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Center for the Future of Health Professions Sept. 2023 digest

The Center for the Future of the Health Professions introduces its September 2023 op-ed column! Our mission is to provide accurate and reliable data and research on the healthcare workforce to assist policymakers and health system stakeholders in effectively planning for a sustainable future.

We are thrilled to have Sarah Chagnon, a dental therapist and president of the American Dental Therapy Association, as our guest author. Sarah has served her community at the Swinomish Dental Clinic in Washington state for 4.5 years. She is dedicated to promoting dental therapy and ensuring everyone has access to dental care. Sarah believes in empowering patients by providing them with the knowledge and resources they need to make informed decisions about their oral health, as she understands oral health is integral to overall well-being.

We encourage you to share your thoughts on this month’s digest with us.

Randy Danielsen, PhD, DHL(h), PA-C Emeritus, DFAAPA

Professor & Director

The Center for the Future of the Health Professions

A.T. Still University

Sarah Chagnon

The dental therapy profession is gaining traction in the U.S.

The dental therapy profession started in New Zealand more than a century ago and has expanded worldwide. In fact, dental therapists (DTs) practice in more than 70 countries.1 Dental therapy has gained traction in the United States over the last 20 years, with six states currently licensing DTs and eight states that have passed legislation to codify the profession.

Now, you might be wondering what a dental therapist is. DTs are highly trained mid-level oral health practitioners and are often described as being comparable to PAs. Their scope of practice can vary slightly from state to state. Typically, they provide the most common straightforward and simple dental procedures and are frequently described as restorative experts. DTs also heavily concentrate and participate in health promotion and disease prevention programs.

DTs can benefit the oral health team in the United States because we live in a time where our society faces a continuing shortage of dentists. The U.S. Health Resource and Service Administration estimated the shortfall will grow to 15,600 fewer dentists than needed by 2025 and nearly 60 million people will forgo regular care as a result.1 Dental problems can lead to serious health risks if left untreated. DTs can provide an alternative for those who may not have access to a dentist or who cannot afford it. Their scope of practice consists of preventive procedures such as cleanings, sealants, and fluoride varnish applications, and oral evaluative procedures such as diagnosing and treatment planning. Routine restorative procedures include fillings and stainless-steel crowns on baby teeth, pulp capping, and simple extractions. This helps relieve some of the burden from the dentist’s schedule and ultimately helps the clinic run efficiently and effectively.

Dentists who utilize DTs can rest assured their patients are receiving the most up-to-date preventive and restorative care. They can then focus on complex treatments, such as root canals, crowns, implants, dentures/partials, specialties, etc. DTs help fill the gap in access to care and are cost-effective. Adding this team member can offer more flexible patient scheduling, eliminate patient wait times, increase revenue, ensure clinics operate at their total capacity, allow every provider to work at their full scope of practice, contribute and improve the overall clinical workflow, and provide new workforce opportunities.

The Commission on Dental Accreditation (CODA) serves the public and dental professions by developing and implementing accreditation standards that promote and monitor the continuous quality and improvement of dental education programs. This means the training meets the same standards as a dentist’s. Depending on the educational route, DT students complete three academic years of full-time instruction, including a clinical preceptorship experience.2

There are only five dental therapy educational programs in the United States: Iḷisaġvik College (CODA-accredited) in Alaska, Skagit Valley College (CODA-accredited) in Washington, the University of Minnesota (CODA-accredited), Minnesota State University, and Metro State University, also in Minnesota.

Dental therapy has faced many barriers since its introduction to the United States. Recognition and awareness have been a slow process, as only a few states have approved practice rights. In fact, DTs were initially only allowed to offer their services to tribal clinics, which led to the next barrier: workforce mobility. Because few states employ DTs and their scope varies by state, DTs cannot move anywhere and be ensured employment. Many states are interested in implementing this profession, but the legislation process is a long journey. In some states, lobbyists and dentists have resisted (though it’s important to note not all dentists feel this way). Adding a new role can be overwhelming and daunting since a dental clinic’s workflow has been the same for decades. The resistance could also stem from the fact that dentists simply don’t understand a DT’s scope of practice and/or how to implement a DT into their clinics.

Dentists have also expressed concern about the amount of training DTs receive. While DTs do receive a shorter education, they learn approximately 100 out of the 500+ procedures dentists learn in their four years of training. In addition, there is a high demand for DTs, but not enough DTs to fill these positions because there are not enough educational programs offering this degree.

Despite the hardships, thousands of case studies indicate this profession’s success in the short time its been around. According to the 2018 Journal of Public Health Dentistry, in Alaska, children and adults had lower rates of tooth extractions and more preventive care in communities served routinely by DTs than in communities with no care by midlevel providers.3  According to the report “Provider and Patient Satisfaction With the Dental Therapy Workforce at Apple Tree Dental,” respondents acknowledged having a dental therapist on staff allowed patients to have more needs met in one visit and improved patients’ sense of having a regular dental provider.4  A study conducted in rural Minnesota towns found having a dental therapist as part of their oral health team improved dentists’ ability to spend more time performing procedures requiring their expertise, resulting in increased revenue. Satisfaction ratings for the therapist’s chairside manner and technical skills were similar to those given to clinic dentists and dental hygienists.5

References

  1. Potter, W. (2021). The Rise of the Dental Therapy Movement in Tribal Nations and the US [Review of The Rise of the Dental Therapy Movement in Tribal Nations and the US]. Lessons from the W.K. Kellogg Foundation.
  2. Licari, F. W., & Evans, C. A. (2014). Recommended standards for dental therapy education programs in the United States: a summary of critical issues. Journal of Public Health Dentistry, 74(3), 257–260. https://doi.org/10.1111/jphd.12057
  3. 2022 Provider and Patient Satisfaction With the Dental Therapy Workforce at Apple Tree Dental. (n.d.). Retrieved from https://oralhealthworkforce.org/wp-content/uploads/2022/05/OHWRC-Provider-and-Patient-Satisfaction-With-the-Dental-Therapy-Workforce-at-Apple-Tree-Dental-2022.pdf
  4. In Alaska, Dental Therapists Seen as Helping to Improve Oral Health. (2019, November 21). Pew.org. Retrieved from https://www.pewtrusts.org/en/research-and-analysis/articles/2019/11/21/in-alaska-dental-therapists-seen-as-helping-to-improve-oral-health
  5. Dental Therapy Increases Access in Rural Minnesota. (2017, May 31). Wilder Foundation. Retrieved from https://www.wilder.org/articles/dental-therapy-increases-access-rural-minnesota

Welcome back!

