Tuesday, March 4, 1975
University Daily Kansan
5
Rieke discusses potential problems for Med Center
By PAULA JOLLY
Kansan Staff Reporter
KANSAS CITY, Mo.—The next head of the KU Medical Center should be someone who can deal effectively with the increased emphasis on primary health care, William O. Rieke, executive vice chancellor for the Med Center, said last week.
Rieke, who on Feb. 18 announced his resignation effective June 30 in order to become president of Pacific Lutheran University in Tacoma, Wash., there was a treatment for cancer nationwide and the training of primary health care and the training of primary care physicians.
"I think it's going to bring with it a peculiar and different set of problems," he said. "I believe someone else might address this set of problems more effectively than I.
"I think I'm still very effective, but I think I can see the time when that might change. I would much rather anticipate it, for the institution's sake as well as my work."
Teaching and research at the Med Center have become so specialized, Rieke said, that it would be difficult to harmonize them with medical students be trained for primary care.
Eikke said he was brought up in academic medicine. Although he also has a commitment to primary care, he said, it would be devastating to him to see the destruction
of the traditional academic strengths of the Med Center, if this was necessary in order to accomplish the goal of meeting primary health care needs.
"I'm not saying that it does have to be said," he said, "but I'm saying it's a possibility."
Rieke denied reports that last semester's reorganization of business and fiscal responsibilities at the University had anything to do with his resignation.
"There has been no change in the authority and responsibility of this job," he said. "If there is any change, it is only in the office." He had had from the chancellor's office.
Rieke said he took the Pacific Lutheran job because general university administration was something he had never tried. However, he said, a return to medical center administration is always possible. He could also take the new job was a family decision.
R里ke said he would like to see the Med Center continue to evolve toward a better balance among education, service, research and outreach.
"My vision for the future, in the next decade, is that I want this center to continue to develop, with the aim being to have all four of those components, but in a better way," he said. "There are short on our four-legged stool right now are outreach and research.
"Although I realize that it's not popular to talk about research in a day when everybody's saying we need more primary care physicians, it's absolutely essential to the long-range health of our nation that centers stay on the forefront of new knowledge."
He said that Wichita's clinical branch of the medical school was an important step for outreach. The Med Center is the second school in the nation to have an accredited program in which an entire segment of the population moves away from the parent campus, Rieke Kuehler.
Medical students may spend the last 18 months of their training at the Med Center or at the Wichita branch. The first 18 months are always spent at the Med Center.
According to Rieke, the outreach program also identified Kansas communities that can support medical students and gets more of these communities involved in training both medical students and nurses who are in residency programs.
Toekeja, Garden City, Halstead, Norton and Kingman are already involved in this program, he said, and many more towns are needed.
This program exposes students to what the practice of medicine is really like and to what life is like in Kansas, Riley County. Students have returned to practice medicine in
Malpractice insurance has become a big roadblock for the program, he said.
Rieke said there was a test case now in which one of the medical students was named individually, along with a physician, in a malpractice case.
Kansas after graduation, he said.
"Should that come down unfavorably, it could wine that program out." he said.
"In the first 18 months of the program, it's a lock-step pattern with a one year penalty if a student falls behind or has other reasons." Rieke said. "It bothers me a great deal."
This lack of flexibility in the first 18 months means that a student with a strong background in a particular area can't test for something else, Rieke said.
An answer to this problem hasn't been found yet, he said. Possibly, he said, the set of variables could be varied have a varying length of time instead of the set time now used. This flexibility might ripple back to the first variable and make the entire program more flexible.
The preceptorship is required for graduation at the medical school. In it, the student spends six weeks with a physician in private practice.
Improvement seen in local ambulance service
BY CINDY MORGAN
and ROXI TAYLOR
Korean Staff Reporters
Ambulance service for Douglas County residents has improved considerably since last August according to the Lawrence-Douglas County Public Health Department.
The improvements were made after the service became county owned and operated on Dec. 24, 1974.刀McFarlane, manager of the county's ambulance service, said last week
After a recent inspection the health department issued a report indicating several improvements had been made at the Douglas County Ambulance Service, 1839 Mass., since the health department's last inspection in August.
Last August the health department found that spare tires and some essential equipment at the ambulance service wasn't in proper working order and the premises, both inside and outside, weren't properly cleaned. Kay Kent, health department
the recent report noted only a few shortcomings. They were the absence of an infant-size mask for use with ventilation units, adult-size mouth-to-mouth artificial ventilation apparatus, aluminium foil, triangular bandages and safety pins.
working compensation for the ambulance service employees, McFarlane said.
HOWEVER, NOW the attendants have passed a three to four hour test over the Emergency Medical Technician (EMT) Manual, McFarlane said. The test doesn't certify them as EMT's they are better to handle emergency situations, he said.
