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Remarks by Dr. Richardson before Senate Health Care, Human Services & Rural Health Policy Committee

Remarks by Mark A. Richardson, MD, MBA, Dean, School of Medicine OHSU Before the Senate Health Care, Human Services and Rural Health Policy Committee RE: Support for SB 879 March 23, 2011

Madame Chair, Mr. Vice-chair and members of the committee, I am Dr. Mark Richardson, Dean of the School of Medicine at the Oregon Health & Science University. I am President of the OHSU Faculty Practice Plan, which includes about 900 faculty physicians employed by OHSU.

Thank you for the opportunity to testify. It is my pleasure and privilege to be here today.

Hands-on experience is an essential component of all health care training. The clinical experience may occur in a hospital or in an outpatient clinic. OHSU supports Senate Bill 879 which would convene a work group to develop standards for administrative requirements for student placement in these clinical training settings in Oregon. This bill has also been called informally the student “passport.”

OHSU concludes that this bill has the potential to not only reduce administrative costs across Oregon’s health care system by eliminating duplication, it will also contribute to laying the necessary groundwork to expand Oregon’s clinical training capacity – an essential aspect of meeting Oregon’s health care workforce needs for the future.

The existing problem that this bill solves can be understood by describing the status quo as it relates to clinical training. I will use medical education as an example, but my example can be extrapolated to education and training in all health care professions where clinical training is essential. This includes nursing, dentistry, physician assistant, midwifery, and many other allied health professions education programs.

At the OHSU School of Medicine, clinical training begins in the first year of the MD educational program and extends through the entire four years. There is not enough capacity at OHSU to accommodate the training needs of all of our students and thus we partner with other hospitals and clinics to complete this part of our curriculum. In addition to addressing capacity constraints, these partnerships also enrich our students’ education because they experience different clinical settings and patient populations.

Our current clinical training partners include the Portland Veterans Affairs Medical Center, Providence hospitals and clinics, Legacy Health System hospitals and clinics, Kaiser Permanente NW, and regional health systems throughout Oregon including in Salem, Roseburg, Eugene, Medford, Bend and Corvallis. In the third year of our MD program, our students complete a required rotation to any one of a number of small, rural, community hospitals or clinics throughout Oregon. Our students also are involved in educational experiences in clinics serving low-income or underserved patients in Portland and elsewhere. 

In each of these clinical settings, a student must undergo a series of screenings or other tests to demonstrate that he or she has met certain standards defined as acceptable – from a regulatory, legal or other compliance perspective – for that particular institution. These relate to drug screening, immunizations, criminal records checks, patient privacy orientations and other topics. These standards not only vary between health systems, they sometimes vary within health systems.

The reasons each institution requires their own tests and screening are understandable. They all want to ensure compliance. However, the duplication wastes money, time and effort and presents a significant “hassle factor” for all health care students.

SB 879 will provide a mechanism to establish uniform standards across all clinical education settings so that each institution is assured compliance with existing laws and regulations and so that each student undergoes the screening only once.

Not only will this save money by reducing administrative burdens, it may also increase educational capacity. In some cases, smaller hospitals and independent clinics may be disinclined to host students for clinical training because of uncertainty of how a student’s presence might affect their compliance with regulatory and legal issues.
As the state works together to address workforce shortages in the coming years, we will need to use as much training capacity as possible in Oregon. SB 879 provides a mechanism by which hospitals and clinics not currently participating in student training due to these compliance concerns may be able to reverse that position.

In summary, OHSU concludes that creating a student “passport” with state defined standards for regulatory and legal compliance will reduce costs and administrative overlap as well as encourage participation in training experiences. OHSU encourages the work group that will be convened by SB 879 to include the broadest number of standards in their review. 

OHSU looks forward to the opportunity to be involved in this ongoing process. Thank you for your time and I’m happy to answer any further questions.

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