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Monday December 15, 2014

2014 – A year of change and transition

By Robin H. Carle


Happy Holidays, Everyone! It’s time again to look back over the year at the healthcare, education and workforce issues and events that influenced The Sullivan Alliance’s work – and shaped the nation.

  1. Our state alliances were busy and successful in 2014. University of Nebraska’s Medical Center faculty and administrators met with leadership from Virginia’s Historically Black Colleges and Universities (HBCUs). Students, faculty and administrators from Norfolk State, Hampton, Virginia Union and Virginia State universities attended these meetings focused Virginia-Nebraska Alliance partner schools’ student and faculty engagement now and in the 2015-16 academic year. The Ohio Alliance’s lead school Northeast Ohio Medical University received a $1 million Talent Dividend in recognition of its success in increasing college readiness, retention-to-degree completion, and degree attainment among adults. All of our state alliance partners continued their community-based efforts, and we look forward to adding new state alliances in 2015.
  2. The dental health therapist movement continues to expand. Dr. Sullivan was privileged to give the graduation address for the 2014 Dental Health Aid Therapists (DHAT) program in Anchorage, Alaska. The event marked the 10th Anniversary of the DHAT program. Minnesota and Maine passed legislation authorizing the training and deployment of mid-level dental providers in their states. More than 15 other states are examining this possibility for their populations, and the New York Times included dental therapists in their Big Ideas in Social Change list for 2014. Our state alliances continue their efforts to improve the oral health of their communities through expansion of the dental health workforce.
  3. The influence of America’s Hispanic Community. Hispanics are the nation’s largest minority. According to the U.S. Census, there are 54 million Hispanics living in the country and by 2050, 30 percent of the American population will be Hispanic. The Census bureau reported that minorities make up 50.4 percent of the nation’s population younger than age 1 as of July 1, 2011. The Hispanic community faces unique challenges regarding access and delivery of health services and management of chronic diseases. The Alliance is developing projects to engage the parents of this new generation by opening the potential for their children’s professional future in the healthcare workforce. Strong partnerships with family, school and community are needed to support a robust pipeline for these potential providers.
  4. Student loan debt is pushing us to question post-secondary education. Our nation has transitioned to supporting students in higher education almost exclusively through loans, rather than grants and scholarships. This transition has turned students into lifetime debtors who must pay off their student loans for decades. This is of particular concern to us at the SA and we will continue to find opportunities to gain the national stage to consider how to minimize the impact on students of modest means and great potential, eager to join the health professions.
  5. Online education options grow as demand increases. Increasingly, there are many alternatives for pursuing higher levels of education outside of our brick-and- mortar degree granting colleges and universities. Individual courses, certificate programs, and degree programs are now offered online through public and private universities, as well as other independent sources. Online education may provide a cost-effective approach for individuals wanting professional training after high school, or as they seek additional training to advance in their chosen field. These options are becoming increasingly important within the health and health education professions. The SA supports quality education, delivered through new, flexible avenues of training.
  6. The growth of telemedicine and the development of virtual physician visits are spreading. There are more applications for Smart phones which monitor health. The goal is to provide more health care services to larger groups, especially the underserved. The Centers for Medicare and Medicaid (CMS) has given telehealth providers a look at its plans to expand reimbursement for telehealth services provided to Medicare beneficiaries.
  7. Ebola spreads across the globe. Every individual, family and community suffering through this disease is in our thoughts. The crisis shines a very bright light on the global community’s lack appropriate numbers of qualified health professionals who can combat this epidemic and provide consistent healthcare to millions across the globe. We must develop solutions to address the glaring lack of health infrastructures in too many nations. Now seems like an appropriate moment to act.
  8. The Loss of Important Health Care Leadership. We lost two great healthcare leaders and SA friends this year: Dr. Aaron Shirley and Lark Galloway-Gilliam. Dr. Shirley was champion of healthcare and social justice. All of us, especially the people in Mississippi, have lost a great servant leader. Dr. Shirley provided care to underserved people in rural and urban communities in Mississippi and served for many years as the only African-American pediatrician in the state. Lark Galloway-Gilliam, the Executive Director of the Community Health Council, championed the cause of health equity. Lark founded the Los-Angeles-based Community Health Councils in 1992, served as the chair of the National REACH coalition, and dedicated her life to social justice.
  9. NIH/NIMHD-UWI Annual Steering Committee meeting and NIMHD poster presentation. The U.S.-Caribbean Alliance for Health Disparities Research (USCAHDR) project (supported by NIMHD/NIH through a cooperative agreement) launched the project’s new UWI-based website which will allow researchers to access the project’s global health disparities research. Project staff also participated in meetings and conferences this year, including the Minority Health and Health Disparities Grantees’ Conference sponsored by the NIMHD. Our USCAHDR project manager presented a poster titled “Building Effective Partnerships to Improve Global Health: U.S.-Caribbean Alliance for Health Disparities Research Program.”
  10. NAACP Image Award nomination for Dr. Sullivan’s new book “Breaking Ground.” We end 2014 with wonderful news that Dr. Sullivan’s new book “Breaking Ground” has been nominated for a NAACP Image Award. Congratulations, Dr. Sullivan!

Looking Ahead. In the year ahead, The Sullivan Alliance, along with our state alliance partners, will continue and expand our efforts to build an academically competent, diverse healthcare workforce, promoting community health and economic development. The relevance of our mission continues to accelerate as the country’s demographics shift and the opportunities for health providers and health educators expand under the Affordable Care Act.

In 2015, The Sullivan Alliance celebrates its 10th anniversary! It has been over 10 years since the Sullivan Commission on Diversity in the Healthcare Workforce and the Institute of Medicine published their important reports regarding the severe shortage of minorities in the health care professions. Stay tuned regarding 2015 activities we are planning to recognize this anniversary. It’s going to be a busy and productive year!

We are grateful to you – our partners and supporters – and we look forward to working with you all in 2015. Have a happy holiday and healthy and bountiful New Year.

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Saturday November 15, 2014

40 Years of Success at NEOMED: Transforming the Healthcare Workforce in Ohio

By Jay A. Gershen D.D.S., Ph.D.


