Bass and St. Mary's

The Tobacco Settlement Endowment Trust (TSET) Board of Directors voted on Friday to expand its partnership with the Oklahoma State University Medical Authority to support the launch of medical residency training programs in Enid.

ENID, Okla. — Despite the recent announcement of funding for a future medical residency training program in Enid, a local coalition says specific launch plans are not yet in place.

The Tobacco Settlement Endowment Trust (TSET) Board of Directors voted July 19 to expand its partnership with the Oklahoma State University Medical Authority to support the launch of medical residency training programs in Enid.

In July, TSET had said residencies were expected to begin on July 1, 2020, and run through June 30, 2023. The OSU Medical Authority provided a roadmap of planning year activities and major milestones to be completed in fiscal year 2020 to ensure successful start-up and implementation of the programs and has agreed to enter into a memorandum of agreement with TSET supporting the roadmap.

The recent announcement of TSET is merely a piece of the puzzle, said Lisa Powell, executive director of the Enid Regional Development Alliance.

“We have not decided to launch a residency program for 2020 with OSU,” Powell said.

“There’s been no decision made in Enid to start a program at that point.”

The amount of physicians that might be in an Enid medical residency program is unknown, said Melani Hamilton, managing director of marketing & communications at the OSU Center for Health Sciences. Further information could be released late this summer or early fall.

Powell said the ERDA has been working with a coalition with OSU, St. Mary’s Regional Medical Center and Integris Bass Baptist Health Center for the past few years on the possibility of opening a new family medicine residency in Enid. In April 2016, the Integris network closed the Northwest Family Medicine Residency Program in Enid.

"One of the major considerations in our planning is the cost of opening such a program," Powell said. "The announcement from TSET of the financial grant of $1.25 million in start-up funds can now be applied to our proforma, and is one of the deciding factors in the viability of the program. 

"All partners involved are thankful for TSET’s grant support, and we look forward to continuing our discussions locally. There is no doubt there is a shortage of primary care physicians in rural Oklahoma, and the Enid team is interested in finding a long-term solution for our area."

Using the remaining grant commitment balance of $2,391,294 from TSET, OSU Medical Authority announced in July it would begin a hospital residency program at St. Mary’s and Integris in Enid.

“We were waiting to see if they would have any funding for the program,” Powell said.

“The coalition is still evaluating, and this funding will be added to that evaluation.”

St. Mary's CEO Krista Roberts said the financial support from TSET to restart an Enid program is greatly appreciated, but this is only a piece of the funding structure for the program currently under evaluation. 

“No formal decision to proceed has been reached at this time, but the funding commitment from TSET was critical to moving the evaluation process forward,” Roberts said. “It is also key to ensure the program has long-term financial sustainability. We remain committed to the evaluation process and look forward to further discussion and next steps with our Enid community partners and OSU."

‘Working hand-in-hand’

Michelle Stephens, TSET Board of Directors vice-chairwoman, said the partnership with OSU to bring additional doctors to rural areas complements efforts would create a healthier Oklahoma in all parts of the state.

“Working hand-in-hand with OSU to recruit more medical residents to areas where health care is scarce provides support to our state’s rural health infrastructure which we know is key to improving health outcomes,” Stephens said.

TSET’s funding would assist OSU Medical Authority in reaching its goal of placing residents in Oklahoma primary care programs specializing in family medicine, pediatrics, emergency medicine, internal medicine, obstetrics and gynecology and general surgery.

“The entire medical community of Enid has been working toward bringing back the primary care residency program to northwest Oklahoma,” said Finny Mathew, president of Integris Bass Baptist Health Center. "As a state, we rank 47th in the nation in health care and that can largely be attributed to lack of access to primary care physicians.

“Bringing back the residency program goes a long way in expanding access to a critically needed medical specialty, because we know that physicians tend to stay in the areas where they complete their residency, and these residents will also be incentivized to remain in medically underserved areas like Enid. Integris Bass is excited that the Tobacco Settlement Endowment Trust recognized how important this program is to Enid, and we are ready to work to make it a reality.”

Dr. William J. Pettit, a member of the OSU Center for Health Sciences Graduate Medical Education Committee, said he thanked TSET for its continued leadership.

“As OSU CHS and the Enid community continue to explore the creation of a new family medicine residency, we are encouraged this funding announcement will give Enid leadership the financial incentive needed to move forward with a new family medicine residency program to bring new doctors to the region every year,” Pettit said.

TSET Executive Director Julie Bisbee said her organization is happy to support the OSU Medical Authority by committing these future funds to medical residencies in Enid.

“This is a crucial first step in the planning process to increase health care access in Enid and the surrounding communities,” Bisbee said. “All or part of 76 of Oklahoma’s 77 counties are designated Primary Care Shortage Areas and TSET is ready to work with partners across the state to increase health care access for all Oklahomans.”

A vital piece

Research shows that most doctors will practice within 100 miles of where they completed their residency program, and officials believe residency is vital piece to solving the physician shortage in Oklahoma.

Having worked in the OU Family Practice Residency for 25 years, Janet Cordell said she knows well the importance of having physicians in the area.

"One of the reasons we have so many great physicians here in Enid is because they either came here for several months as a medical student and/or came for several years as a resident," said Cordell, a retired registered nurse who has served as the Enid Community Clinic’s coordinator for more than a dozen years. "Having this opportunity to get to know the community in all areas — medical, social, fine arts, spiritual — they tend to look seriously at Enid as a place to work, live, and raise their families."

Todd Earl, Enid president of Stride Bank and a member of the Enid Graduate Medical Education Task Force, said additional details need to be settled at an upcoming meeting.

“I am very pleased with the outcome of the TSET vote and continue to support the return of a medical residency to Enid,” Earl said. “This has been a priority for our community and area for over three years as having a residency improves physician access and solidifies our standing as the medical hub for Northwest Oklahoma. We remain committed to this vital community asset.”

In 2015, the TSET Board of Directors awarded a six-year, $3.8 million grant to the Oklahoma State University Medical Authority to address the critical shortage of physicians in Oklahoma. Within two years, a total of 54 medical residency slots were funded at Comanche County Memorial Hospital in Lawton and at Norman Regional Medical Center. The OSU Medical Authority provided a match of $5.6 million using Dean’s Graduate Medical Education federal funding dollars, which was eliminated in FY2017 by the Federal Center for Medicaid and Medicare Services.

Without the matching Medicaid dollars and a residency program ready for implementation, the authority did not use TSET funds in FY2019.

The July agreement complemented TSET’s existing grant with the Physician Manpower Training Commission to recruit practicing physicians to rural and medically underserved areas. Under that grant, physicians enrolled in the program can receive up to $160,000 in loan repayment if they practice up to four years in a rural or medically underserved area. Twenty-eight physicians currently are practicing as part of the Oklahoma Medical Loan Repayment Program and eight physicians have completed the program and remain in the rural or medically underserved area in which they were placed.

TSET is funded by a portion of the payments received by the state of Oklahoma as part of the 1998 Master Settlement Agreement in which the tobacco industry pays the endowment trust in a long-term strategy to improve health. The funds are placed in an endowment to ensure a growing funding source for generations to come. Only earnings from the endowment are used to fund grants and programs. 

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