ATSU campuses are abuzz with new and returning students ready to complete another exciting academic season. Unusually hot weather in Missouri and Arizona made the first several weeks challenging for all. Thanks for hanging in there!

Summer commencements honored a record number of graduates with 911 students receiving diplomas across six ceremonies. Thank you to everyone who supported our graduates, faculty, staff, and commencement activities. We are also looking forward to September graduations for physician assistant programs in California and Arizona.

Thank you, Board of Trustees members, Danielle Barnett-Trapp, DO, ’11; Bertha Thomas; Jonathan Cleaver, DO, FAOCD, FAAD, FASMS, ’08; and Kim Perry, DO, MBA, MHCM, FACEP, FACOEP, ’91, for participating in commencement and white coat ceremonies.

California dreaming

On Friday, Sept. 8, 2023, ATSU will celebrate College for Healthy Communities’ physician assistant program’s inaugural commencement.

Thank you, Drs. Ted Wendel, Eric Sauers, and Dan McDermott, and faculty and staff, for all of your hard work and perseverance. Also, thank you to the pioneering inaugural class for battling through COVID, curriculum updates, and new campus snafus.

California’s Central Coast community continues to play a vital role in the success of our students and campus. We are thankful for their support.

2023-2024 strategic plan focus areas

  1. Incorporating ATSU’s core professional attributes (CPAs) and osteopathic philosophy into students’ education and experiences

ATSU students and graduates possess a unique set of knowledge, capabilities, and skills to succeed in today’s and tomorrow’s challenging world. ATSU’s CPAs cover five domains critical to graduates entering healthcare.

Knowledge regarding the philosophy of osteopathic medicine also provides graduates an advantage in providing, guiding, and leading healthcare delivery. Today, more than ever, understanding the interconnectedness of our bodies’ systems is essential in delivering whole person healthcare. 

  1. Exploring artificial/augmented intelligence’s emerging role in healthcare and education

Three ATSU AI projects are underway to improve student, faculty, and staff experiences. Funds have also been allocated to provide pilot research grants for interested faculty and staff.

  • Ivy.AI chatbots to assist students, faculty, and staff. 
  • Google Bard to assist with generating text, language translation, and answering questions. 
  • Anthology CRM for crafting messages and promoting engagement. 

  1. Student recruitment and retention

Colleges and universities are facing future headwinds with fewer high school graduates, the public’s questioning of higher education’s value proposition, and rising costs.

Focusing on student retention is paramount to a successful health science university. College deans and Student Affairs are working closely together to assure ATSU students receive the support necessary for success.

  1. Cultural proficiency

Essential to becoming the best healthcare professional, student, faculty, or staff member requires understanding and practicing cultural proficiency. Appreciating the unique perspectives we all bring to healthcare and education makes ATSU a great place to learn and work.

Understanding recent conversations around the U.S. Supreme Court’s decision regarding admissions and race is helpful. Please visit this link to learn more.

Reaccreditation news

The A.T. Still University-College of Graduate Health Studies’ (ATSU-CGHS) Master of Public Health – Dental program successfully met all metrics required for reaccreditation. After an April 3, 2023, site visit on the Mesa, Arizona, campus, the program was notified it met all standards and complied with all commission policies. Congratulations to Jeff Chaffin, DDS, MPH, MBA, MHA, assistant professor and program director; Mary-Katherine McNatt, DrPH, MPH, MCHES, CPH, COI, professor and chair; and team on this accomplishment.

ATSU commencement ceremonies

Arizona School of Dentistry & Oral Health (ATSU-ASDOH)

Friday, May 12
Mesa, Arizona
76 graduates
Commencement speaker: Wayne Cottam, DMD, MS, vice dean, associate professor, ATSU-ASDOH

Missouri School of Dentistry & Oral Health (ATSU-MOSDOH)

Friday, May 19
Kirksville, Missouri
57 graduates
Commencement speaker: Dennis A. Mitchell, DDS, MPH, vice provost for faculty advancement, Columbia University

Kirksville College of Osteopathic Medicine (ATSU-KCOM)

Saturday, May 20
Kirksville, Missouri
166 graduates
Commencement speaker: Robert A. Cain, DO, FACOI, FAODME, president and CEO, American Association of Colleges of Osteopathic Medicine

College of Graduate Health Studies (ATSU-CGHS)

Friday, May 26
Mesa, Arizona
217 graduates
Commencement speaker: Daryl Nelson, MS, ATC, director of team growth and development, Las Vegas Raiders

School of Osteopathic Medicine in Arizona (ATSU-SOMA)

Friday, May 26
Mesa, Arizona
138 graduates
Commencement speaker: Faith L. Polkey, MD, MPH, CPE, CEO, Beaufort-Jasper-Hampton Comprehensive Health Services Inc.

Arizona School of Health Sciences (ATSU-ASHS)

Friday, June 2
Mesa, Arizona
257 graduates
Commencement speaker: Victoria Garcia Wilburn, DHSc, OTR, FAOTA, assistant professor of occupational therapy, Indiana University-Purdue University Indianapolis

Upcoming ATSU commencement ceremonies

College for Healthy Communities (ATSU-CHC)
Friday, Sept. 8
Santa Maria, California

ATSU-ASHS Physician Assistant
Friday, Sept. 22
Mesa, Arizona

ATSU white coat ceremonies

ATSU-ASHS Physical Therapy

Class of 2024
Thursday, June 1
Mesa, Arizona

ATSU-ASDOH

Class of 2027
Friday, July 14
Mesa, Arizona

ATSU-SOMA

Class of 2027
Friday, July 14
Mesa, Arizona

ATSU-ASHS Physician Assistant

Class of 2025
Friday, July 14
Mesa, Arizona

ATSU-MOSDOH

Class of 2027
Friday, July 14
Kirksville, Missouri

ATSU-KCOM

Class of 2027
Saturday, July 15
Kirksville, Missouri

ATSU-CHC Central Coast Physician Assistant

Class of 2024
Friday, Aug. 18
Santa Maria, California

Faculty and staff updates (as of July 31)

Recent promotions: Please view the list of employee promotions (PDF).
Accomplishment kudos: Please view the list of accomplishment kudos (PDF).
Anniversary milestones: Please view the list of employee anniversaries (PDF).

Ideas and concerns?

Please submit your ideas to ideas@atsu.edu. Each email will receive a personal response from me. Ideas are only shared with the sender’s permission.

