St. Louis University School of Medicine on Probation?? Really?? Time to Throw The Red Flag!

One of us remembers attending his son’s White Coat Ceremony when he was beginning his first year at SLU School of Medicine some nine years ago. The guest speaker, a female physician addressing a group of fledgling medical students who were facing medical education long known for grinding students down, described the behavior of a flock of migrating geese. She described how members of the flock take the lead position for a while, and then, when fatigued, drop back to draft off the others. She also noted that when a single goose was not able to continue, it was common that another member of the flock would drop out to stay with the one who just couldn’t go on. All these years later we wish that more of those who manage and regulate medical education had the good sense of a flock of geese, and the moral compass and compassion that has, we believe, guided SLU to place a very high value on the mental health and well being of the medical students in attendance at their University. Over 50 % of doctors suffer from burnout and we lose more than 400 doctors a year to suicide caused by a toxic work environment. About 1/3 of resident physicians suffer from burnout. It starts in medical school. Three years ago the Journal of the American Medical Association- Psychiatry published an article titled: Med Student Depression, Suicide: National Response Required. SLU has been one of the most active and undeniably the most successful medical school to address this ongoing tragedy, basing medical education on the Jesuit underpinnings of educating and nurturing...

The Extinction of the United States of America- A letter to Erik Erickson

Dear Mr. Erickson, Every once in a while I read your opinion about the presidential election and I think of fossils.  You are stuck in the past.  You oppose Trump as if there were some other choice for our country beside Mrs. Clinton.  You appear to believe that we can endure a Clinton presidency and come back from it.  Later on…..  With a better Republican nominee…..  And a better party…. We can’t. You think you are being smart, and you believe you have more insight than the citizens across this country that voted for Donald Trump in historic numbers.  You have failed to grasp that a shift has occurred and it is leaving the past behind.  Many Republicans elected to the US Congress have betrayed the people who elected them to majorities in the House and Senate.   The people have seen their hopes and dreams for those majorities fade and they are taking a new direction. You continue to attempt to degrade the Republican nominee and throw in with the candidates who stood on the stage with Mr. Trump and pledged to support the eventual nominee, only to disgrace themselves by breaking their promise when they did not win. You are denying the existence of the revolution that is occurring around you .  Trump was not my first choice, but his election is the last hope for me to see some restoration of our former country in my lifetime.  I serve in the Missouri House of Representatives as a very conservative Republican and your blog makes me sad, not Mr. Trump.   You are too far entrenched in your...

Non Compete Clauses for Physicians Are Snuffing Out Competition and Innovation

Missouri’s Doctor Shortage is Self Inflicted Missouri has a shortage of primary care physicians and mental health care all over our state, but your local not- for-profit hospitals might prefer the doctor leave town than let him or her establish a private practice in the area. Most of the time a doctor who signs up with a hospital is told ‘take it or leave it’ when it comes  to  the  ‘non compete clause’.  This means if the doctor ever stops working for the hospital he or she is prevented from practicing within 15-20 miles of the hospital for 1-2 years.   Not-for-profit hospitals are exempt from most taxes by virtue of their IRS status as a 501 C 3 Corporation which they obtain by agreeing to look out for the welfare of their community in many ways. IRS Designation as a Tax Exempt Organization Below is the description of the criteria/obligations for qualifying to be tax exempt as a 501 C 3 organization.  To reap the tremendous benefits of tax exemption, a not-for-Profit hsopital is supposed to be looking out for the community, not forcing doctors out of the area.  This is especially counterproductive when the region served is a Health Profession Shortage Area which nearly all counties in our state are.  Does forcing a doctor to leave a health care in a shortage area “combat community deterioration?- No, it leads to deterioration and the practice should be prohibited. Exempt Purposes – Internal Revenue Code Section 501(c)(3) The exempt purposes set forth in section 501(c)(3) are charitable, religious, educational, scientific, literary, testing for public safety, fostering national or international amateur...

Measuring the Performance of Academic Institutions Should Inc Mental Health

In this world we live in young an old alike are awash with stress  in our lives. For young people seeking to advance themselves through education, the mountain to climb on the path to a successful career is, it seems, increasingly taking its toll on their mental health and well being, and it is beginning at a younger and younger age. National data indicate that 17% of high school students reported seriously considering suicide and 8% reported making one or more suicide attempts in the preceding 12 month period. Medical students have been shown to have a high rate of depression, anxiety and suicidal thoughts, and their suicide rate is much higher than the general population.  The same is true for doctors. Much of the response to this challenge all across the United States has been to focus on identification of those who are suffering from depression and who are at risk for suicide and offering support and treatment to them. Those efforts are great and should be continued, but are not enough. The academic process needs to be re-evaluated and in some cases restructured to reduce the damage being done to students rather than only seeking to bind up their wounds after the damage has been done. In my view the performance measurement of educational institutions needs to include a measurement of the mental health and well being of the students at all stages of their education. For instance our medical schools should not only be evaluated by the Board Exam Scores that their students and graduates achieve, but it should be asked and answered ” at what...

Medical Student Depression and Suicide

    Research  reported last year by St. Louis University School of Medicine revealed that by the end of the first year of medical school 26% of medical students are struggling with depression and at the  end of the second year the prevalence is 32%.  Another study reveals that 11% of medical students suffer from suicidal ideation.  Medical school classes currently are about 50 % female students, and suicide among female medical students is 400% higher among them than among females in other professions.  I have introduced legislation to seek answers to this tragedy, but so far at least one medical school in our state is opposing the proposal. Below is an email I sent to the Lobbyist for Washington University Physicians who oppose HB 867 which calls for a research study regarding depression and suicide among our medical students. It calls for transparency by offering medical students the opportunity to voluntarily participate in a survey that will determine the prevalence of depression, and after a period of three years that data would be available to the public allowing students to have informed consent when choosing a medical school.  Washington University School of Medicine did not testify in opposition to this bill when it was heard in Committee.   In fact there was no testimony in opposition and there was over an hour of compelling testimony in favor including testimony from the President of the American Medical Student Association, physician experts, psychiatrists, and mental health organizations, and medical students studying in our state.   This bill was voted “Do Pass” by unanimous vote of the Standing Committee on Health and Mental Health Policy.   It is currently in the...