There aren't enough doctors, pharmacists and other clinicians to meet the needs of our region's residents, particularly the poor, elderly and developmentally disabled, Dr. Ronald Paulus told attendees of the annual meeting of The Arc of Buncombe County on June 20.
“There simply aren’t enough highly skilled medical professionals, particularly in the rural communities in our Western North Carolina region,” Paulus said.
The local chapter of a national nonprofit that helps individuals and families dealing with intellectual and/or developmental disabilities, The Arc of Buncombe invited Paulus, president and CEO of Mission Health System, to be the annual meeting's keynote speaker. He provided Arc board members and other attendees with an overview of the challenges facing healthcare facilities and practitioners in the area.
The first physician to hold the top executive position at Mission, Paulus noted that while North Carolina has more physicians per resident than the national average, WNC has less, and it's a challenge to get doctors and other medical professionals to the region's rural areas and even to the Asheville metropolitan area.
Where doctors train after medical school largely determines where they stay to practice medicine, Paulus explained. He touted Mission Health’s partnership with the Mountain Area Health Education Center, a local training facility that provides residency training for medical and dental school graduates, as well as continuing education for established health-care workers. In an agreement with MAHEC, Mission hires any of its primary-care residents who commit to staying in WNC.
Another challenge is financial, said Paulus: Medical professionals can make more money in bigger cities and metropolitan centers. “If we moved our hospital system to … Greenville [S.C.], Raleigh, Durham, Chapel Hill, this health system would generate an extra $100 million per year in profit,” said Paulus. That's money that could be reinvested in the community or could provide lower premiums for businesses, he argued. “We get paid … less for doing the exact same thing here in WNC that those other folks do in those other parts of the state.”
Another challenge? Unhealthy lifestyles also plague WNC residents, according to Paulus. “As a physician, I know that the decisions we all make, each of us, when we’re at the grocery store, or at a restaurant, or when we’re at home relaxing — that also has a very significant impact on our health,” he offered. Poor diets lacking in fruits and vegetables, as well as a lack of exercise, contribute to WNC’s poor rating on overall health.
Looking more broadly, Paulus mentioned that the U.S. compares poorly with other nations in “lost life expectancy,” a figure that tracks the number of years lost due to a person’s premature death. Depending on their age at death, American men lose between nine and 51 potential years of life compared with their counterparts in other wealthy nations, Paulus said. American women, meanwhile, lose between 10 and 38 years.
He also addressed health-care costs, particularly spending on Medicare, a program that has “significantly improved the care for older Americans, but [which has] come with a massive — some would argue unsustainable — cost,” Paulus said.
He also acknowledged the work that The Arc of Buncombe does, saying that he was excited about a $10,000 grant from the Mission Healthcare Foundation that will help set up a new health-and-wellness project. Aimed at helping adults with intellectual and developmental disabilities maintain healthy lifestyles, the project dovetails into existing community programs and is designed to help the staff of those programs assist their clients.
To be administered by The Arc, such programs are effective at increasing levels of physical activity, as well as improving the nutritional habits and oral health of people with intellectual and developmental disabilities, according to studies at the University of Kansas and the University of Montana. Good oral health has been shown to correlate with good cardiac health, and it’s thought that many of the causes of heart disease begin with bacteria that form in the mouth, Paulus added.
Paulus emphasized that unhealthy lifestyle choices are a large part of why the region’s overall health ranks low and why programs such as those offered by The Arc are needed, and said “This isn’t about doctors and hospitals. This is about each of us as individuals, and how we talk with our own families.”
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