If you see something you are worried about, please contact the anonymous Fraud Hotline to report situations or behavior that compromises ATSU’s integrity. The hotline is available 24/7 at 1.855.FRAUD.HL (1.855.372.8345) or fraudhl.com. Reference code “ATSU” when making a report.

In closing

Thank you for taking a few minutes to catch up on ATSU activities. For daily updates, please visit ATSU News.

May your 2023-2024 academic year be one of professional and personal successes. 

Yours in service,

Craig M. Phelps, DO, ’84
President

A.T. Still University of Health Sciences
800 W. Jefferson St., Kirksville, MO 63501 | 660.626.2121
5850 E. Still Circle, Mesa, AZ 85206 | 480.219.6000
1075 E. Betteravia Rd., Ste. 201, Santa Maria, CA | 805.621.7648
Office of the President | president@atsu.edu
ATSU Communication & Marketing | communications@atsu.edu

A.T. Still University of Health Sciences serves as a learning-centered university dedicated to preparing highly competent professionals through innovative academic programs with a commitment to continue its osteopathic heritage and focus on whole person healthcare, scholarship, community health, interprofessional education, diversity, and underserved populations.

The Center for the Future of the Health Professions will post its fifth monthly op-ed column for 2023. Our columns represent strong, informed, focused opinions on issues affecting the health professions’ future. As mentioned, the center was developed to provide state, local, and national policymakers and health system stakeholders with accurate, reliable, and comprehensive data and research about the healthcare workforce to effectively plan for a sustainable future and make the best use of available resources.

This month we feature a discussion on using standardized patients in health professions education. Standardized patients (SPs) are used in healthcare professions education to simulate a realistic patient experience. SPs can help students learn how to effectively interact with patients, practice communication skills, and gain clinical experience. SPs also help to ensure that all students have the same learning experience and that their assessments are fair. Additionally, SPs provide a safe and controlled environment where students can practice their skills and develop confidence. Finally, students are better equipped to handle real-life patient interactions by interacting with SPs.

This month’s column will turn to our own Mandy Weaver as she interviews her husband, George Cohen, an SP for over two years, in a Q&A entitled “Confessions of a retired standardized patient.” George was a community leader and a senior partner with CPA firms. The majority of his clients were physicians and other health care professionals.

We look forward to your comments on this month’s digest.

Randy Danielsen, PhD, DHL(h), PA-C Emeritus, DFAAPA

Professor & Director

The Center for the Future of the Health Professions

A.T. Still University

George Cohen

Confessions of a retired standardized patient

Howard Barrows, MD, was the first to use standardized patients (SPs) in 1963. He initially referred to those SPs as “programmed patients.” They have been called by several names since, and the more generic term is “simulated individuals,” especially in nonmedical fields, such as education, spiritual care, law, police training, and many others. Since Dr. Barrows trained those first SPs, human simulation has become an integral part of medical education worldwide.1

A.T. Still University’s Kirksville College of Osteopathic Medicine (ATSU-KCOM) in Kirksville, Missouri, has documentation of SP cases as early as 1995, according to Lisa Archer, director of simulation and performance assessment. Lorree Ratto, PhD, associate professor at A.T. Still University’s School of Osteopathic Medicine in Arizona (ATSU-SOMA) began the SP program officially for SOMA’s inaugural class of 2011.  

ATSU’s Arizona-based Interprofessional and Culturally Proficient Standardized Patient Experience Center opened in 2019. Lisa McNeil is the center’s manager. The facility is open to ATSU’s medical, dental, physician assistant, physical therapy, and occupational therapy students. One technological tool utilized by the center is the GERonTologic suit, which simulates the effects of aging, teaching students empathy for older adult patients.2

This article features an interview between ATSU’s Center for the Future of the Health Professions program administrator Mandy Weaver and her husband, George Cohen, CPA, who was an SP for over two years. He also participated in the SP programs at Arizona College of Osteopathic Medicine – Midwestern University and Southwest College of Naturopathic Medicine. Cohen is a recognized community leader and ambassador for the osteopathic medical profession in Arizona.

What drew you to the SP program?

Cohen: I was a budding actor after retiring from a successful professional accounting career. Soon after my retirement, I talked to someone who was an SP who told me about the ATSU program. I thought, “What better way is there to hone my skills for acting?” Working with students was also appealing.

Were there other actors in the program?

Cohen: There were many actors and other people looking to make a few extra bucks. So, it was a cross-section of individuals. Kudos to the program faculty and staff for getting a diverse population with whom the students can learn.

Were you familiar with medical education?

Cohen: I really wasn’t familiar despite having a career surrounded by physicians and having a spouse who was deeply involved in the medical profession as the executive director of the Arizona Osteopathic Medical Association. So, I wasn’t aware of the educational rigors a budding physician would be going through, particularly in year one.

Were there any surprises about medical education?

Cohen: I was pleased and pleasantly surprised to see how much attention and effort is given to teaching the students empathy. When I grew up, most physicians were very stiff and clinical. Having a physician who has a more caring attitude and takes an interest is much more reassuring to their patient.

Were there any surprises with the students?

Cohen: I was surprised by the diversity of the students. There were older students who had some type of medical background, such as PAs and EMTs. There were also “legacy” students whose parents or other family members were physicians. In addition, there were international students from other cultures with more poverty and different healthcare systems than U.S. students have experienced.

What was the interaction between the students and faculty and staff?

Cohen: The interaction was incredible and a confidence-building relationship. The faculty and staff were genuinely interested in the students. A special thanks to the ATSU team Lisa McNeil and Dr. Lorree Ratto.

Did you have a script?

Cohen: Everything was scripted, and you had to stick to the script – no improvising. The scripts indicate the age and symptoms of the patient and social determinants, such as a homeless single mother. The students took the history and examined the SPs. My favorite symptom was kidney stones because the SPs were told that if the student touches the kidney, it is ok to scream and reach for the roof. Pretending to pass out was also a valuable acting experience.

Did they ask their patients about their current environment?

Cohen: Yes, such as:        

  • Are you depressed?
  • Do you interact with other people?
  • Can you walk to a pharmacy to get meds? Do you know the meds you are using?
  • Are you eating every day?

I understand that the SPs also evaluate the students from a patient’s perspective.

Cohen: There was a checklist that included:

  • Washing their hands when they entered the exam room.
  • Knocking on the exam room door before entering.
  • Helping the patient get on and off the exam table.
  • Being kind and courteous.
  • Facing the patient and making eye contact when talking to them.
  • Taking a thorough history.
  • Asking for social determinants information.

