Family medicine gets booster shot

Preparing for the future of health care in the nation, three institutions in Westchester County have joined resources to train resident doctors in family medicine, a less lucrative practice often not encouraged at medical schools but needed to make care less specialized and more cost-effective for patients and employers.

Phelps Memorial Hospital Center in Sleepy Hollow in 2012 will accept its first six physicians in a three-year family medicine residency program. The program when fully operating will train 18 young doctors. The hospital is spending about $1.5 million to start the program.

St. Joseph”™s Hospital in Yonkers is the only hospital in Westchester County that currently offers a family residency program. Its sponsor, New York Medical College in Valhalla, also is academic sponsor for the Phelps Memorial program, which has been accredited by the national Accreditation Council for Graduate Medical Education.

Phelps residents will treat outpatients and be introduced to primary care in a community setting at the Open Door Family Medical Center in Sleepy Hollow, one of four Open Door community health centers serving uninsured and underinsured, low-income families in the county.

“We know that the demand for primary care physicians and family care physicians is picking up steadily” with an aging population and a projected physician shortage, said Lindsay Farrell, president and CEO of Open Door Family Medical Centers in Ossining. By giving family medicine residents training in ambulatory care in the broader community, “We”™re sort of hedging against the future.

“It”™s been demonstrated around the world and the U.S. that communities that have a very robust primary care system, their medical costs tend to be less,” said Farrell. The family medicine program “is an effort to sort of rebalance, because New York is one of the most expensive settings in the world as far as health care expenses go” ”“ and especially so in Westchester, said Farrell.

Among med school graduates, “There”™s been an uptick in interest in family medicine,” said Dr. Shantie Harkisoon, whom Phelps Memorial hired in 2010 to direct the new residency program. Of U.S. medical graduates in 2011, 11 percent planned to enter family medicine practice, compared to 8 percent in 2010. “It was trending down so we”™re happy to see it trending back up,” she said.

Harkisoon said the Sleepy Hollow hospital was approached about starting the program by Dr. Montgomery Douglas, chairman of the family and community medicine department at New York Medical College. For NYMC, the Phelps program replaces a family medicine residency program at a Queens hospital that closed in 2009 after its operator, Caritas Health Care Inc., filed for bankruptcy.

Douglas in a press release called family medicine “the lynchpin in what is becoming an increasingly complex health care system. Health care costs are lowered as patients of family physicians make less frequent visits to higher-cost specialists and emergency rooms.”

Harkisoon said Phelps has received 517 applications for its initial six residency positions, many from international medical graduates. Those accepted will be paid starting salaries of $60,000 a year ”“ the second highest salary among New York hospitals for family medicine residents, said Harkisoon ”“ and are offered $200-a-month rentals for on-site apartments provided by the hospital.

“Phelps has been really committed to the success of these residents and they want them to stay in Westchester County,” said the program director. “Our main motive for having our own residency here is to grow our own family doctors” at Phelps.

About 100 Phelps physicians to date have signed on to supervise and teach residents in their respective clinical fields. The teaching physicians should benefit too from the program in quality of care and “professional satisfaction,” said Dr. Lawrence L. Faltz, chief medical officer at Phelps Memorial.

“My mentor said the best way to learn medicine is to teach it,” said Faltz.

Keith F. Safian, Phelps Memorial president and CEO, said the family medicine residency program will help meet a growing need for primary care services in a reformed health care system. “In 2014, when insurance coverage is extended to millions of people who are now uninsured, there will be a sharp increase in demand for services and an estimated national shortage of 60,000 primary care physicians,” he said.