NEOMEDToday’s changing healthcare landscape requires our providers and educators to not only address a deluge of urgent needs facing the country’s health systems and models of care, but also train the healthcare providers of the future to effectively manage their patients’ care in this volatile environment.

While America’s healthcare environment continues to change, we know that the several areas where healthcare educators can have an exponential impact remain constant: developing a healthcare workforce reflective of the diverse patient populations it serves; training interprofessional primary care providers who provide team-based, patient-centered care; and implementing pipeline programs that encourage youth to enter the health professions while supporting and mentoring them throughout their pursuit of a professional degree.

For 40 years, Northeast Ohio Medical University (NEOMED), a public university and academic health center in Rootstown, Ohio, has collaborated with its educational, clinical and research partners to successfully train health professionals and medical researchers while improving the health, economy and quality of life of individuals throughout the region, state and country.

I’m so proud of how the University has transformed its campus, diversified its degree program offerings, invested in its research enterprise, expanded its wellness and service programming in the community and more recently celebrated its successes in impacting the future of health care.

Health Workforce Solutions Reflective of Diversity

BioMed buildingWhile African-Americans, Hispanics and Native Americans represent more than 30 percent of the U.S. population, they constitute only 12.3  percent of physicians. Clearly, our nation is failing to provide a culturally and economically diverse workforce.

Our workforce development solution that is beginning to demonstrate return on investment is NEOMED’s Education for Service initiative. The Education for Service initiative creates a pipeline of students from economically, educationally and culturally diverse backgrounds into the health professions and is based on four components:  pipeline, curriculum, community engagement and scholarships.

NEOMED has established multiple educational pipeline programs. These include the NEOMED-Cleveland State University (CSU) Partnership for Urban Health, which encourages economically disadvantaged students from Greater Cleveland to complete undergraduate coursework at CSU, earn a Doctor of Medicine (M.D.) degree from NEOMED and return after residency to work in medically underserved urban communities.

Only four years into the initiative, we have raised commitments totaling close to $4 million for Education for Service scholarships, including recent support of more than $400,000 from more than 600 donors, alumni and friends who attended the University’s 40th Anniversary Gala, the finale to our year-long anniversary celebration. These scholarships reduce student indebtedness, increase access to health care services, and improve the economy of the region.

Interprofessional Primary Care Providers Focused on Patient-centered Care

The industry continues to experience a lack of primary care physicians: a shortage estimated to be 46,000 by 2025.

NEOMED recently entered into an innovative business partnership with Mercy Health, a premier healthcare provider with more than 80 network locations across Ohio, to address primary care needs while serving local communities. Through the new partnership, the first of its kind between a health system and academic health center, Mercy Health will provide scholarships covering full tuition and living expenses to our qualifying students who are pursuing an M.D. degree in exchange for their future service commitments to Mercy Health following residency training.

The partnership allows NEOMED and Mercy Health to alleviate the shortage of primary care physicians in rural and underserved communities, improve access to a diverse health care workforce dedicated to the region, and improve the economy of the communities served.

Pipeline Programs that Support Professional Degree Attainment

A member of the Northeast Ohio Council on Higher Education (NOCHE), NEOMED continues to champion partnerships and collaborations with its educational partners throughout Ohio to develop pipeline programs that lead to professional degree attainment. These efforts were recognized nationally last month when CEOs for Cities awarded a $1 million Talent Dividend grand prize to NOCHE, NEOMED and other Greater Akron higher education partners in recognition of the region’s success in improving college degree attainment. From 2009-10 through 2012-13, the region experienced an astonishing 20 percent increase in post-secondary degrees earned.

NEOMEDWe at NEOMED were excited to play a significant role in developing, promoting and implementing a variety of pathway and pipeline initiatives highlighted in the national Talent Dividend. These pathway programs are designed to excite students at the middle school and high school levels about careers in health care, especially primary care, and then connect students to programs at partner undergraduate institutions in order to successfully enter a pathway to NEOMED.

Examples include our Health Professions Affinity Community (HPAC) programs, a partnership among schools and community organizations that offer a host of academic and community-based experiences with the aim of empowering ninth to twelfth grade students to take charge of their academic and career development and make a difference in the health of their communities. To date these programs have involved more than 500 students representing 107 high schools and 12 higher education institutions in Ohio. Importantly, 83 percent of HPAC students intend to pursue a career in the health care field.

Another success story is Bio-Med Science Academy, a public STEM+M high school embedded on our campus. The Academy trains students in the traditional STEM disciplines with an additional emphasis on medicine that is supported through the mentorship and instruction of NEOMED faculty and students. The Ohio Department of Education recently announced the Academy as the top achieving STEM high school in the state and also announced its rank as first among all high schools in Portage County, sixth among all high schools in Northeast Ohio and thirteenth among all high schools across the state of Ohio.

Receipt of the Talent Dividend grand prize is testament to the collaborative strength of our region in supporting students throughout their degree attainment. And it affirms that our efforts to create pathways and reduce barriers for the ultimate success of our students – and the economic growth of our region – are having an undeniable impact.

Today’s healthcare landscape may be undergoing constant change, but we look forward to inspiring and training tomorrow’s healthcare providers who will embrace new models of care and meet the needs our increasingly diverse patient populations.

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Wednesday October 15, 2014

Pharmacists on the frontline of healthcare

By Lucinda L. Maine, PhD, RPh, AACP Executive Vice President and CEO


PharmacistsDespite issues with affordability and access in the U.S. healthcare system, we trust our healthcare providers. And according to a 2013 Gallup poll, pharmacists – the third largest group of providers, and the most accessible – are the second most trusted healthcare professionals after nurses. Yet, with the invaluable services they provide in our communities, pharmacists are often little understood and may be somewhat underappreciated.

Our nation’s 281,560 pharmacists are on the frontlines of healthcare. They truly are first responders regarding our day-to-day healthcare needs. The average American lives within 5 miles of the nearest community pharmacy. And pharmacists do so much more than just fill prescriptions. They also provide advice on all of our health conditions, from temporary illness to chronic diseases.

America is getting older as Baby Boomers reach age 65 in record numbers daily. This, plus greater demands for services resulting from increased access to insurance coverage, put enormous strain on the availability of healthcare professionals of all types. With the current primary care shortage creating longer wait times (it can take about three weeks for an individual to see a general practitioner), people turn to their community pharmacists for immediate health advice.