Note: An instructor can watch the exchange between the SP and the student from a nearby video monitor room. Later, the student and the instructor can view the video and discuss ways to improve exam skills.

What is the benefit of the SP program to the students?

Interacting with a human being is much better than a simulated encounter. You are eye to eye. That is a good life lesson when they learn how to communicate and listen.

What impact did you have on the students and what impact did they have on you?

The impact they had on me was to elevate my medical education and be aware of things going on in my body. I learned that medicine, in general, requires educated guesswork. My expectation that healthcare professionals can just solve things is unrealistic. I must take responsibility for myself in terms of being aware of issues and being able to communicate those issues. I need to take better care of myself.

The ATSU SP program is incredibly well run; I am sure it is a role model for other schools. I really hope that I made a difference in the student’s education. It was a wonderful experience.

References

  1. https://www.upstate.edu/standardpatient/history.php
  2. https://www.atsu.edu/news/atsu-holds-open-houseforsttandarizedpatient-center. June 18, 2019
  3. https://www.upstate.edu/clinicalskillscenter.php

The Center for the Future of the Health Professions will post its fourth monthly op-ed column for 2023. Our columns represent strong, informed, focused opinions on issues affecting the health professions’ future. As mentioned, the center was developed to provide state, local, and national policymakers and health system stakeholders with accurate, reliable, and comprehensive data and research about the healthcare workforce to effectively plan for a sustainable future and make the best use of available resources.

This month we feature a discussion on the future of the optometric profession by Dr. Taylor McMullen. Dr. McMullen is an optometrist working in the private practice modality. He received his undergraduate training from the Indiana University of Pennsylvania and earned a Bachelor of Science degree in natural sciences and mathematics in 2003. While an undergraduate, he spent a semester studying abroad at the University of Valladolid in Valladolid, Spain. He continued his education and earned a Bachelor of Science in vision sciences and a Doctor of Optometry in 2007 from the Pennsylvania College of Optometry. He founded Salt River Eye Care, PLLC, in 2012 and enjoyed seeing patients there. In addition to primary eye care, Dr. McMullen has extensive training in the diagnosis and treatment of ocular disease, as well as the management of ocular complications of systemic disease. He is active in his community and a member of the Arizona Optometric Association Board of Directors.

According to the U.S. Bureau of Labor Statistics, optometrists diagnose and treat visual problems and manage diseases, injuries, and other disorders of the eyes and work in standalone optometry offices. Optometrists may also work in doctors’ offices and optical goods stores. Some are self-employed. Most work full-time, and some work evenings and weekends to accommodate patients’ needs. Optometrists typically need a Doctor of Optometry (OD) degree and a license to practice in a particular state. OD programs take four years to complete, and most students have a bachelor’s degree before entering such a program. Employment of optometrists is projected to grow 10 percent from 2021 to 2031, faster than the average for all occupations.

About 1,700 openings for optometrists are projected each year, on average, over the decade. Many of those openings are expected to result from the need to replace workers who transfer to different occupations or retire and exit the labor force.

We look forward to your comments on this month’s digest.

Randy Danielsen, PhD, DHL(h), PA-C Emeritus, DFAAPA

Professor & Director

The Center for the Future of the Health Professions

A.T. Still University

Dr. Taylor McMullen

The future of optometry through the lens of its past

Though not officially recognized in the United States until 1901,1 optometry can trace its roots back to 1263 when Roger Bacon, in his study of optics, described lenses as “useful to old persons and those with weak eyes.2 “Useful” is a great way to describe optometry. Throughout the last 122 years, this profession has sought to be useful to people.

When thinking of optometry, it is natural to think of eyeglasses and perhaps maladies like conjunctivitis or glaucoma. Before optometry existed, eyeglasses and disease were the domain of two different groups: opticians and oculists. While opticians were responsible for creating and fitting eyeglasses, oculists were concerned with diseases of the eyes.3,4 When fitting eyeglasses, the first step is refraction. Refraction is the process used to determine an optical prescription and the gateway to assessing the health of an eye. A healthy eye should achieve 20/20 vision. If an eye is incapable of 20/20 vision after careful refraction, then there must be another cause for the decreased acuity.5 The person performing the refraction is first to know if something is out of the ordinary; thus, optometry combines physics and physiology.     

In 1901, Minnesota became the first state to pass legislation regarding optometry. This first law established the minimum educational requirements for the practice of optometry. Other states followed, and universities soon offered optometry programs with standardized curricula.6 However, the definition would have to expand only a short time after optometry was defined. An important step forward in scope expansion came during and after World Wars I and II. There were not enough enlisted ophthalmologists to treat the needs of soldiers and veterans. Optometrists began using diagnostic and therapeutic drugs under the supervision of physicians even though this was not allowed by legislation in any state. After leaving the service, these optometrists lobbied for the ability to continue practicing at that level.7 Thanks to their successful efforts in scope expansion, optometrists are now regarded as primary eye care practitioners. Indeed, “optometry delivers more than two-thirds of the primary eye healthcare in America, with doctors practicing in more than 10,176 communities.”8 Now training includes using diagnostic drugs to dilate pupils to obtain a better view of internal ocular structures. Training also involves using therapeutic drugs to treat conditions, including the many causes of conjunctivitis, inflammation like uveitis, and diseases like glaucoma. Filling a gap in access to healthcare is the primary driving force for optometric scope expansion. Medical school enrollment has increased, but residency slots have not increased at the same rate.9

As our population grows, so does the demand for refractive and medical eye exams. As a point of reference, let’s look at the time frame of 2015 to 2025. In that period, refractive eye exams are projected to increase by 3.2%, whereas medical exams are projected to increase by 31.5%.10 A 31.5% increase equals 16.3 million annual medical exams.10 Compare these figures to the number of full-time-equivalent optometrists and ophthalmologists joining the workforce. One calculation projects that the number of eye care providers in the U.S. will increase by 34 ophthalmologists per year while the number of optometrists will increase by 1,800.10 As things are currently in eye care, we face a real shortage of medical eye care providers. The easiest and least costly way to counter this is by expanding the scope of practice for optometrists because “99% of the U.S. population has access to a doctor of optometry.”8

Optometry education is standardized in the U.S., but the scope of practice for optometry is regulated at the state level. This means that many states need to allow optometrists to practice at the level they are trained to. Some of the minor in-office procedures that optometrists can perform are laser procedures and the removal of noncancerous eyelid lesions. These few items would decrease the patient load for surgeons, but optometrists are only legislated to practice at this level in a few states.11, 12

The patient need will ultimately determine the growth of optometry. Even with pandemic-related setbacks, increased access to healthcare and improved healthcare outcomes have been made in many states.13 The future of optometry lies in the hands of the people who, working tirelessly, seek to bring high-quality eye care to the people living in all 50 states.

