Doctors' assistants sought to aid doctor shortage
*(Editor)* note: This is the last in a series of stories
*(Editor)* note: the shortage of hospitals in rural Kansas.
By PAULA JOLLY
Kansan Staff Reporter
One of the most highly publicized aspects of health care in Kansas today is the doctor shortage. While part of the solution lies in training more primary care physicians to serve in rural areas, the total solution includes health care person who caniment the physician and extend his effectiveness.
Three programs in Kansas are now training health care personnel to supplement physicians: the nurse practitioner training program at the KU Medical Center, the nurse clinician program at Wichita State University (WSU) and the physician's assistant training program at WSU.
While the two nursing programs only accept applicants who are registered nurses, the physician's assistant training program accepts people who have either a bachelor's degree or four years of direct patient contact, medical experience in university-level academics adding up to four years.
VAL. VALGORA, the program's director and a physician's assistant himself, said the physician's
assistant could be valuable to a doctor in rural Kansas as the physician's assistant could extend the doctor's capabilities in both quantity and quality.
"The physicians in rural Kansas are seeing a tremendous number of patients," Valgora said. "And besides that, there is a tremendous number of patients who are left unseen."
"The physician's assistant may extend a doctor's capability up to 50 or 60 per cent. this is because most of the things that come into a general practice are not always possible for people wanting birth control and this type of thing."
VALGORA DEFINED the physician's assistant as a person qualified by experience and academics to approach a patient, collect historical and physical data, conduct research in the case. He said the disposition could be to tell the
doctor what is wrong with the patient, or, in the case of a healthy baby, to give routine immunizations
"I would further define the physician's assistant as a graduate of a 24-month American Medical Association-approved program, who has passed the physician's assistant certifying examination of the Neurology Examiners," he added. The first 11 months of the training with WSU. Subjects very closely approximate the traditional ones taught during the first two years of a four-year medical school, Valgora said. These subjects include psychology, pathology, microbiology, pharmacology, history and physical examination and patient evaluation.
"THE SECOND YEAR is spent in a clinical rotation phase," he said. "This includes a variety of clinical experiences throughout the state of Kansas, of about six weeks at a time, in such areas as obstetrics, pediatrics, medical inpatient, family practice, primary care and so on."
He said the last clinical rotation was called a preceptorship. This is designed to place the physician's assistant with an interested physician, who will be given the physician's assistant would be hired after graduation.
January 1973 and graduated in January 1975. Of the 12 graduates, 10 stayed in Kansas, Valgura sad. Only one of these remained in Wichita. The rest were moved to Oklahoma as Augusta, Oberlin, Westmoreland and Pratt.
The first physician's assistant class started in
Valgura said the first class had two women in it. In the second and third classes, 15 of the 48 students were girls.
PATIENT ACCEPTANCE of the physician's assistant has been extremely good, Valgora said, although there have been isolated cases of a patient wanting to see a doctor instead of a physician's
He said there had been few problems with physician acceptance. For example, he said, the Kansas Medical Society has adopted a resolution supporting the program.
"However, I don't think it would be fair to say that every physician thinks were the greatest thing since crackerjacks," he said. "There are some who have had a bad experience, and every physician acceptance has been used to excellent."
Valigera said the biggest acceptance problem had been with nurses, although he would still be able to administer medications.
problems had been in areas that previously hadn't any physician's assistants.
THE PROGRAM'S EMPIHAS is on rural applicants, Valgora said, although those from other backgrounds aren't refused. In the past, most of the students in the program have been Kansas residents, he said.
"We've somehow gotten notoriously nationally, and this year we have had somewhere around 100 applications from out of state, from as far away as Mainland Florida, California, and Alaska." he said.
In the field of nursing, both the Med Center's nurse practitioner program and WSU's nurse clinician program train nurses to function in expanded roles. However, confusion exists over the exact definitions of the nurse practitioner and the nurse clinician.
According to Martha Barnard, program director of the nurse practitioner program at the Med Center, the nurse practitioner receives her advanced skills through a continuing education course, while the nurse clinician must go through a master's degree program in nursing. However, the American Nursing Association (ANA) is in the process of redefining these roles now, Barnard said.