PharmacistsWhat does it take to become a pharmacist? Students must complete a minimum of two years of pre-pharmacy coursework and some schools of pharmacy have three or more years of prerequisites. The coursework must include biology, physiology and chemistry. Also, many schools require students to take the Pharmacy College Admission Test (PCAT). PCAT is an admission test that measures academic ability and scientific knowledge. The single entry-level degree to become a licensed pharmacist is a Doctor of Pharmacy (Pharm.D.). The Pharm.D program takes four years to complete. During pharmacy school, students will study pharmacology, therapeutics, management, and medical ethics. Also, students will work in hospitals, clinics and community pharmacies under the supervision of licensed professionals. After students obtain their Pharm.D degree, they must attain their license to practice. Graduates need to pass the North American Pharmacist Licensure Examination (NAPLEX) to gain licensure, and take the Multistate Pharmacy Jurisprudence Exam (MPJE) for most states.

PharmacistsWhat are the career prospects for pharmacists? Pharmacists have one of the highest average salaries of any of healthcare field. The median annual salary for a pharmacist was $116,670 in 2012. The best-paid 10 percent of pharmacists made $145,910 in 2012, while the lowest paid made $89,280. Excellent career opportunities are also available in the pharmaceutical and medicine manufacturing industry. Pharmacists make $34,000 more than average physical therapist and $47,000 more than registered nurses. As far as other healthcare fields, only dentists and physicians earn more, taking home $163,240 and $191,520 respectively.

There are still good opportunities for those who do not want to pursue the Pharm.D.degree. Pharmacy technicians assist pharmacists with working with the public and filling prescriptions. In order to become a pharmacy technician, students can get accredited on-the-job training or enroll in Associate degree programs. These programs prepare students for the Pharmacy Technician Certification Board (PTCB) exam which is required in certain states.

As with other fields in healthcare, we need more minorities in pharmacy. The Argus Commission examined diversity in its latest report Diversity and Inclusion in Pharmacy Education. For this report, the commission examined diversity from five viewpoints: society diversity; the applicant pipeline; current students; pharmacy faculty and American Association of Colleges of Pharmacy’s (AACP) member institutions.

According to a study conducted in 2009, the percentage of women faculty members more than doubled in the time period of 1989 to 2009, from 20.7 percent to 45.5 percent. However, the number of minority faculty increased only slightly over the same period and remained below 10 percent for tenure-track faculty. The challenge of diversifying pharmacy also extends to the students. Of the total number of students enrolled in pharmacy degree programs for Fall 2013, 61.2 percent were women and 11.9 percent were underrepresented minority students.

PharmacistsWhile the increase in female faculty in pharmacy is significant, the AACP wants to extend opportunities to underrepresented minorities. The Argus Commission recommends that AACP create a Task Force on Diversity and Inclusion to advance the organization’s diversity goals. This committee will evaluate effective diversity programs in other healthcare professions such as medicine. There are effective outreach programs worth examining. For example, the University of Texas at Austin’s (UT Austin) College of Pharmacy has a Cooperative Pharmacy Program with the University of Texas at El Paso (UT El Paso). The student population at UT El Paso is predominately Hispanic. The Cooperative Pharmacy Program (CPP) allows El Paso students to obtain all of their pre-pharmacy prerequisites through the College of Pharmacy at UT El Paso. After students finish the program, they will receive a clinical doctorate degree offered through by UT Austin’s College of Pharmacy.

Pharmacists are an essential, accessible, trustworthy part of the healthcare team. In order to meet the growing demands of healthcare, we need more diversity in pharmacy to meet the needs of our increasingly diverse society. As the nation’s health needs – whether prevention, management of chronic disease or new public health challenges – grow, the role of pharmacists will remain at the core of our nation’s health delivery system. Pharmacy has a bright and expanding role in maintaining and improving the health of families and communities across the nation.

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Monday September 15, 2014

State of Hispanic Health in America

By Ciro V. Sumaya M.D., M.P.H.T.M.


As Hispanic Heritage Month begins, we typically celebrate the significant contributions the Hispanic community has made to American culture. In fact, Hispanics are influencing all aspects of America society from science, literature, the armed services and entertainment, to the Nation’s health – and economy. U.S. economic prosperity depends on Latino productivity.

51.9 mil Hispanics lived in the US in 2011With these contributions in mind, I want to explore the economic, demographic, health, and health workforce trends that are impacting this ever-more important “minority” group.

First, how strong is America’s economic connection to its Hispanic population? Hispanic spending power is 11 percent of the country’s total spending power. By 2015, Hispanic buying power will increase to $1.5 trillion. At nearly 23 million workers, Hispanics comprise 15 percent of the American labor force – and will be 19 percent by 2020.

Next, what are some of the emerging demographic trends regarding Hispanics? Hispanics are the Nation’s largest minority. According to the U.S. Census estimates, there are 54 million Hispanics living in the United States, representing 17 percent of the population. The CDC estimates that our Hispanic population will reach 132. 8 million – that’s 30 percent of the population – by 2050.

With the Hispanic and Latino community growing so quickly, it is important to consider the health issues most affecting the community. Hispanics make up the largest group of individuals without health insurance. In 2013, more than 15 million non-elderly Hispanics did not have health insurance. Although enrollment in the Health Insurance Marketplace surged to 8 million, only 10.7 percent of the enrollees are Hispanic.

Chronic diseases are also very prevalent for Latinos:

  • 10.4 percent of Hispanics age 20 years or older have diabetes
  • 22.2 percent of Hispanic adults have high blood pressure
  • 65 percent of adult Hispanics are overweight or obese
  • 15 percent of Hispanic high school students are obese
  • Heart disease is the leading cause of death for Hispanics, followed by cancer

Is the current health care workforce diverse enough or culturally competent enough to serve our Hispanic and Latino communities as they face these chronic health issues? Not really.

Hispanics made up 17% of the US population in 2011Hispanics are severely underrepresented in the field of medicine. We represent the smallest share of employed physicians and surgeons at 5.8 percent. In 2007, just over 1,100 Hispanic students graduated from medical school which is 6.8 percent of total graduates.