References

1. Kekevian B. Senior. Legalizing Optometry. https://www.reviewofoptometry.com/article/legalizing-optometry

2. James RR. THE FATHER OF BRITISH OPTICS: ROGER BACON, c. 1214-1294. Br J Ophthalmol. 1928;12(1):1-14. doi:10.1136/bjo.12.1.1

3. Prentice CF. Legalized Optometry and the Memoirs of Its Founder. Casperin Fletcher Press; 1926. Accessed January 7, 2023. https://www.google.com/books/edition/Legalized_Optometry_and_the_Memoirs_of_I/MTWsAAAAIAAJ?hl=en&gbpv=0

4. John F. Amos O.D. A Summary of the Life of “The Father of Optometry,” Charles Prentice. Hindsight: Journal of Optometry History. 2022;53(1 & 2). doi:https://doi.org/10.14434/hindsight.v53i1&2.35648

5. 20/20 Vision | Cleveland Clinic. Cleveland Clinic. Published 2020. https://my.clevelandclinic.org/health/articles/8561-2020-vision

6. Taron A. A Fight for the Right to Learn. www.reviewofoptometry.com. Accessed January 7, 2023. https://www.reviewofoptometry.com/article/a-fight-for-the-right-to-learn

7. McAlister WH, Weaver JL, Davis JD, Newsom JA. Military Optometry from World War I to the Present. Hindsight: Journal of Optometry History. 2021;52(1):4-8. doi:https://doi.org/10.14434/hindsight.v51i3.31044

8. The scope of success. www.aoa.org. Accessed March 11, 2023. https://www.aoa.org/news/advocacy/state-advocacy/the-scope-of-success?sso=y

9. Boyle P. Medical school enrollments grow, but residency slots haven’t kept pace. AAMC. Published September 3, 2020. https://www.aamc.org/news-insights/medical-school-enrollments-grow-residency-slots-haven-t-kept-pace

10. Edlow R.C. The Future of Optometry in America. Modern Optometry. https://modernod.com/articles/2019-mar/the-future-of-optometry-in-america?c4src=article:infinite-scroll

11. Cooper SL. 1971 – 2011: Forty-year history of scope expansion into medical eye care. Optometry. 2012;83(2):64-73. Published 2012 Feb 15.

12. Kekevian B. Expanding Scope of Practice: Lessons and Leverage. www.reviewofoptometry.com. Accessed March 11, 2023. https://www.reviewofoptometry.com/article/expanding-scope-of-practice-lessons-and-leverage

13. Spiegle L. Scoping Out Optometry’s Next Era. www.reviewofoptometry.com. Accessed April 12, 2023. https://www.reviewofoptometry.com/article/scoping-out-optometrys-next-era

The Center for the Future of the Health Professions will post its third monthly op-ed column for 2023. Our columns represent strong, informed, focused opinions on issues affecting the health professions’ future. As mentioned, the center was developed to provide state, local, and national policymakers and health system stakeholders with accurate, reliable, and comprehensive data and research about the healthcare workforce to effectively plan for a sustainable future and make the best use of available resources.

This month we feature a discussion on the future of the acupuncture profession by Catherine Niemiec, JD, LAc. Niemiec obtained her juris doctorate in law from the University of California College of the Law, San Francisco, after receiving her undergraduate training from the University of Arizona (political science major and biology/chemistry minor). After practicing law, she became the director of a national bar review company. While working as a litigator in the San Francisco Bay area, Niemiec was introduced to acupuncture medicine to address repeated bouts of bronchitis. After a Chinese herbal tea cleared her symptoms within minutes, she was inspired to study medicine and became an herbalist. Returning home to Arizona, she helped draft legislation establishing the Acupuncture Board of Examiners and established the first medical school of acupuncture in Arizona. The Phoenix Institute of Herbal Medicine & Acupuncture (PIHMA) is now in its 28th year, offering four-year master’s and doctorate degrees in acupuncture and herbal medicine. With more than 400 graduates working in private practice, integrative clinics, and hospitals, PIHMA spreads this highly effective, safe, and cost-effective medicine through its alums and onsite community clinic. For more information, visit pihma.edu

We look forward to your comments on this month’s digest.

Randy Danielsen, PhD, DHL(h), PA-C Emeritus, DFAAPA

Professor & Director

The Center for the Future of the Health Professions

A.T. Still University

Catherine Niemiec, JD, LAc

The future of the acupuncture profession

What is acupuncture medicine?

Acupuncture medicine, also known as Asian or Oriental medicine (AOM) or traditional Chinese medicine (TCM), is also known by the various Asian nationalities or approaches, e.g., Chinese, Korean, Japanese, 5-Element, and French Energetics. This traditional medicine is a highly effective, affordable, low-risk treatment option for many health issues and chronic conditions. It is one of the most requested complementary and alternative medicine choices in the U.S. today. Used by most of the world’s population, it is highly efficacious, providing solutions and relief for various health conditions. The World Health Organization cites more than 43 conditions successfully treated by acupuncture. While some insurance companies cover acupuncture treatments, most are paid out of pocket. In the U.S., nearly 40,000 licensed practitioners and 56 colleges teach this medicine. The future of the acupuncture profession depends upon its continued and greater acceptance into mainstream healthcare. However, it has existed outside of this system and has been used by the general public for several decades.

As stated by the Council of Colleges of Acupuncture & Herbal Medicine, acupuncture medicine (AM) is an ancient and empirical system of medicine based on the concept of Qi, pronounced “chee”, meaning energy/life force and its flow through the body along channels or meridians. This invisible energy guides the flow of blood, fluid, and energy to all parts of the body. Any imbalance or deficiency of this energy, fluid, or heat can cause disease and aging. Specifically, acupuncture refers to the stimulation of specific points on the body, called acupoints, by inserting very fine, sterile, stainless steel needles to elicit a predictable physiological response. This stimulus may also be administered to the points using mild electrical stimulation (with or without needles), pressure techniques with the hands (acupressure), or the application of heat or energy using other methods such as laser, fire cupping, electrical, or mechanical. Applying pressure or needling to these points stimulates the nervous system to release certain chemicals in the muscles, spinal cord, and brain. These chemicals either change the body’s experience of symptoms, especially pain, or trigger the release of additional hormones that influence the body’s internal regulating system.

