The Teaching Health Center Initiative: Funding Residencies, Fueling Renewal, Generating Hope

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As the largest Teaching Health Center in the nation, we are privileged to train doctors who are interested in making a genuine difference in their communities. Thanks to the tireless work of leaders in Graduate Medical Education and the support of our elected officials, the Teaching Health Center program is receiving necessary exposure at the national level, most recently through a research report entitled “Primary Care Residents in Teaching Health Centers: Their Intentions to Practice in Underserved Settings After Residency Training”.
Its authors: Zohray Talib, MD; Mariellen Malloy Jewers, MIA; Julia H. Strasser, MPH; David K. Popiel, MD, MPH; Debora Goetz Goldberg, PhD, MBA, MHA; Candice Chen, MD, MPH; Hayden Kepley, PhD; Fitzhugh Mullan, MD and Marsha Regenstein, PhD enlisted the feedback of Teaching Health Center residents from across the nation. Our Wright Center residents contributed their thoughts and experiences.
The misdistribution of provider talent, coupled with the challenging healthcare landscape has led underserved areas across the nation without appropriate access to affordable healthcare. Teaching Health Center programs have answered the call for physicians in the areas that need them most and play a vital role in training the next generation of providers.
The doctor shortage does not discriminate. Regions across the country – both urban and rural – are in need of primary care. With Teaching Health Center residents handling approximately one million patient visits over the course of each year, the program has helped establish the foundation necessary for fueling physician renewal. In fact, this year’s most recent report showed that 82% of Teaching Health Center graduates remain in primary care practice, as compared to 23% of traditional Graduate Medical Education graduates – and that’s only the beginning.
Here are five fast facts about the Teaching Health Center program:

  • 742 residents train in 59 HRSA-supported Teaching Health Center Graduate Medical Education programs
  • 63% of Teaching Health Center residents specialize in family medicine
  • Teaching Health Center programs are located in 27 states and the District of Columbia
  • Teaching Health Center Graduate Medical Education programs received more than 100 applications for each residency position
  • Teaching Health Center residents will provide more than 1 million primary care medical visits in 2017 to underserved communities

We are proud that an overwhelming amount of The Wright Center’s graduates choose to practice in underserved areas. Of our most recent graduating class of our Teaching Health Center National Family Medicine Residency program, 76% chose to practice in a medically underserved area; some even chose to sign on with the partner site at which they completed their training in the early stages of their residency.
As an organization comprised of a multidisciplinary staff of providers and administrators, we understand the value of a committed, diversified team as we remain in relentless pursuit of our mission to continuously improve patient care and education in a collaborative spirit to enhance outcomes, access and affordability.
Sustaining Teaching Health Center funding is a vital step towards The Wright Center’s mission. Federal Teaching Health Center funding is currently set at $116,000 per resident, significantly lower than the estimated training cost of $157,000. To provide comprehensive healthcare services to patients who need it most, Teaching Health Center programs need the full support of the federal government and advocates to help them get there. The Wright Center’s team has been passionately lobbying for the expansion of Teaching Health Center funding on behalf of our learners and our patients who need them most.
Legislation (S. 1754 and H.R. 3394 to reauthorize section 340H of the Public Health Service Act to continue to encourage the expansion, maintenance, and establishment of approved graduate medical residency programs at qualified teaching health centers, and for other purposes) has received bi-partisan support and thanks to the lobbying efforts of many, is gaining traction where it matters most. An extension, and possibly an expansion, of sustainable Teaching Health Center funding can be a catalyst for change, an inspiring demonstration of a republican and democratic collaboration for continued pursuit of the Quadruple Aim — outcomes, access, affordability and joy in practice — in America.
Click here to read the full report.

All facts and figures attributed to the research and tireless efforts of the American Association of Teaching Health Centers.

Linda Thomas-Hemak, MD & Terri Lacey, RN Highlight the Partnership of the Behavioral Health Initiative to Combat Psychiatrist Shortage