This glaring underrepresentation is also found among other health professions disciplines. Latinos account for only 4.7 percent of registered nurses, 7.1 percent of licensed practical and licensed vocational nurses, 9.3 percent of physician assistants, and 5.9 percent of pharmacists. According to the Hispanic Dental Association, there is also a significant shortage of Hispanic dentists. The 2010 Census reported 161,305 active dentists in America and of that number only 8,650 are Hispanics.

It is a fact that minority health care professionals are more likely to treat minority and indigent patients, and minority patients are more likely to select a minority health care provider. Minority health professionals are likely to have cultural and linguistic skills that create more successful and sustained encounters with their minority patients and will result in quality, cost effective care with better outcomes. Further, Hispanic health care providers are important resources to assist with improvements in the skills and competencies of non-minority health providers serving minority populations.

This academic year, we have a ‘majority minority’ in our public schools for the first time. And by 2042, the United States is projected to become a majority minority country. The country will face a shortage of over 130,600 physicians by 2025. Do the math. We clearly need a more diverse health care workforce. 2025 is just around the corner.

In order to make progress, we need more K-12 programs to foster an interest in math and sciences. Programs that attract children of color to the sciences are essential. This process must also create strong mentoring efforts to support the students, as well as involve their families in their journey toward a health professions career. Yes, we need more physicians, particularly those interested in providing primary care; but increasingly interprofessional teams are delivering quality care. There are many existing and emerging health professions disciplines that do not require the lengthy, expensive training of medical school and yet are essential to the delivery of quality care in our communities.

Diversity is an essential asset in our society. Hispanics and Latinos continue to play a vital and fast-growing role in every corner of the nation. We must invest more directly in efforts to address their health and health care disparities, particularly those caused by chronic diseases that heavily impact this important group within our society. The future of our country depends upon a healthy, educated workforce. Providing quality health care, promoting health, and preventing disease — for everyone — is the way to achieve that goal.

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Friday August 15, 2014

U.S.-Africa Leaders Summit reinforces link between economic vitality, education and health

By Robin H. Carle


John Kerry at US Africa Leaders SummitEarlier this month, I had the opportunity to attend the U.S.-Africa Leaders Summit. The auditorium was filled with the sounds of powerful enthusiastic leaders from African nations and the United States, meeting again – or for the first time – all eager for the opportunity to express their perspectives about progress, and barriers to progress, in their countries.

Secretary of State John Kerry and Vice President Joseph Biden addressed the group. Members of the panel who fielded questions from the audience, and those engaged over Skype, included President John Mahama of Ghana, President Jakaya Kikwete of Tanzania, and Dr. Joe Okei-Odumakin of Nigeria.

I was reminded again that democracy, when married to civic engagement makes for a great and positive future. A well-written constitution protects its citizens and provides a framework for opportunity – but the community gives a country its soul. The situations may vary – greatly sometimes – but the goals are shared:

These are significant tasks for those African countries and for ours, but the collective passion and capable voices in that room reinforced what is possible.

Joe Biden at US Africa Leaders SummitThis September marks the beginning of our 10th Anniversary activities around the Sullivan Commission report Missing Persons: Minorities in the Health Professions”. While much has been accomplished in the last decade, there is even more left to do to create a culturally-competent health workforce capable of caring for the increasingly diverse population of our nation.

As our academic colleagues begin their new school year, and our national organizational collaborators intensify their work to expand and diversify the nation’s health workforce, we at The Sullivan Alliance look forward to growing our partnerships with all of you and leveraging our collective efforts to expand our health work force and reduce the health disparities that compromise the futures of far too many of our fellow citizens.

I hope all of you enjoy the final days of summer – and I look forward to working with you on important projects in the days ahead.

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Tuesday July 15, 2014

From on campus to online: What are my choices for learning?

By Robert S. Gold Ph.D., Dr.P.H., F.A.S.H.A., F.A.A.H.B.


John F. KennedyOn July 25, 1961 President John F. Kennedy proclaimed: “Let us think of education as the means of developing our greatest abilities, because in each of us there is a private hope and dream which, fulfilled, can be translated into benefit for everyone and greater strength for our nation.”

His intent was clear but times have changed in the more than 50 years since this declaration. It was presumed at that time that a high school education would be all someone needed to find a productive and well-paying job. Now many believe that the education needed for today’s well-paying jobs requires at least a college-level degree. And yet for many the dramatic increases in costs associated with higher education have locked them out of this opportunity. On March 18, 2014 in a national story entitled “How the Cost of College Went From Affordable To Sky-High,” National Public Radio reported that the cost of a college education in Arizona has increased by 77 percent in five years; that those who live in Georgia have seen 75% increases, and in Washington State, 70% increases.

In fact, current data present a very compelling picture of the impact of not completing a college education. Recently the Pew Research Center reported: “On virtually every measure of economic well-being and career attainment – from personal earnings to job satisfaction to the share employed full time – young college graduates are outperforming their peers with less education. And when today’s young adults are compared with previous generations, the disparity in economic outcomes between college graduates and those with a high school diploma or less formal schooling has never been greater in the modern era.” The graph below illustrates these data very clearly.

Rising Earnings Disparity Between Young Adults with And Without a College DegreeSo where does this leave someone who is capable of earning a degree, or who wants simply to learn more about a topic but is unable to afford it given today’s costs? There are actually some good choices available so let’s review some of them:

  • If you’re interested in applying for a degree program at a public or private college or university; or at some for-profit degree granting institutions there are a variety of loan programs available;
  • If you’re interested in simply learning more about a particular topic, or you want to earn certain certificates of achievement, there are some options such as the Khan Academy or MOOCs; and
  • If you are willing to go to school part time while working, there are a number of exciting opportunities for that as well.

So let’s take a look at some of these.

Loan Programs:

There are in fact many loan programs available to students besides financial aid and scholarships offered directly from colleges themselves. Here are a few:

  • Perkins loan: a government guaranteed loan issued to low-income students to lower costs.
  • Stafford loans: a form of federal aid to help undergraduate or graduate students pay for their education.
  • Parent PLUS loans: a federally guaranteed loan to parents to help support their child’s undergraduate education.