There have been many attempts to define a common physiological mechanism that explains the location and healing attributes of these points. The ancient theory of “channels,” where flows an unseen energy called the “qi,” has been called pseudoscience by many. Despite thousands of years of usage and effectiveness, this medicine continues to be challenged in finding its fully accepted place in conventional medicine. Acupuncture channels are utilized in acupuncture education and actual practice as a way to group points in terms of location and function and for ease of learning and utilization. It is a metaphorical way of describing a very scientific system of energy flow. This approach has endured for centuries as a way of understanding, explaining, and healing using a simple and effective way of moving and rebalancing energy. Understanding and mastering this approach has allowed for this medicine to be used and delivered throughout the world beyond the practice of conventional medicine. It has allowed many to use it as a form of health maintenance and prevention, as well as anti-aging and recovery from illness or injury.

The need to put AM into the conventional western medical framework is vital for the future so that this medicine can take its proper place and work with other health professions and professionals in a way that comprehensively addresses the needs of patients and the public. Thus, research helps improve credibility and foster the growth of integrative medicine hospitals and practices. Since the mid-20th century, several studies have demonstrated the mechanism of acupuncture from various perspectives. For example, during an acupuncture session, the practitioner and subjects should attain the “de qi sensation, an alternative way to describe the needle sensation.1,2 Some studies have shown that the central nervous system plays a crucial role in the outcome of acupuncture.3-5 Like common studies on the function of the brain, neuroimaging technologies, such as positron emission tomography,6 functional magnetic resonance imaging,7,8 as well as electroencephalography,9 and magnetoencephalography10 have also been employed to map the effects. In addition, some studies have attempted to define the location of acupoints according to the interstitial connective tissue with ultrasound.11

In contrast, others link acupuncture to the release of neurotransmitters, neuromodulators, and cellular signaling molecules in the peripheral and central nervous systems.12 Ultimately, there is no single answer to explain why or how acupuncture works. The exact mechanism is multifactorial, involving a number of different paradigms depending on anatomical location and the specific effect acupuncture tries to induce in each case.

The AM field

Nevertheless, despite this, the field of acupuncture and AOM has grown widely and rapidly ever since James Weston, a reporter for The New York Times, wrote about his emergency appendicitis surgery when reporting on President Nixon’s trip in China in the 1970s. Reston’s surgery in China was performed without anesthesia and only used acupuncture needles for pain and sedation. His subsequent article spawned a rapid growth of interest in Asian medicine. Training and schools started with the first on the East Coast, expanding over the years to more than 50 colleges in the U.S. Acupuncturists are now licensed or regulated in all 50 states.

Training and knowledge

Acupuncturists receive more than 3,000 hours of training with at least 1,400 hours specifically in acupuncture theory, practicum, and 800 hours of supervised clinical training in this Asian medical theory and pathology. Theory and practicum include knowledge of more than 365 points, training in angle and depth of insertion, and many indications and contraindications. Herbal medicine training is more than 500 hours, with the classification of herbs and formulas according to the energetics, matched to the specific energetics of a patient’s patterns of disharmony. It is the original “personalized” medicine. The training also includes more than 700 hours of western biomedicine and pharmacology. The Accreditation Commission for Acupuncture & Herbal (formerly Oriental) Medicine oversees the standards for colleges which offer these four-year master’s and entry-level Doctorate degrees in acupuncture or acupuncture and herbal medicine. This is the minimum requirement for state licensing, along with successfully passing an extensive certification exam by the National Commission for Certification in Acupuncture & Oriental Medicine. In addition, there is post-graduate doctorate training (DAOM).

The practice of acupuncture by other health professions may impact the future of AM. While there are other health professions (MD, DO, DC, ND, PT) that incorporate a weekend to 200 hours of acupuncture needling training, which can be very effective, the practice of this medicine requires a deeper, more comprehensive, and extensive training to accomplish all that this medicine has to offer. (For a comparison of training and skills, see Know Your Acupuncturist.) Notably, acupuncturists must take nearly 1,000 hours of supervised clinical training, practice, and needling technique before independently practicing on patients, as several hundred hours are required to conduct this invasive surgical needle technique safely, effectively, and comfortably. Nonetheless, these other health professions have Medicare and insurance coverage, which is not yet fully available to acupuncturists. This has impacted access to comprehensively trained acupuncturists who can offer even more to the public.

Another factor in the future of acupuncture is the growing realization that AM provides a viable solution for those areas where conventional medicine is challenged. A 2012 study of acupuncture published in Archives of Internal Medicine showed that acupuncture outperformed sham treatments and standard care for osteoarthritis, migraines, and chronic back, neck, and shoulder pain. This study was conducted by researchers at Memorial Sloan-Kettering Cancer Center and 30-40 other people worldwide over six years for a meta-analysis of 29 randomized high-quality studies. One meta-analysis of almost 18,000 patients across 29 randomized controlled trials found that true acupuncture was significantly more effective than the absence of the service or sham acupuncture (placebo) controls.13 More specifically, the Acupuncture Evidence Project has tabulated research studies that have found evidence of acupuncture’s positive or potentially positive effects on different conditions, covering 46 different symptoms.14 Recognizing the potential of acupuncture as a pain management modality, the American College of Physicians (ACP) published guidelines in 2017 strongly recommending acupuncture as an effective treatment for chronic and acute lower back pain, often leading to opioid prescriptions among sufferers.15 The ACP also promotes payment reforms by public and private insurers to cover these services.

Thus, acupuncture can replace an initial opioid prescription when faced with acute or chronic pain concerns. In fact, beyond simply treating pain, the mechanisms of acupuncture produce and release endogenous opioids in the body, acting as a natural analgesic without prescribing opioid drugs.15 Additionally, acupuncture activates opioid receptors in the brain, thus allowing lower doses of opioid medication to be more effective when used with acupuncture treatments. Acupuncture provides the same analgesic effects as opioid medications, reducing the harmful potential for abuse or addiction. Significantly, studies on acupuncture as an opioid complement can reduce opioid-like medications consumption by more than 60% in post-surgical environments.16, 17

The Joint Commission, which accredits all hospitals, released its standards in 2018, stating that hospitals should prioritize modalities such as acupuncture before prescribing opioids. Further, the Veteran’s Administration and the Department of Defense incorporated acupuncture for pain and other health issues for years and continued to do so. Acupuncture also addresses symptoms post-addiction or abuse, reducing or alleviating opioid withdrawal symptoms.18 The National Acupuncture Detoxification Association cites more than 1,000 programs across the U.S. and Canada that use acupuncture to overcome addiction. As the number of opioid addicts in the U.S. continues to rise, acupuncture can and should be more widely used to achieve drug independence.19

The World Health Organization has recently published ICD-11 classifications and terminologies for traditional medicine codes globally based on the work of the International Classification of Traditional Medicine project experts from China, Japan, Korea, Australia, U.S., U.K., Netherlands, and other countries. These ICD-11 codes will facilitate research and reimbursement.