"He can then set up a course in Lawrence to train and certify EMT's." McFarlane an
Most of the personnel are the same people who were here when the service was provided.
McFarlane said that he was sending one of his men to the KU Medical Center in March and April to become an EMT teacher-coordinator.
McFarlane said that he hoped by the end of the summer all his personnel would be
Better coordination between the Lawrence police and fire department, the Douglas County Sheriff's office and the University of Kansas Security and Parking department have also helped to create a new office for Douglas County residents, Filkins said.
Duane Flippen, ambulance attendant, said that the ambulance attendants were getting more training, to enable them to give better care to victims at the scene of the attack. "We've learned to learn how to give better treatment to heart patients at the scene, he said.
The county has also improved pay and
The vehicles, building and surrounding premises are cleaned and inspected daily, McFarlane said. That was not done when it was privately owned, he said.
"As we see it now, the ambulance service in Douglas County is very, very effective, and I am confident."
A Lawrence resident within city limits can usually receive aid within five minutes after the ambulance service has received the call, Fiklins said. The ambulance should be able to arrive anywhere in the county within 20 to 25 minutes, he said.
The cost of the service to an individual hasn't risen since the county took over the operation at the beginning of the year, Filkins said.
A non-emergency run, one without flashing lights or sirens, costs $25 base rate
An emergency run, one with lights and sirens, has a base rate of $30 plus $1.20 a mile from the scene of the emergency to the hospital. Filkins said.
He said that the patients were also billed for any supplies that they used.
In Johnson County there is a county ambulance service coordinated according to the fire districts that provides free service to all Johnson County residents, Larry Joy, manager of the Johnson County paramedical units, said.
McFarlane said that he could foresee a rise in rates in the near future. The rise would be necessary to provide better services, he said.
Cross Ambulance Service, in Shawnee County, charges the same base rates as the Franklin County service, Ray Smallley, owner, said. However, they charge $1.50 a mile from the scene if it is outside the Topeka city limits, Smallley said.
McFarlane said that he had restocked the ambulances with essential medical supplies. He said that medical supplies were expensive and that Barber hadn't been able to keep the ambulances properly stocked.
"We are the lowest in the area," McClure said. "We would only bring us up to the average level."
Ambulance services in Shawnee and Franklin counties are privately owned. Charges in these counties are slightly higher.
In Franklin County four ambulances serve the county at a base rate of $30 for a non-emergency run plus $1.00 a mile from an emergency room. Dave Miller, manager of the service, said.
An emergency run costs $33 plus $1.25 a mile, he said. Miller's 12 employees are EMTs and serve 52 miles of interstate highway. Miami and Coffey counties, Miller said.
"It was fulfilling to open a major branch of our school in Wichita, and then to live long enough to see it and the rest of the institution accredited together," Hickie wrote. "We are deeply committed, so we put our own accreditation on the line when we opened the branch."
Rieke said the most fulfilling thing he had done as head of the Med Center was to put together the package that included a branch curriculum in medicine, and at the Med Center, an increase in student enrollment in medicine, nursing and allied health and reorganization into schools of medicine.
On Oct. 14, 1974, county owned and operated mechanical units began
"Particularly in the clinical setting, when you're starting to examine and work with the patient, why isn't it possible to do some of that as a team?" he said. "Why can't a student of nursing, a medical student and a graduate nurse be reassessed approach the patient as a team?"
Rieke said he would like to see the Med Center place more emphasis in the future on the training of health teams in the educational setting.
"That's better than training them and giving them a degree, and then saying 'We don't need it.'"
There are two crews capable of responding to emergencies at all times, where before there was only one crew available, McFarlane said.
"We've always taught in a segmented, compartmentalized fashion, and it's hard to imagine how we could be better."
Riake said the future looked bright for the entire University, mainly because KU had fewer financial problems than some other universities.
The county commissioners were assured by McFarlane, that these items would be obtained soon, Arthur Heck, county commissioner, said.
However, it would be hard to train teams because tradition is against it, he said.
McFarlane has made many improvements.
Kent said that the premises had been cleaned and the three vehicles were safe, clean, well-organized and functional. They are equipped with new medical kits, others, sensors and spare tires, life-suits.
Mcfarlane said the county commissioners would probably decide a definite budget sometime this month. They will use the past two months spending to determine how much money will be necessary to finance the service, he said.
A definite budget hasn't been established for the ambulance service since it became county operated. McFarlane said that he thought it would be about $100,000 to $150,000 a year. That averages about $9,000 to $12,000 a month.
WHEN THE SERVICE was privately operated, Leonard Barber, the owner, received about $1500 a month from the county to help缴 the costs of operating the vehicle. The county also leased the vehicles to Barber at a nominal price. McFarlane said.
"The report was certainly much better than last time," Kent said.
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Tuesday, March 4, 1975, 7 p.m. and 8:30 p.m.
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