What these loan programs allow you to do is to go to a school of your choice and reduce the overall cost to you while you are attending school. Each of these loan programs are in fact loans, so they must be paid back. There are, however, some loans that are able to be forgiven under certain circumstances and these almost always involve giving back to communities when your training is done.

Depending upon your professional interests, there may also be other loan repayment support programs that help you reduce your student loan debt. So if you must, explore the many loan programs available to you; but don’t forget that for health care professionals, researchers and others there are also opportunities for government sponsored loan repayment and forgiveness programs.

Online Learning

Today however, there are other alternatives for ensuring higher levels of education other than degree granting colleges and universities. There are individual courses, certificate programs, and degree programs offered online at public and private universities and through other independent sources as well. Many have heard of the Khan Academy, a non-profit system of education created by Salman Khan in order to provide a free, high quality education to anyone in this country or anywhere in the world. At this time there are more than 5,000 lectures online – many with video tutorials that are available. There are courses in such areas as computer science, mathematics, history, healthcare, medicine, and all the basic sciences. More than 10 million students a month access these courses for free. The Khan Academy however, does not offer degree programs, only courses.

You may also have heard the term MOOC, which stands for “massive open online course.” These are courses offered online by many different sources. These courses are often designed to be open-access and may have very large numbers of students registering for them online. Aside from often being free, someone who registers for a MOOC will find that some require you be online at a specific time (synchronously) or allow you to access full course materials whenever you are able (asynchronously). Moreover, anyone can register for any course – there are rarely requirements for taking a course other than your interest. A good review of the pros and cons of MOOCs, what they can do, and the strengths and weaknesses can be found at the site Skilledup. In addition, some of these MOOC providers provide Certificates of Achievement or Advanced Certificates for completing sequences of courses on their sites. To take a course on most sites it is generally a free service. For some of the certificates however, there may be a charge.

For higher education three of the best known providers of MOOCs are:

  • Coursera – which may be the best known of the MOOC providers and may be one of the easiest to use.
  • edX – which may have the best choices of science related classes among the major MOOC providers.
  • Udacity – which is a provider that has focused on self-directed learners interested in simply viewing materials.

Going To School Part Time While Working

Although many would argue this is not the best way to get a degree, it is still an option should you have no other way to afford going to school. If you have a fulltime job, you may find that your employer has tuition assistance programs. Some companies offer full tuition assistance and other partial tuition assistance.

You should check with your employer regarding such benefits. But I’d like to close this post with recognition of one of the newest of these employee benefit programs designed to ensure its employees are able to continue to learn while they work. Maybe you read an announcement a few weeks ago with the following headline: “Starbucks Offers Full Tuition Reimbursement for Partners (Employees) to Complete a Bachelor’s Degree.” There is an interesting video associated with this program and more information. Check out the video to see how Starbucks describes the real issues around higher education for those unable to pay. More importantly, this is an example of an organization that provides tuition assistance to its employees.

So in closing, you actually have a number of choices when considering your learning future. There are others as well. I remember something I was told a long time ago. There are three sources of power in this world: money, weapons, and knowledge; and knowledge is the only one that can be freely shared with others without you losing any of yours.

Lifelong learning is critical, and you have many choices. Enjoy them.

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Sunday June 15, 2014

Celebrating 10 years of better dental care in Alaska

By Louis W. Sullivan, MD


I had the pleasure of addressing the 2014 graduates of the Dental Health Aide Therapist (DHAT) program (as well as program alumni, students still in training, faculty, staff, and administrators) in Anchorage, Alaska earlier this month. This is a particularly special year because it’s also the 10th Anniversary of the DHAT program.

Here is an excerpt from my June 6th remarks that captures my thoughts about the DHAT program, the 10th anniversary, and the current state of oral health care in America.

Dr. Sullivan with DHAT Graduates“Congratulations Graduates and Happy 10th anniversary to the DHAT program.... [And] thank you to the Alaska Native Tribal Health Consortium! Thank you for your vision of a better future for your people and your communities. Thank you for your courage, your tenacity and for your leadership in establishing a new health order in Alaska. Thank you for refusing to accept the status quo in dental health in Alaska. That is why we are here to celebrate with you today.

You have changed the dental landscape in Alaska. You changed the healthcare environment in this state. You are charting a new course for better health today and tomorrow in Alaska.

The rest of America is watching Alaska with great interest and fascination. Your success is beginning to be emulated in the lower 48 states. Minnesota and Maine have passed legislation authorizing the training and deployment of mid-level dental providers in their states. More than 15 other states are examining this possibility for their populations . . . and they should!

More than 49 million people in America live in places where it is difficult to access dental care. Many more receive less than optimal oral health care, including preventive services. Our nation needs more dentists, hygienists and mid-level dental providers, to achieve appropriate levels of dental services and improved oral health at reasonable costs and with easy access. Dental Therapists have existed in other countries, for more than 80 years, including Australia, New Zealand, England and Canada. They are well accepted and are providing needed and valued quality services at a lower cost. And now Dental Therapists are providing needed care here.

Our nation’s current health system has many strengths. We also spend more on health care than any other nation. In spite of this, the United States is not the world’s healthiest nation. Many other developed countries have a longer life expectancy, a lower infant mortality and other indices of better health status. What is the reason for this?

We have a distribution problem. Not all of our citizens have access to our array of health services — a reality beginning to be addressed with the implementation of the Affordable Care Act.

AlaskaAs a nation we must strengthen our emphasis on prevention of illness and injury, including maintenance of good oral health. Here in Alaska, you are already contributing to a better future for America by producing well-trained dental health aide therapists available to work and live in communities across your state.

In the nation’s health system, we are witnessing many changes to better address today’s health challenges. Our country has begun a process which will extend health insurance to millions of Americans who previously had no health insurance. If implemented successfully, the Affordable Care Act will not only provide health insurance, it should lead to more appropriate, and more rational use of our nation’s health care resources. This means access to care earlier, in practitioners’ offices, in community clinics, it will mean continuity of care, as opposed to episodic, sporadic and expensive care in our nation’s hospital emergency rooms. It means greater utilization of dental preventive services, childhood immunizations, pregnancy counseling, fitness programs, avoidance of tobacco and other addicting substances.