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A 2015 white paper published by a physician staffing firm called it a “silent shortage.” In a country gripped by the grim phenomenon dubbed “deaths of despair,” “it” is a severe and under-appreciated shortage of the very people with the skills and knowledge necessary to reverse the trend. Our region, like the rest of the nation, needs psychiatrists.
How bad is the problem? The late Richard Cooper, M.D. of the University of Pennsylvania, a noted national authority on physician supply, distribution and utilization, finds that a population of 100,000 should have 14.7 psychiatrists, or one for every 6,800 people. The counties of northeastern Pennsylvania average about 8.5, according to Dartmouth Atlas of Health Care. Moreover, the few psychiatrists we have must cope with three of the “Top 10” diseases most associated with lost quality of life. According to the World Health Organization (WHO), “unipolar depressive disorders” are the No. 1 cause of medical disability in the United States. Dementias, including Alzheimer’s, and alcohol and ecstasy disorders come in at No. 3 and No. 4. The escalating opioid crisis is, no doubt, claiming its place as it climbs the rank order.
Despite the suffering and lost years of life caused by (often undiagnosed) behavioral and mental health diseases, we still cling to outdated ideas about psychiatry like, “If people just had more willpower and determination, they’d “snap out of” their depression,” and, “Addiction is a sign of moral weakness, so patients have only themselves to blame.” The healthcare system is fragmented; it is not built on resiliency, but on brokenness. The persistence of these discredited notions about mental health has led to what should be a national wake-up call – for the first time in decades, mortality rates for a certain U.S. demographic (whites aged 45 to 54 – an important demographic in NEPA) rose by half a percent a year since 1998. The cause of these deaths is overwhelmingly attributed to suicide and addiction. No other rich country has experienced anything like these “deaths of despair.” As Angus Deaton, an economist, Nobel Laureate and co-author of the paper which first identified the trend, told the Washington Post, “That means half a million people are dead who should not be dead. That’s about 40 times the Ebola stats. You’re getting up there with HIV-AIDS.”
Although Dr. Deaton’s ground-breaking report was published in 2015, a Community Health Needs Assessment conducted by the Institute for Public Policy and Economic Development in 2012 identified mental and behavioral health challenges, including higher-than-national-average suicide rates, in our region. That’s when Geisinger Commonwealth School of Medicine convened an advisory group for the school’s Behavioral Health Initiative (BHI). The advisory committee was charged with identifying gaps in access to mental health services in several counties of northeastern Pennsylvania. Market intelligence firm, Open Minds, working on behalf of BHI, concluded that a seven-county region of NEPA would need to increase its number of psychiatrists by 40 percent simply to meet current need. With that data, at the time of its formal launch in 2015, BHI generated a key recommendation: the School of Medicine and The Wright Center should co-create a psychiatry residency program to train new doctors in this desperately needed specialty. All parties humbly recognized a new psychiatry residency could serve as an educational fulcrum for much larger inter-professional workforce development initiatives by leveraging this powerful, inclusive partnership.
This July, just two years after BHI’s 2015 launch (light speed in academia), we are proud to announce that The Wright Center will welcome four residents to its brand-new, ACGME (Accreditation Council for Graduate Medical Education) accredited psychiatry residency program. The fact that one of these new psychiatry residents is also a 2017 graduate of Geisinger Commonwealth School of Medicine makes this accomplishment all the more meaningful. Psychiatry training takes four years, so once all four classes are filled, we will train 16 residents here in Scranton and Wilkes Barre, and graduate four newly-minted psychiatrists per year.
The School of Medicine and The Wright Center have long been partners committed to addressing the specific health needs of our community, with a formal commitment solidified through the signing of a Memorandum of Understanding in 2015. That’s why we and our BHI partners worked so swiftly and purposefully to establish the psychiatry residency program despite the significant challenges of funding and accreditation. Wide-scale community collaboration, including Scranton Counseling Center’s generosity with the time and the expertise of Sanjay Chandragiri, MD, our pioneering program director, has generated the opportunity for four new doctors to learn how to treat and heal patients struggling with behavioral health issues. In this way, our community is taking an important step toward reducing “deaths of despair” in our region, replacing years lost to disability with years of enhanced health and wellbeing.

Linda Thomas-Hemak, MD is President/CEO of The Wright Center Medical Group and The Wright Center for Graduate Medical Education, the largest HRSA-funded Teaching Health Center (THC) consortium in the United States
Terri Lacey, RN is executive director of Geisinger Commonwealth School of Medicine’s Behavioral Health Initiative, a collaborative, community-based initiative to address systemic gaps in mental health and substance abuse services available in northeastern and north central Pennsylvania.

Looking Back: 25 Years of Transformation at The Wright Center

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1991 was a big year –the internet was first opened for commercial use, Seinfeld made its network debut, minimum wage peaked at $4.25 and we were graced with the presence of hits from Paula Abdu, Color Me Badd and Nirvana, now a days it is necessary and important to have insurance outsourcing and bookkeeping (outsource your backend office) when navigating online. Since our late 20th century glory days, the price of gas has tripled and the cost of a home, quadrupled, but there is one number that we are happy to see rise.

