thursday, January 31, 1980
pags 1 1
daily nebraskan
Changes suggested to lure more rural doctors
By Mary Fastenau
The lack of medical services in rural
Nebraska has prompted Regent Prokop of
Wilber to suggest changes in NU Medical
tenter admission policies.
Prokop said more medical center
graduates would choose to practice in rural
areas if the school did not admit students
who established residency in the state just
to go to medical school.
At an NU Board of Regents meeting
earlier this month Prokop said 16 of the
153 students accepted to medical school
last year did not graduate from a Nebraska
high school or have parents living in the
state.
He said some of the applicants have,
established residence in rural areas of the
state, knowing rural applicants have an ad.
vantage. ttn ?M he,does not condemn the
students, iaim .ig that he might make the
same effirt if he were in the same
situation.
Few Nebraskans elsewhere
Prokop said that one of the arguments
for taking out of state students is that
other states accept Nebraskans. He said he
couldn't believe in that defense because he
said he looked through a manual which
lists all of the medical students in public
institutions and found only three
Nebraskans were accepted somewhere else
in 1978-79.
Prokop said he didn't think it would be
discriminatory to encourage more native
Nebraskans trom rural areas to enroll. He
said he considers the .current medical
school admittance policy somewhat pre
judicial. He said he based his observation on the
record of students accepted and-rejected.
For example, he said, in the 1981 graduate
ing class a person who ranked 327 on his
medical school entrance exam was accept
ed, while those ranked .'eighth and ninth
were rejected.
' 'Prejudicial elements'
"I know there are certain prejudicial
elements and that is why 1 thought other
things could be considered," Prokop said.
He also said the admissions committee
does not give students a written document
explaining why they were rejected. :.
His concerns are based on what he sees
as his duty to represent rural areas and the
taxpayer, Prokop said.
He said residency training programs also '
affect where doctors choose to practice.
His observations were based on several
studies he has conducted on the placement
of medical school graduates, he said, These
results have been presented to the Legis
lature and were shared at the February -1979
Regents' meeting.
He said the studies show that only 4.4
percent of doctors Who took residencies
outside of the state between 1963 and
1974 returned to practice in Nebraska.
This figure compares to 31 .2 percent ot all
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medical school graduates who stayed in the
state during the same time period.
. Prokop said there is only one state with
a major medical school which has a lower
percentage of doctors staying in the state
of their alma mater. '
Need for rural care
Much of the concern about doctors
leaving Nebraska is the need for health care
in many of the state's rural areas.
One of Prokop's studies deals with the
distribution of doctors across the state.
The 1974 study shows that there are 149
doctors in the three counties with
populations exceeding 50,000 compared to
138 doctors in 47 counties with
populations less than 10,000.
Ken Wall, assistant director of the
state's Health Manpower Referral Service,
said there are 16 counties without
physicians. In the west central part of the
state one physician serves eight counties,
he said.
The distribution decreases as the
doctor's practice becomes more
specialized. For . example, there are no
pediatricians in counties with populations
less than 25,000, but there are 86 in
counties where the population exceeds
50,000.
No clear cut answers .
Prokop said there are no clear cut
answers to the shortage. One of the major
problems in rural health, he said, is that
wives of physicians often aren't interested
in moving to the country. One-doctor
communities also are not appealing because
of the heavy work load, he said.
Another problem, which he said was in
directly related, was the lack of contact
with further - educational opportunities.
This may lead doctors to question their
knowledge . and become unsure of them
selves, Wall said.
Wall also noted that doctors establish
professional relationships in the areas
where they, complete their residency train
ing. These contracts often affect where the
doctor practices, he said. - ?
Programs are offered which attempt to
encourage medical students to investigate
rural practices. One such program provides
low interest loans foi medical students
with the provision they practice in an area
of the state where there is a shortage of
medical care, Wall said. '
Loans are incentive
The loans were made possible through a
bill passed by the Legislature last year and
are administered through the Nebraska
Commission of Rural Health Manpower, he
said.
There are currently seven students in
the program, Prokop said, although there
were 10 loans offered.
Dr. Robert Wigtdon, assistant dean for
graduate medical education at the NU
College of Medicine, said he sees a positive
trend with "good evidence" that doctors
who stay in the state are choosing to
practice in middle-sized and smaller cities.
In an article in the November 4979
Nebraska Medical Journal, Wigtdon noted
an increase in state residency programs
"with the objective of influencing the
number and distribution of physicians who
choose to practice in Nebraska."
The article mentioned several studies
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which show a relationship between where a
student practices and the state where he
did his residency training.
Wigtdon said Nebraska's residency '
training has increased in size, almost
doubling in the past 10 years, but the per
centage of doctors remaining in the state
has remained stable. These figures combine
to show an increase in the number of
doctors in the state, he said.
Programs encourage
Another program offered through
UNMC is designed to encourage students to
apply to medical school.
The Student Health Medical Task Force
is composed of medical students who go
areas across the state where there are no
applicants encouraging students to apply
said Pete Boughn, executive assistant to the
chancellor at UNMC.
Currently about half the Nebraska
counties aren't represented in the medical
school enrollment, he said.
Communities also develop their own
methods of attracting physicans.
Prokop mentioned one community
which paid for a doctor's education on the
provision he would practice in that town
for five years. The agreement worked, but
the doctor left immediately after the five
year period, he said.
Wall said his office sends physicians
interested in Nebraska copies of items such
as the Omaha World-Herald Magazine of
the Midlands Christmas supplement, which
stresses the benefits of the state.
Some things that attract doctors to the
state, no office can control. Wall said a
state senator once took a prospective doc
tor from California to a Nebraska football
game. The doctor now practices in
Nebraska. Wall said there were consider
ations other than football.
Office helps handicapped
handle campus barriers
By Debora Hemminger
Have you ever imagined what it
would be like not to read this article?
About 15 students on campus can
not read this article unless it is read to
them.
One such student is Darrell Walla, a
second-semester graduate student in
special education. Walla is blind. He ex
plained that getting tapes or braille
textbooks is the largest inconvenience
to blind students.
Physical barriers, such as stairs and
rooms without numbers in braille may
seem like another inconvenience, but
Walla said physical barriers are a way of
life and nothing unique to the campus.
Services which minimize inconven
iences are available to the blind and
c handicapped students, he said. , , vf
Aid to handicapped
In 504 Administration Building is an
office which aids the handicapped stu
dents on campus, according to Bradley
Munn, coordinator of handicapped
services. Munn also is UNL affirmative
action officer.
For blind students, the office assists
students in obtaining class materials,
organizes transportation, lends record
ing devices, testing materials, and keeps
up parental contact, Munn said.
Walla receives recordings of his 4ext
. books from an organization in New
York called Recordings for the Bund.
He said he must send them a list of the
books he needs, several months in
advance, however. When recordings
can't be obtained, he pays students to
read his assignments to him.
Financial boost
The Nebraska Services for the Visual
ly Impaired is another organization
which is available to help blind citizens.
Rosemary Lurdahl said one of its ser
vices is to help those who need assis
tance in paying for the extra cost of
tapes or readers.
Lurdahl said she advises blind stu
dents to advertise for readers. Munn and
his secretary often record materials for
students. '
Munn said sometimes he needs extra
volunteers in assisting the blind and
other handicapped students on campus.
Another service the department pro
vides for the blind student is to arrange
testing times, according to Munn.
If an essay test is required in the
class, the answer must be taped since
the students involved cannot write a
test. Special times and places must be
organized, Munn said.
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