The transformation of our health system will not occur overnight. It will unfold over the next 1-2 decades, and many changes will occur in how health services are delivered. A recurring theme is, and will be, individuals taking more initiative and more responsibility for protecting, enhancing and maintaining their own health.

We must also improve the health literacy and health behavior of our citizens, to successfully address problems such as tooth decay, the most common chronic disease in children. Good oral health is an important component of overall health.

We are witnessing more interprofessional education in health professions schools, between physicians and dentists, and between physicians, dentists, nurses, pharmacists, psychologists, public health professionals and others – another welcome development.

81 Alaskan villages participating in the DHAT programOur health system must be open to exploring the training of new kinds of health professionals. In medicine, in the 1960’s and 1970’s we saw the introduction of physicians assistants and nurse practitioners, to work with physicians as members of the health care team. Initially resisted by my colleagues in medicine, today nurse practitioners and physician assistants are well-accepted, valued colleagues on the staffs of the nation’s hospitals and in physician practices around the country.

In this second decade of the Twenty-First century, we have much to be proud of. Significant improvements in health and healthcare were achieved in the Twentieth Century. Yet, much remains to be done, to further improve the health and the lives our citizens. Improvements in oral health are an important part of the challenges we confront.

Because of the vision and generosity of W.K. Kellogg Foundation, the Rasmuson Foundation and the Bethel Community Services Foundation, Alaska is leading the nation in innovations in the education of a new dental professional. The University of Washington School of Medicine is also to be commended for its academic supervision of today’s graduates of the DHAT program.

And so, today, we celebrate this 10th anniversary of the DHAT program, which has trained dental therapists who work under the general supervision of dentists, and have provided basic dental care to more than 40,000 Alaskans, and has improved oral health in 81 villages.

I congratulate today’s graduates and all of you, and urge you continue to lead the nation in finding ways to see that all our citizens have access to preventive dental services and basic dental care. As Alaska continues to lead, the rest of the country will follow, to improve the oral health of our citizens.”

DHAT Students and Graduates

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Thursday May 15, 2014

Telemedicine - bringing more patients and health providers together

By Jonathan Linkous, CEO, American Telemedicine Association.


Jonathan LinkousWe have the pleasure of having the CEO of the American Telemedicine Association (ATA), Jonathan Linkous, as our guest blogger this month. As the ATA's annual conference starts later this week, we invited Mr. Linkous to answer a few questions about how telehealth can improve health equity.

 

The Sullivan Alliance: The terms "telehealth," "mHealth" and "telemedicine" can mean a lot of different things. How do you and your ATA's members define them?

Jon Linkous: There are so many terms including “eHealth” and “Connect Care”. And they all mean providing care for patients remotely through telecommunications. The focus is on the patient and patient care instead of a specific technology. “mHealth” focuses on what types of technology is being used – wireless, mobile devices, mobile apps, etc.

 

The Sullivan Alliance: The Sullivan Alliance is committed to increasing the number of minorities in our nation's health workforce, as well as bringing more health professionals to communities that currently don't have access to adequate care. How can telemedicine help to address these issues?

Jon Linkous: Telehealth started out targeting remote areas like rural communities, the Australian Outback, and even NASA in space. Telemedicine takes out the “going to” part of seeing the doctor for patients and provides access to care regardless of the location, including the inner cities. It’s especially useful with reaching individuals suffering from chronic diseases. Patients can also live in suburban areas but have trouble getting to a specialist downtown.

Telemedicine also allows doctors who are thinking about retiring to continue working remotely from home – or part-time. For example, radiologists do not have to be in the hospital to diagnose their patients.

 

The Sullivan Alliance: It's graduation season so there are a lot of high-school seniors and college graduates trying to decide what to do next. What types of health professionals-- and what areas of specialized training – are needed to support new telemedicine services and technologies?

Linkous: Today’s graduates are extremely tech-savvy. Using technology is commonplace for them because they’re already using Google to gather health information or get to online services. We all have access to information through the Internet. People can keep track of health data. Patients are becoming very informed consumers. Telemedicine used to be focused on high-end technology and now such technology is commonplace.

Specialists like radiologists, neurologists and dermatologists are providing the most services remotely. And there are many hospital administrators, x-ray technicians, and IT support staff who support them. These are all great careers for our graduates to consider.

 

The Sullivan Alliance: What treatments in medicine and dentistry are best suited to telehealth?

Linkous: The largest numbers of treatments are in radiology. The other big areas include neurology (for treating stroke patients in the emergency room), dermatology (for skin conditions) and mental health care.

 

The Sullivan Alliance: As you are well aware, there are significant health disparities in this country. Do you have examples of how telemedicine is already helping patients who don't have local access to appropriate healthcare?

Linkous: About 10 million patients are seen and get treatment using telemedicine. It is quite abundant. I encourage you to look at all of the case studies on our website. They detail everything from treatments of pediatric head injuries and pre-natal care, to stroke diagnosis and daily biometric monitoring and education.

 

The Sullivan Alliance: Certification and accreditation issues often limit changes and advances in health delivery. What obstacles does today's health delivery system present to the growth of telemedicine?

Linkous: Every doctor has to be qualified and certified state-by-state. Telemedicine is no different. Since each state has the authority to license, state licensing can be a problem – but there are a number of options that are being considered. The fact is people tend to move around and when they do, they want to keep their doctors – wherever they practice.

American Telemedicine Association Conference 2014

The Sullivan Alliance: ATA 2014 is just days away. What featured technologies or topics are you most excited about? And what should we all be looking out for in the coming year?

Linkous: There is a ton of good stuff this year. There are 300 exhibitors and both service providers and tech-based companies attend. There are always the newest and cheapest technologies on display. Some of the newer applications are focusing on Parkinson’s disease. This is important because Parkinson’s patients are isolated and remain at home. They’ll see a primary doctor but not a specialist.

 

The Sullivan Alliance: Is there anything else that you'd like people to know about the ATA or telehealth/telemedicine?

Linkous: Yes, there’s a big trend in the state legislatures. Forty states want to expand Medicaid coverage to cover telemedicine. Also, it’s the private providers and insurers who are really driving growth in telemedicine because they see the benefits in expanding care and saving costs. For example, United Health Care, the largest health care provider, will attend ATA 2014.