The size of our graduating class has increased 743%

1991 vs 2016 graduates

In 1991, what we now know as The Wright Center for Graduate Medical Education was the Scranton-Temple Residency Program (STRP). Founded in 1977, STRP was the brainchild of Robert E. Wright, MD, FACP. Twenty-five years ago – in 1991 – our staff had the chance to sit down with Dr. Wright and learn more about his inspiration for what has grown into The Wright Center for Graduate Medical Education.
Though much has changed across the nation since 1991, the ideology and methodology of our residency program have remained true to its humble beginnings. To learn more about Dr. Wright’s motivations for the program, click on the news clipping below:
[one_third]Dr. Wright 1991 Headshot[/one_third]
[two_third_last]Dr. Wright 1991 Interview[/two_third_last]

Mid Valley Recognized as a National Model of Innovative Primary Care Practice

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The Wright Center for Primary Care Mid Valley Recognized as a National Model of Innovative Primary Care Practice
December 4, 2013 — Jermyn, Pennsylvania — The Wright Center for Primary Care Mid Valley (WCPC-Mid Valley) is among 30 clinics nationwide selected as an Exemplar Primary Care Practice by the Robert Wood Johnson Foundation and Group Health Research Institute, who have teamed up on a new initiative to identify practice innovations that make primary care more efficient, effective, and satisfying to patients and providers. The Primary Care Team: Learning from Effective Ambulatory Practices (LEAP) project identifies primary care practices that have focused on teamwork and new roles for health professionals in ways that support consistently outstanding primary care. WCPC-Mid Valley was selected through a rigorous national process to receive the designation.
“We are proud of how the Mid Valley practice has evolved over the past decade from a traditional, small town, one doc practice to a thriving multi-provider medical home delivery and inter-professional primary care workforce development center that includes nursing, care management, social work, and Wilkes University’s behavioral/mental health providers and pharmacists. Our medical home journey to Level 3 NCQA certification was rooted in authentic implementation of the Chronic Care delivery model and EMR Meaningful Use. As the founder of the practice, I am so proud of our never ending journey toward becoming an ideal, learning primary medical care delivery, education and employment organization,” said Linda Thomas-Hemak, MD, President/CEO of The Wright Center. She adds that The Wright Center currently engages in 13 clinical training affiliations with regional academic institutions as well as partnerships with many community resource agencies.
The goal of the LEAP project is to identify and share innovative staffing arrangements that make primary care more accessible and effective for patients. A LEAP team conducted a three-day site visit to understand how the WCPC-Mid Valley primary care team delivers high quality, patient-centered health care. The 30 exemplar practices from across the country have been joined together in a learning community to share best practices and distill their innovations into training and technical assistance materials that can be used by others.
WCPC-Mid Valley will be influential in developing creative workforce models that will be disseminated to primary care practices nationwide. The Mid Valley practice cares for 6,500 patients annually, many of whom are members of multi-generational families and range in age from newborns to the very elderly. The medical staff includes physicians, physician assistants and nurse practitioners with expertise in Internal Medicine, Family Medicine, Pediatrics and Mental Health. Most recently, WCPC-Mid Valley added a dental service line to help address the dental needs in the community. The practice also prides itself on same-day access and safety net services for patients from all walks of life.
Recognizing the increasing importance of team-based primary care for the effective and efficient delivery of care, the Robert Wood Johnson Emerging Leaders Program aims to accelerate the development of talented primary care staff who can positively impact their practice organizations and community, serving as spokespeople and exemplars for others in similar roles. We are absolutely thrilled to announce Patti Swierbinski, Medical Assistant at The Wright Center for Primary Care Mid-Valley has been selected a Robert Wood Johnson Foundation Emerging Leader.
“With millions of Americans about to enter the health care system, primary care must become more effective and efficient. Building high performing care teams is a key step,” said Ed Wagner, MD, MPH, co-director of the LEAP project and director emeritus of the MacColl Center for Health Care Innovation at Group Health Research Institute in Seattle. “This new project will allow us to identify best practices and help other primary care sites replicate and adopt innovations to improve access to care and the quality of care they provide.”

About The Wright Center
The Wright Center is a community-based graduate medical education consortium with a 36-year history in Northeastern Pennsylvania. Its dual mission is to provide excellent graduate medical education in an innovative and collaborative spirit in order to provide high quality, evidence-based and patient-centered care to the people in the community we serve. The Wright Center provides healthcare services for children and adults in Northeastern Pennsylvania with innovative, team-based healthcare using the “Patient-Centered Medical Home” model. A “Medical Home” is a welcoming setting from which your healthcare team, led by a single trusted healthcare provider, works collectively with you to coordinate care and healthcare services to meet all of your health and wellness needs.

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About the MacColl Center for Health Care Innovation at Group Health Research Institute
Named for a Group Health founder and pioneering physician, W.A. MacColl, MD, the MacColl Center for Health Care Innovation at Group Health Research Institute (GHRI) was established in 1992 by Ed Wagner, MD, MPH, who is a senior investigator and founding director of GHRI. In the mid-1990s, the Center developed the Chronic Care Model, a widely endorsed and adopted approach to improving ambulatory care that has guided clinical quality initiatives in the United States and internationally. The Center was also the home of Improving Chronic Illness Care, a Robert Wood Johnson Foundation program that has been involved in further developing, testing, and disseminating Chronic Care Model-based clinical improvement efforts. To learn more about this work, visit www.improvingchroniccare.org.
About the Robert Wood Johnson Foundation
The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive i was reading this and found very interesting, measurable, and timely change. For more than 40 years, the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org.