Conclusion

The future growth of AM is strong and steady. This medicine has grown to regulation in every state due to word of mouth from satisfied patients paying out of pocket, up to now, when medical referral, insurance reimbursement, and hiring of acupuncturists regularly occur. Research continues to prove and support its efficacy, safety, and benefits for the public. Combining all the aspects and greater scope of acupuncture treatments by comprehensively trained acupuncturists with the strengths of conventional western medicine will save healthcare costs in the long run and create a healthier, happier public. The growth of AM is both necessary and beneficial. Desired by the public and saving costs for insurers, hospitals, and employers, it is worth promoting its growth and supporting its preservation.

References

1. Jung WM, Shim W, Lee T, et al. More than DeQi: Spatial Patterns of Acupuncture-Induced Bodily Sensations. Front Neurosci. 2016;10:462.

2. Zhou W, Benharash P. Significance of “Deqi” response in acupuncture treatment: myth or reality. J Acupunct Meridian Stud. 2014;7:186–9.

3. Hui KK, Liu J, Makris N, et al. Acupuncture modulates the limbic system and subcortical gray structures of the human brain: evidence from fMRI studies in normal subjects. Hum Brain Mapp. 2000;9:13–25.

4. Lundeberg T, Lund I, Näslund J. Acupuncture–self-appraisal and the reward system. Acupunct Med. 2007;25:87–99.

5. Fang J, Jin Z, Wang Y, et al. The salient characteristics of the central effects of acupuncture needling: limbic-paralimbic-neocortical network modulation. Hum Brain Mapp. 2009;30:1196–206.

6. Huang Y, Tang C, Wang S, et al. Acupuncture regulates the glucose metabolism in cerebral functional regions in chronic stage ischemic stroke patients–a PET-CT cerebral functional imaging study. BMC Neurosci. 2012;13:75.

7. Wang Y, Qin Y, Li H, et al. The Modulation of Reward and Habit Systems by Acupuncture in Adolescents with Internet Addiction. Neural Plast. 2020. https://doi.org/10.1155/2020/7409417.

8. Cai RL, Shen GM, Wang H, Guan YY. Brain functional connectivity network studies of acupuncture: a systematic review on resting-state fMRI. J Integr Med. 2018;16:26–33.

9. Yang X, Yu H, Zhang T, et al. The effects of Jin’s three-needle acupuncture therapy on EEG alpha rhythm of stroke patients. Top Stroke Rehabil. 2019;1-5.

10. Dhond RP, Witzel T, Hämäläinen M, Kettner N, Napadow V. Spatiotemporal mapping the neural correlates of acupuncture with MEG. J Altern Complement Med. 2008;14:679–88.

11. Langevin HM, Yandow JA. Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec. 2002;269(6):257-265. doi:10.1002/ar.10185

12. Li Y, Wu F, Cheng K, Shen XY, Lao LX. Zhen Ci Yan Jiu. 2018;43(8):467-475. doi:10.13702/j.1000-0607.180196

13. Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE, et al. Acupuncture for Chronic Pain: Individual Patient Data Meta-Analysis. Archives of Internal Medicine. 2012; 172(9): 1444-53.

14. McDonald J, Janz S. The Acupuncture Evidence Project: A Comprehensive Literature Review. Australian Acupuncture & Chinese Medicine Association Ltd, Dec. 19, 2016.

15. Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and

Chronic Low Back Pain: A Clinical Practice Guideline from the American College of Physicians. Annals of Internal Medicine, 2017 April 4; 1667(7): 514-530.

16. Zhang, R, Lao L, Ren K, Berman BM. Mechanisms of Acupuncture-Electroacupuncture on Persistent Pain. Anesthesiology, 2014; 120(2): 482-503., and Lin JG, Lo MW, Wen YR, Hsieh CL, Tsai SK, Sun WZ. The Effect of High and Low Frequency Electroacupuncture in Pain after Lower Abdominal Surgery. Pain

17. Wang B, Tang J, White PF, Naruse R, Sloninsky A, Kariger R, et al. Effect of the Intensity of Transcutaneous Acupoint Electrical Stimulation on the Postoperative Analgesic

Requirement. Anesthesia and Analgesia, 1997; 85(2): 406-13.

18. Wen H, Cheung SYC. Treatment of Drug Addiction by Acupuncture and Electrical Stimulation. Asian Journal of Medicine, 1973; 9:139-141.

19. National Acupuncture Detoxification Association. “About NADA.”

See also:

Learn about AM

Acupuncture: What You Need To Know

Acupuncture and Herbal Medicine News and Resource Center

Society for Acupuncture Research – Every month, an average of 100 acupuncture-related articles are published in more than 50 journals. PubMed lists more than 1,000 randomized controlled trials assessing efficacy or effectiveness of acupuncture.

The Center for the Future of the Health Professions will post its second monthly op-ed column in the new year. Our columns represent strong, informed, focused opinions on issues affecting the health professions’ future. As mentioned previously, the center was developed to provide state, local, and national policymakers and health system stakeholders with accurate, reliable, and comprehensive data and research about the healthcare workforce to effectively plan for a sustainable future and make the best use of available resources.

This month we feature an article by Maria Centeno-Vazquez, PhD, CCC-SHP, BCS-S, on the speech-language pathology profession and student training at A.T. Still University’s Arizona School of Health Sciences (ATSU-ASHS). Dr. Centeno-Vazquez has a demonstrated history of working in the higher education industry. She is skilled in swallowing disorders, voice and neurocognitive disorders, research, lecturing, and public speaking. She has a Doctor of Philosophy (PhD) from The University of Cincinnati and focuses on communication sciences and disorders. She is a board-certified specialist in swallowing and swallowing disorders.

Dr. Centeno-Vasquez is the program director and an associate professor at ATSU-ASHS. Previously, she was program director and associate professor at the Inter-American University of Puerto Rico for two years and the speech-language pathology and speech-language therapy programs director at the School of Health Sciences at Universidad del Turabo in Gurabo, Puerto Rico, for seven years. Additionally, for four years she was director at the Caribbean Neurocognitive Comprehensive Center for treatment, research, and community services. The center provides services for adults and members of the geriatric population with swallowing disorders.