See DOCTOR page '
THE UNIVERSITY DAILY
KANSAN
Vol. 85-No.115 Friday, March 28, 1975
The University of Kansas Lawrence, Kansas
York speaks
By Staff Photographer GEORGE MILLENER II
NC bamericanman John Parelli checks the light reading before an interview with Jlm York, a former army deterence whose loss
of a city job has prompted controversy. York, interviewed at his home, had earlier talked with a film crew from CBS.
York unsure on amnesty
By WARD HARKAVY Kansan Staff Reporter
Santee, a local insurance agent and a representative of the Marine Reserve Off-Load
Jim York is called Thursday that he still didn't know whether he would continue in President Gerald R. Ford's amnesty program and should be sent an in NBC news interview at his home.
"I have two choices, I guess." York said. "I can either get a low-paying job and stay with the amnesty program or I can go out and try to find a job of my own that doesn't comply with the program just to be able to make a living."
The city commission March 11 refused to have York fired, but Santee appealed to Department of Labor officials in D.C., Kansas City, Mo., and Topeka.
York is a former Army deserter whose eligibility for a federally funded job with the Lawrence Parks and Recreation Department was challenged recently by Wes
LABOR OFFICIALS in Topeka ruled March 20 that York was ineligible for the city job, which was partially funded by the city's employment and Training Act.
York for almost two hours Thursday at his home. Bell said the interview probably would be shown on the NBC Nightly News at 5:30 p.m. Monday.
The city then requested York's resignation, which was received March 20.
Tim Knauff and Randy Pettit, both Winfield juniors and hometown friends of York, were present during the NBC interview.
NBC News correspondent Kebeza Bell and a three-man film crew interviewed
Earlier in the day, York was interviewed by a CBS news film crew that included Bill Penn, CMS College correspondent. Plant's crew divided part of the interview in South Park.
Search group forms to replace Saricks
The selection of an 11-member search committee to find a replacement for Amber Sarkis, vice chancellor for academic research at the University by Del Shankel, executive vice chancellor.
Saricks resigned two weeks ago to return
to teaching. His resignation is effective
until November 29.
Shankel said the committee would meet
No Kansan on Monday
The next issue of the Kansas will be published Tuesday. There won't be a newspaper because of the Easter holiday. The newsroom will open today and after 2 p.m. Monday.
Arthur Breipohl, professor of electrical engineering; John Brushwood, professor of computer science; John Dean of the School of Law; Barbara Ekelzel, professor of human development; George Griffin, curator of the Kansas Collection of antiquities; Jacob Kleinberg, professor of chemistry;
SANTEE SAID the CBS film crew interviewed him at noon Thursday after the York interview. Bell said the NBC crew involved in the controversy on Friday
He said that he hoped the committee would complete the screening of applicants before the end of April and that he hoped to have an appointment made by the first part of May. The deadline for applications is April 5.
as soon as possible to organize and determine a chairman.
The selection of the committee was made after consultation with Senxx and Chan-*
*ngui.
The members of the search committee are:
James Moeser, professor of organ;
Joseph Pichler, dean of the School of
Business; Ed Rolfs, student body president;
James Seaver, professor of history and
western civilization; and Evelyn Swartz,
professor of curriculum and instruction.
He said, in addition, it would be difficult to live on the kind of kit he might set.
"The economy makes things a bit worse," York said, "But the same thing applies. I like it because it's more about life."
York said before the NBC interview that he was going to Winfield this weekend to talk to his parents about the amnesty program.
"I'm not sorry I came back to the U.S., York said. "I 'fidant to go back to Canada, I can. That option's open to me. This has been quite an experience, to say the least."
HE SAID THERE were many people in the amnesy program who had similar problems. York said he didn't think the way I worked because of the way it was set up.
York told NBC he thought that national economic problems had much to do with the current job shortage. But he said that the government had made it even harder to find work.
The March 20 ruling said York was ineligible for jobs that had more applicants than available jobs, if those jobs were funded by federal, state or local governments. Under the amnesty program, York can't work for a private employer.
York said most of the jobs available to him were so low paying, it would be difficult to live on their wages. He said janitorial and cleaning jobs had been the only ones offered him.
