Healthcare

Affordable Care Act creates residencies for doctors in South Florida health centers

 

Community Health of South Florida trains physicians to help combat primary care doctor shortages.

nmadigan@MiamiHerald.com

Peering in the darkness toward the murky image of a 22-week-old fetus on a computer screen, Dr. Fabio Paes pointed to a tiny bump that, to a layman’s eyes, appeared indistinguishable from the undulating shapes around it.

“That’s the nose,” the radiologist said, explaining the bulge on the sonogram’s image. “And those are the lips. We’re looking for cleft palates.”

Sitting next to Paes, riveted by the pictures, was Dr. Andrius Lescauskas, 28, an aspiring family-medicine physician who is enrolled in a new residency program run by Community Health of South Florida, Inc., a not-for-profit healthcare company that caters primarily to a low-income population.

Lescauskas and a dozen other doctors under CHI’s supervision are the first in Florida to be accepted into residencies as a result of a provision in the Affordable Care Act that establishes grants for the training of primary-care physicians. The aim is to address a severe shortage of such doctors nationwide.

Moving on to images of a 58-year-old woman who had complained of swelling in her neck, Paes pointed to a shape on the screen and asked his pupil, “Do you know what that is?”

Lescauskas identified it as the woman’s trachea.

“That’s right,” the radiologist said, evidently pleased with his younger colleague’s progress.

Lescauskas, a Lithuanian who graduated from the Chicago College of Osteopathic Medicine, is one of four residents specializing in family medicine under the program at CHI, which began July 1. Another four residents are focused on obstetrics and gynecology, and five on psychiatry. The training, much of it at the Doris Ison Health Center in Cutler Bay, costs $1.95 million a year, a grant administered by the U.S. Department of Health and Human Services.

The money given to CHI is part of a package of $83.4 million in grants nationwide to train new primary-care doctors in the coming year under the Teaching Health Center Program, which expands residency training for medical students in community-based settings. CHI and other organizations must apply for the grants every year.

“This is a huge step forward,” said Dr. Saint Anthony Amofah, the chief medical officer at CHI. “The physician shortage is becoming more and more real — it’s worsening. So this becomes a pipeline. By doing this, they increase the chances that there will be more doctors staying in health centers in underserved areas. I thought it was genius, actually. It showed incredible vision.”

A driving impetus of the residency provision, Amofah said, was the certainty that the number of insured patients would rise following enactment of the ACA, and that the shortage of primary-care physicians would be even more keenly felt as a result.

“The patients are so happy to see us, which makes learning easier,” said Dr. Alison Dubin Goldberg, a 29-year-old family-medicine intern from Miami Beach who was spending a month in the pediatric unit at Doris Ison as part of her rotation through the center’s various departments and affiliated hospitals. “I didn’t know I liked pediatrics until now.”

Goldberg, a graduate of Nova Southeastern University’s College of Osteopathic Medicine, said she had applied for residencies only in Miami and was thrilled to be accepted in CHI’s.

In August, Goldberg’s residency will take her to the surgery unit at Larkin Community Hospital in South Miami, followed by a month of night shifts there. She will be back in pediatrics at Doris Ison in October. The month after that, Goldberg will hone her skills in radiology, under Paes, and she will see the year out in Larkin’s emergency room. Goldberg and her fellow family-medicine residents will keep up that kind of schedule for three years, while their psychiatry and ob-gyn colleagues are looking at four.

Officials at CHI, founded more than 40 years ago with a focus on the uninsured, say they treat almost 300,000 patients every year. The organization runs 10 health centers — CHI officials prefer to not use the term “clinic” — in Miami-Dade and Monroe counties, and operates also in 42 public schools.

Tiffani Helberg, a spokeswoman for CHI, said the organization “gets a lot” out of having the 13 residents in its system. “We have more doctors to see patients,” she said. “We also increase the quality of our care, because when you teach you really have to be on top of everything, a master of your craft.”

In addition, Helberg said, CHI officials hope that once the residents become full-fledged specialists in their respective fields, they will join CHI’s staff.

Hilary Gerber, an ob-gyn resident and a single mother of two boys, said it was “a dream come true” to be placed at Doris Ison, less than a mile from her home. Two years ago, as a fourth-year medical student at Nova Southeastern, she did a rotation at the facility. “I said at the time that I wanted to work here,” Gerber recalled.

“There’s only one other obstetrics residency within 500 miles, and they have hundreds of applicants,” she said, referring to a program at Jackson Memorial Hospital in Miami. “There a real crisis of residency positions around the country, and especially in ob-gyn. This was like a gift-wrapped present for me.”

This story was produced in collaboration with Kaiser Health News, an editorially independent program of the Kaiser Family Foundation.

Read more Miami-Dade stories from the Miami Herald

Miami Herald

Join the
Discussion

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

The Miami Herald uses Facebook's commenting system. You need to log in with a Facebook account in order to comment. If you have questions about commenting with your Facebook account, click here.

Have a news tip? You can send it anonymously. Click here to send us your tip - or - consider joining the Public Insight Network and become a source for The Miami Herald and el Nuevo Herald.

Hide Comments

This affects comments on all stories.

Cancel OK

  • Marketplace

Today's Circulars

  • Quick Job Search

Enter Keyword(s) Enter City Select a State Select a Category