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Tuesday April 15, 2014

The Crisis of Student Loan Debt in Post-Secondary Education

By Robin H. Carle


Crisis of Student Loan Debt word-cloudHigh-school seniors who have applied to college are about find out if they’ve been accepted or rejected from the college they want to attend for the next 2-4 years. Those acceptance letters will be quickly followed by an avalanche of confusing financial information about how they might pay for their undergraduate education. Scholarships, grants, loans, FAFSA, Stafford, Pell, Direct PLUS…. How do students and their parents decipher all these names and acronyms and the myriad financial options they represent?

A recent NPR story reported that, at over $1 trillion, student loan debt is now larger than total credit card debt. NPR’s Morning Edition asked young adults about their biggest concerns, and more than two-thirds of respondents mentioned college debt. Many indicated they have put off marriage or buying a home because of the financial burden they took on as students.

Clearly, something is very wrong.

Over the last several decades, our nation has transitioned to supporting students interested in higher education almost exclusively through loans instead of scholarships and grants. This change has turned our students into lifetime earners who must pay off their student loan debt for decades. We have been sending our young people down a path to a lifetime’s financial burden for too long. We as a nation need to address the problem that has been created by well-intended policies that have run amuck.

The burden of debt is even higher for students pursuing Graduate degrees. And nowhere is the dilemma more obvious than within the health professions pipeline. It is projected that the United States needs 150,000 more physicians, 250,000 more pharmacists and up to 1,000,000 more nurses in the United States over the next 10-20 years. But not surprisingly, many well-qualified students don’t choose to be physicians, dentists or nurses because of the daunting $150,000 to $250,000 tuition fees (and debt) that come with those degrees .

The good news is that higher student debt has not yet stopped Americans from seeking college degrees. In fact, according to a new Lumina Foundation report, even though less low-income college-age students enroll in college than high-income students, college attainment for all racial and ethnic groups is increasing. In addition, some newer Federal income-based loan repayment plans could enable lower-income students to consider post-secondary educations – and perhaps a career in one of the health professions.

Let us work together and find creative, sustainable ways to ensure the future personal and economic success of the next generations of college-bound children. Let’s begin a true dialogue that results in a reduction of the overwhelming burden of higher education debt that is currently saddling a majority of our young people.

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Saturday March 15, 2014

The Ins and Outs of Building International Collaborations to Research Global Health Disparities

By Dr. Marlene Y. MacLeish


Dr. MacLeish presentingIn late February, The Sullivan Alliance (SA) hosted the third annual Steering Committee Meeting of the U.S.-Caribbean Alliance for Health Disparities Research (USCAHDR). As the project director, it is my privilege to discuss the significance of this unique governmental/non-governmental partnership among SA, the University of the West Indies (UWI), and the National Institutes of Health (NIH).

Our project focuses on research to ascertain similarities and differences between U.S. and English-speaking Caribbean populations of African descent and explores how this knowledge advances current understanding of the relationship among determinants of health, including lifestyles and health practices. The framework for our analysis comes from the Institute of Medicine’s 2009 recommendations published in U.S. Commitment to Global Health: Recommendations for the Public and Private Sector.

The work of the USCAHDR project is supported through a cooperative agreement, which includes the National Institute on Minority Health and Health Disparities (NIMHD), The Sullivan Alliance, and The University of the West Indies. Dr. Louis W. Sullivan and Dr. E. Nigel Harris, Vice Chancellor of the UWI, serve as principal investigators of the project.

UWI is a university system serving 18 separate countries and territories in the Caribbean. The University consists of three campuses at Mona in Jamaica, St. Augustine in Trinidad and Tobago, Cave Hill in Barbados, and the Open Campus. There are satellite campuses in Mount Hope, Trinidad and Tobago, and Montego Bay, Jamaica, and a Centre for Hotel Tourism Management in Nassau, Bahamas. The other contributing countries are served by the Open Campus which has presence and Heads of Sites in each of the 18 countries. 

In 2012, a delegation including Dr. Sullivan, Dr. Claudia Baquet, representing the USCAHDR Steering Committee, and  I visited the UWI Mona Campus for the project’s first planning meeting. Dr. Sullivan gave a University-wide presentation, Global Health Disparities: Challenges and Opportunities, which was attended by faculty and students from across the disciplines. This event gave us important momentum and became a cornerstone for building this unique partnership.

Dr. Sullivan, Secretary of Health and Human Services under President George H. W. Bush, brings unique leadership, including policy perspectives from his signatory, Healthy People 2000to build this synergistic collaboration among SA, the UWI and the NIMHD, which is an invaluable partner, financial supporter and an important advisor for every aspect of this venture.

As part of disseminating the project’s research findings, The Sullivan Alliance and the UWI are creating an Electronic Platform (E-Platform) which will serve as a knowledge transfer portal for researchers interested in obtaining global health disparities research data. Researchers from across the globe will soon be able to access new health disparities data on the United States and the Caribbean to craft future policy and public health interventions that impact the health of the regions.

The USCAHDR project is currently in its third phase and our team of researchers is poised to publish initial findings in prominent peer-reviewed publications and journals. As the global community turns increasing focus to the rapid development of chronic disease across the globe, we are eager to share our findings with the scientific community and to establish future collaboration targeting global health disparities reduction research.

I want to take this opportunity to salute and thank members of USCAHDR research team, including Drs. Rainford Wilks, Anselm Hennis, Trevor Ferguson, Ian Hambleton, Novie Younger-Coleman, Nadia Bennett, Lynda Williams, Aurelian Bidulescu, Mr. Christopher Hassell, Mr. Damian Francis and Ms. Brigitte Collins for their stellar contributions to this project. Also, I acknowledge the invaluable support of NIMHD professionals Drs. Nate Stinson, Jennifer Alvidrez and Irene Dankwa Mullan. 

The USCAHDR team looks forward to the next phase of our research collaborative and our collective contribution to global health disparities research.

