane: One of the things that we have been reading about over the past few months are these kinds of huge, philanthropic donations that made tuition free at two medical schools. Would you say that your work is also part of the broader trend to reduce these barriers associated with medical school and medical school cost especially?
Yeah, I would say we're highly focused on that. And one of the things we're doing is looking for ways, looking for partners to help fund scholarships to eliminate that financial barrier for Black and Brown students, for first generation immigrants like myself. That becomes a huge barrier to—it's hard to see the future when you think, I'm going to get $250,000 of debt, but where can I borrow this money? How can I borrow this money?
So we're highly focused on looking at ways we can provide scholarships to eliminate that. And look, we applaud Bloomberg and the work he has done to do that with Hopkins. And we applaud what NYU has done in that area, too.
Unger: Yeah, pretty incredible. I mean, when you think about all the things that you're doing to increase the number of students who can attend medical school and go on, of course, to become physicians, you know, what else is there that is, kind of in your plans and not only for you, but other health systems out there?
Dr. Seoane: No, I think, look, I hop—well, hopefully, we can be a model for other health systems and universities. And I think these partnerships, when I've talked to founding deans across the U.S., one of the most difficult hurdles is finding the clinical clerkships and the clinical partner for them to work with. And I think this partnership of a university like Xavier University of Louisiana and a health system like Oxford Health, coming together to solve the physician workforce crisis.
But you mentioned the Gulf Coast, and the challenges we have with tropical storms and hurricanes. But the Gulf Coast also has an incredible resource and that's our diversity. And so, this partnership takes advantage of that diversity. And I think other health systems and universities think they should be thinking through how they can impact their communities through these types of partnerships.
Unger: Dr. Seoane, thank you so much for joining us today and telling us about what's happening at Ochsner. I just think, you know, you've got a problem, and you've really taken that into your own hands to build the pipeline and make a lot of creative changes to help solve this problem. The AMA is also committed to addressing the physician shortage, and we encourage you to support our work by becoming an AMA member at ama-assn.org/join.
That wraps up today's episode, and we'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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