By YAEL ABOUHALKAH Kansan Staff Reporter
Rieke opposes cut
Approval of a proposal to cut state funds to the KU Medical Center could tie it to future financial uncertainty. William O. Williams, an assistant color for the Med Center, said Thursday.
The proposal is under consideration today by the Kansas House Way and Means Commission.
It asks that $271,096 of state funds be eliminated from the Med Center's Other Operating Expenses (OOE) budget for fiscal 1976. The proposal would then allow the Med Center to use $271,096 of next year's revenues to replace the state fund cut.
However, Rike said elimination of the pressure per petroleum pressure on future Mid Center facilities is needed.
Rieke said hospital revenues were hard to predict from year to year. He said many factors could diminish the Med Center's revenue, so he required to fulfill the OEE budget next year.
"TO BE TIED to the proposal is to be to an uncertainty. Riake said, "We're certain."
Rieke said he would be in Topeka today to ask the committee to reject the proposal. But he said his chances were slim of accomplishing that goal.
State Rep. William Bunten, R-Topka, made the subcommittee that made the
BY SUSIE HANNA Kausan Staff Reporter
BvSUSIEHANNA
Average turnout likely Tuesday
About 8,000 Lawrence residents are elected to vote in Tuesday's general election, Delbert Mathia, Douglas county clerk, said Thursday.
Mathia said he estimated 10,000 votes would be cast in contests throughout the year.
A total of 29,332 Lawrence residents are registered to vote in the election.
Donald A. Binnis, 57, director of the Lawrence High School extension program and a former Lawrence High teacher, had lost in two primarys before winning in the March primary. He said that better equipment would improve communications with residents. He is also strongly opposed to the proposed location.
proposal, said he would be surprised if the committee didn't approve the proposal.
Matiaa said applications for absentee ballots would be accepted by his office until noon Monday. Applicants must be registered voters.
BINNS HAS CALLED himself a "people's program" candidate and has said that more revenue sharing money should be allocated to help them their homes to cut down on heating costs.
RIEKE DISAGREED with that argument.
Marjorie H. "Marnie" Arngersinger, 52, is the wife of William Arngersinger, vice president of graduate studies. The only candidate endorsed by Lawrence League of Women Voters in the March 4th primary, Arngersinger has spoken out strongly against the proposed location of Marjorie's home.
THE MAIN THRUST of the commission campaign has centered on the location of a proposed city garage, communication and allocation of revenue sharper funds.
Voters will select three city commissioners from six candidates. They will also cast ballots for four of eight candidates for Lawrence Unified School District No. 2, which is outside the city but within the school district will also vote on the board candidates.
Arngrisser has said that the people's confidence in the city government can be developed through stabilization of neighborhoods. She also said she wanted to see schools and public funds allocated to service programs, such as child day care and care for the aging.
John E. Colyer Jr., 43, president of John E. Coloyer Co., Inc., a plumbing and heating supply firm, and vice president of Wilson Supply and Service Co., has also said he is opposed to locating the city garage in a residential area.
Colyer has said he would like to encourage "the right type" of industry in the
Buntan the subcommittee had made the recommendation for the transfer of funding responsibilities because the hospital's revenues this year had been greater than originally projected. The transfer, he said, would let the state spend more on next fiscal year, while allowing the hospital to maintain its OOE budget.
area and cut unnecessary spending. The city commission, he said, should be more responsive to the people. He has also supported a new sharing allocation policy of the city.
"It still isn't a loss to the state," he said. "If we do make enough money, all that happens is that those (state) revenues are paying for next year's hospital budget."
See ELECTIONS page 10
Some factors could reduce the Med Center's collection of revenues, Rieke said. They include inflation, decreased admissions of patients and a possible increase in their $58 request for a rate increase in fees charged to Blue Cross and Blue Shield members.
He said the hospital would request a
percent rate increase in July, to be effective
next fiscal year. If the increase was reduced
investors would not expect the hospital's
ability to meet its OOB budget.
Rikke said, though, that even if the increase was approved and patient admissions remained the same or increased, the rate of inflation must be contend with a high rate of inflation.
Pedal power
By Staff Photographer ROD MIKINSKI
Sunny weather Thursday afternoon gives Ben Curtil, night jailer at Strong Hall, a chance to show off his new powered pelican car. Jerry Stubbs, Springer Sports