USCAHDR Annual Steering Committee MeetingFront (left to right): Claudia R. Baquet, M.D., M.P.H., University of Maryland Baltimore School of Medicine; Louis W. Sullivan, M.D., Principal Investigator, Chairman, Chief Executive Officer, The Sullivan Alliance; E. Nigel Harris, M.Phil, M.D., D.M., Vice Chancellor, UWI; Nigel Unwin, B.M., B.Ch., M.Sc., D.M., F.R.C.P., F.F.P.H., UWI.
Standing (left to right): Ian R. Hambleton, Ph.D., UWI; Aurelian Bidulesco, M.D., Ph.D.; Nathaniel Stinson, Jr., Ph.D., M.D., Scientific Officer, NIMHD; Robin H. Carle, B.A., COO, The Sullivan Alliance; Trevor S. Ferguson, M.B.B.S., D.M., UWI; Marshall Tulloch-Reid, M.D., Ph.D., UWI; Marlene MacLeish, Ed.D., Program Director; Jennifer L. Alvidrez, Ph.D., Health Scientist Officer, Division of Scientific Programs, NIMHD; Anselm Hennis, M.B.B.S., M.Sc., Ph.D., F.R.C.P., UWI

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Saturday February 15, 2014

Interprofessional practice, diversity initiatives to enhance healthcare in Ohio

By Jay A. Gershen D.D.S., Ph.D.


Sergio Garcia, Jay Gershen, Joxel GarciaIn June 2013, The Sullivan Alliance to Transform the Health Professions, in partnership with Northeast Ohio Medical University (NEOMED) and with the generous support of the Josiah Macy Jr. Foundation, convened a conference to showcase best practices to advance diversity, interprofessional education and practice in healthcare through pipeline-to-practice efforts in Ohio. I’m proud to share a copy of the recently published conference report, which can also be found on the Ohio Alliance website.

Attendees were leaders and stakeholders representing Ohio-based academic institutions, the business and political communities, and other community entities that in some way shared interests in advancing educational pathways leading to and improving the healthcare workforce in Ohio.

The conference report highlights four themes that are critical to the development of The Sullivan Alliance, the budding Ohio Alliance and the priorities of the Josiah Macy Jr. Foundation. These themes were reflected in the conference’s plenary sessions, panel presentations and working group discussions:

  • Middle school to pre-professional pathway programs: Programs and best practices that are designed to attract middle, high school and undergraduate students from diverse, educationally and economically disadvantaged backgrounds to healthcare careers.
  • Innovative interprofessional training pathways: Curriculum at the pre-professional and professional school levels that focuses on programs in interprofessional healthcare team training, primary care, population health and social determinants of health, and encourages students to practice in urban and rural underserved areas.
    Attendees from Ohio Pipeline to Practice Conference
  • Diversity: Diversity becomes an essential aspect of the health professions training and healthcare delivery missions as the patient population in the U.S. becomes increasingly diverse. Demographic diversity in the healthcare workforce enhances the capacity of the healthcare system to reflect and effectively care for an increasingly diverse patient population.
  • Community engagement and resources: Initiatives that develop and strengthen the engagement of all Ohio communities are essential to composing a healthcare workforce that is reflective of and responsive to community healthcare needs. Mobilizing communities to become partners in sustaining and improving community health is crucial.

The conference outcomes ultimately prompted key stakeholders to further recognize how national imperatives and innovations translate to Ohio-based opportunities and challenges. The workgroup activities helped strengthen attendees understanding of how multiple Ohio-based interests could collaborate to improve the healthcare system and mutually advance multiple missions on that theme.

Dr. Sullivan, Marc Nivet, and Congressman Louis StokesThe combination of both the presentations and workgroup discussions served to fuel an action plan for developing the Ohio Alliance into a center of excellence. The Ohio Alliance will focus its near-term efforts on convening and focusing stakeholders on a collaborative approach to enhancing the healthcare system through interprofessional practice and diversity initiatives that span the continuum from pipeline to practice.

Clearly, the challenges and opportunities of our education and healthcare delivery systems were well considered by the participants at the conference. I encourage you to share this timely report with your colleagues.

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Wednesday January 15, 2014

America’s Healthcare Workforce – A Decade of Progress?

By Louis W. Sullivan, MD


Happy 2014! It’s hard to believe that almost 10 years have passed since the Sullivan Commission on Diversity in the Healthcare Workforce and the Institute of Medicine published their seminal reports* recognizing the severe shortage of minorities in the health professions and focused on opportunities to increase diversity in America’s health professions education programs at all levels, across the country. The goal of these efforts was, and is, to increase the numbers of people from underrepresented and underserved communities as professionals in the nation’s health care system. These reports shaped many projects and programs within the academic community and government aimed at reducing these shortages. As Chair of the Sullivan Commission, I am proud that our work has helped to guide healthcare workforce development for the last decade.

Today the country’s demographics have shifted. One in three Americans is a member of a racial or ethnic minority, with African Americans, Hispanic Americans, and American Indians making up more than 30% of the nation’s population. For those under the age of 20, the percentage rises to 43%. The U.S. Census Bureau predicts that by 2043, there will be no majority population in the United States.

Yet, how many of this newest generation dream of a career in the health professions? Or live in a family or community committed (yet unable) to support the necessary educational, social/emotional, and financial path toward that future? Even with the ACA and today’s improved access to healthcare, is there sufficient federal focus to train health professionals who can serve all of the Americans who now access the health system?

This 10th anniversary year gives us an important opportunity to reflect on the last decade’s successes, bring continued deficits into national focus, and identify policy leaders who can further propel implementation of the original studies’ recommendations. In addition, we will examine how a decade of technological and societal change – everything from telemedicine and electronic health information sharing to online access, mobile technology and social media – could impact the next decade – offer new pathways to health professions’ careers and more dramatically reduce health disparities.

We look forward to working with our partners and colleagues around the nation to recognize these important anniversaries, as well as reflect on how we can increase the cultural competency of our health professionals and the size of the health workforce to further improve health status, access to healthcare, and health outcomes for those whose race, ethnicity and/or socioeconomic status are still associated with health disparities.

There is much work to do!

*Missing Persons: Minorities in the Health Professions(the Sullivan Commission) and In the Nation’s Compelling Interest: Ensuring Diversity in the Healthcare Workforce(the IOM’s Committee on Institutional and Policy-Level Strategies for Increasing the Diversity of the U.S. Healthcare Workforce).

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