Local Doctor Leads MOA

October 5, 2007
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As president of the 4,992-member Michigan Osteopathic Association for 2007-08, Dr. Susan Sevensma of Metro Health Hospital said universal access to health care, the promotion of family practice, and a process called “practice transformation” are key issues.

Access to health care has reached a critical point, and Sevensma said she expects the issue to become central in the 2008 presidential election.

“One issue that looms right now anytime I’m at a meeting is the issue of universal coverage, so that everybody has access to health care in this state,” Sevensma said. “I hear a lot of talk about that, and I think it’s going to become a huge national issue.”

About 65 percent of osteopathic physicians work in primary care areas such as pediatrics, family practice, obstetrics and gynecology, and internal medicine, according to the American Osteopathic Association. Supporting primary care is another top issue, Sevensma said.

“We feel that a good medical system incorporates — in fact, the foundation of a good medical system is — primary care. So we’re doing everything we can in the process to support primary care. Why is that important in Michigan? Because we are facing a physician shortage in Michigan.”

Michigan State University’s College of Osteopathic Medicine has increased enrollment, as have other medical schools in the state, she said. Michigan has 7,230 osteopathic physicians and 23 osteopathic hospitals. However, fewer physicians are choosing to go into primary care.

“Any of the graphs we throw up on the screen show a steady decline in primary care and an increase in specialties,” she said. “So the number of people in medicine is increasing. The number of primary care physicians is going down, because of that medical school debt.

“Now a family practitioner in Michigan starts at about $120,000. That seems like a lot of money, but that’s not a lot of money if you’re trying to start a family and pay back this horrendous debt.”

To keep a flow of new doctors choosing primary care, the state should consider ways to make it more attractive than the higher-paying specialties, Sevensma said.

She suggested the state whittle down the $150,000 to $200,000 in medical school debt by forgiving some student loans in exchange for a period of practice in rural or underserved areas. She said the idea has gained “favorable” reaction in Lansing, but she expects the 2008 state budget must be resolved before any action will be taken.

Also important is “fair reimbursement” that rewards primary care doctors at a level closer to their specialist colleagues, she said.

“There was a time when the federal government made it more advantageous for family practitioners to exist. Certainly at the federal level with Medicare and Medicaid, the fees that are paid to family practice docs are low. And they keep getting cut. Reimbursement is part of the mission — fair reimbursement.”

To her fellow doctors, Sevensma is promoting the idea of “practice transformation,” a method of reviewing the delivery of health care services to improve access to care, to establish “medical homes” for patients, and to ensure continuous quality improvement.

For example, “we had a very large no-show rate at this clinic, for whatever reason. We were booking two months out, so our no-show rate was always in the high 20s. So we implemented something called open access, which is one of the concepts of practice transformation, and it reduced our no-show rate. I think last month it was 7 percent. It’s a remarkable difference.

“What does that mean to a clinic like this? It means we can see more patients.”

Sevensma is medical education director at Metro Health Hospital and medical director of its Breton Health Center. She also serves as program director for Metro Health’s family practice residency. She has staff privileges at Metro Health as well as at Spectrum Health’s Butterworth Hospital.

A native of the Detroit area, Sevensma graduated from Grand Valley State University, and from MSU’s College of Osteopathic Medicine where she is an assistant clinical professor; she is also assistant regional dean for the Kirksville (Mo.) College of Osteopathic Medicine.

Sevensma serves on the State Planning Project for the Uninsured, the Governor’s Task Force on Elder Abuse, and the Michigan Osteopathic Medical Advisory Board at MSU. HQX

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