Speech-language pathologists (SLPs) are experts in communication. They work with people of all ages, from babies to adults, and treat many types of communication and swallowing problems. SLPs also work on issues with speech sounds, or how we say sounds and put sounds together into words. SLPs are in great need across the United States to support individuals in diverse environments.

We look forward to your comments on this month’s digest.

Randy Danielsen, PhD, DHL(h), PA-C Emeritus, DFAAPA

Professor & Director

The Center for the Future of the Health Professions

A.T. Still University

Dr. Centeno-Vasquez

The speech-language pathology profession and student training at ATSU-ASHS

The U.S. News and World Report ranked speech-language pathologist as number 31 in its 100 Best Jobs of 2023. According to the U.S. Bureau of Labor Statistics, job opportunities in speech-language pathology are expected to grow by 29% between 2020 and 2030, far outpacing the average for all occupations. The American Speech-Language-Hearing Association (ASHA) represents 188,143 certified speech-language pathologists (SLPs). The demand for SLPs will continue to climb with population growth and the increase in average life expectancy. In addition, there is now significant awareness of the need for early intervention services and the prevention of speech and language disorders that will spur the demand for these professionals.3

The act of communication is an essential activity for humans and individuals will require practical and sophisticated communication skills in most of their daily activities. The comprehension and use of language will demand refined neurological performance for one person to communicate with another. The physiological and neurological mechanisms used for speaking and swallowing can easily be affected secondary to illness, congenital conditions, neurological disorders, cancer, or physical trauma, among many other possible medical conditions. In addition, with an increase of individuals over 65 years of age, there will be an increase of speech-language pathology services to meet the communication and swallowing needs of older individuals who suffer from several medical conditions such as strokes, traumatic brain injuries, dementia, and Parkinson’s, among other chronic conditions.

The survival rate of premature infants is also increasing, resulting in the need for SLPs who specialize in managing fragile infants with communication, swallowing, and feeding disorders. Some infants are born with medical conditions, such as cleft lip and palate, and other congenital anomalies that result in speech, language, and swallowing issues that can directly affect their daily living skills, development, and social and educational performance. Therefore, early intervention services are critical and in constant demand. According to the National Center for Education Statistics, school-age student enrollments continue to rise. This will result in the need to provide individualized services related to the range and severity of disorders and for students from various ethnicities and cultures. Federal law guarantees special education and related services to all eligible children with disabilities; thus, there is a high demand for school based SLPs to provide services for children with disabilities and from diverse backgrounds.

SLPs incorporate modifications to provide services using best practices for diverse clients. It is imperative to use interpreters and modified assessment and treatment protocols according to the client’s background and individual needs. Best practice for delivering services to diverse clients includes active interprofessional collaboration among clinicians. Issues related to the accessibility of services for people in remote or rural areas are of high importance as well. Most recently, the COVID-19 pandemic created opportunities to innovate and develop new ways of preparing clinicians to provide clinical services using modified delivery methods such as telepractice. Telepractice has now become a staple of service delivery for SLPs.

The speech-language pathology profession continues to evolve secondary to recent historical events and changes in the U.S. demographics. SLPs are in great need across the United States to support individuals in diverse environments across the age span. SLPs are essential healthcare providers in hospitals, rehabilitation centers, private practice clinics, homecare services, skilled nursing facilities, and educational settings. There is a high demand for SLPs to be prepared to provide services to bilingual clients and to use culturally responsive practice principles.4 SLPs are also ready to use the most advanced equipment and instrumentation to conduct state-of-the-art evaluations and treat patients with communication and swallowing disorders.

The future of the speech-language pathology profession is focused on refining and increasing the quality-of-service provision in areas like telehealth, interprofessional collaborative practices,1 and diversity, equity, and inclusion (DEI).2 SLPs are expected to increase their clinical practices in the previously mentioned areas while engaging in interprofessional collaborative practices. Future SLPs need to be innovative, creative, and flexible to provide global services to diverse clients to address challenges and changes due to societal, humanitarian, or health crises as we advance into the future. Another imperative trend is the need for more specialized clinicians to support client-specific needs. Therefore, several board recognition groups have been advocating and promoting training to supply the demand for board-certified clinicians.

The Master of Science program in speech-language pathology at A.T. Still University’s Arizona School of Health Sciences (ATSU-ASHS) prepares students to become whole-person healthcare providers in alignment with the mission of the university and its osteopathic heritage. The pedagogy of multicultural education is a cornerstone of this program, with a significant emphasis on SLP training and the delivery of bilingual services. The curriculum focuses on addressing diversity issues through culturally responsive practices and using competency-based methods with interpreters to provide ethical services to individuals from linguistically diverse backgrounds. Curriculum content will prepare students to be proficient in using the most advanced equipment and instrumentation to conduct evaluations and treatments of patients with communication and swallowing disorders.

Students also will master telepractice methodologies and technology to meet the needs of clients from underserved, diverse, rural, and global communities. ATSU’s speech-language pathology program also allows students to understand and participate in activities with interprofessional practitioners (IPP), adhering to IPP principles in delivering services to individuals with speech, language, and swallowing disorders. Graduates of the ATSU-ASHS speech-language pathology program will become the next generation of scholars and leaders who will make a global impact.

References

1 American Speech-Language-Hearing Association. (n.d.). Asha’s envisioned future: 2025. American Speech-Language-Hearing Association. Retrieved January 16, 2023, from https://www.asha.org/about/ashas-envisioned-future/

2 Regan, J. (2023, January 14). Asha outlines advocacy and policy priorities for 2023. ASHA. Retrieved January 16, 2023, from https://leader.pubs.asha.org/do/10.1044/2023-advocacy-goals-aud-slp/full/

3 Future outlook: Speech-language pathology. ASHA Career Portal. (n.d.). Retrieved January 16, 2023, from https://careers.asha.org/getting-started/future-job-outlook-speech-language-pathology

4 Hyter, Y. D., & Salas-Provance, M. B. (2021). Culturally responsive practices in speech, language, and hearing sciences. Plural Publishing.

Students, faculty, and staff came together on Thursday, Sept. 22, to celebrate A.T. Still Memorial Library’s 100th anniversary and learn about the facility providing them with a wealth of information.

The library has come a long way from its humble beginnings in Kirksville, Missouri. When it first opened in September 1922, the library was housed in a small room next to the President’s Suite in the Andrew Taylor Still College of Osteopathy and Surgery (ATSCOS). Then, in 1924, ATSCOS merged with its rival, the American School of Osteopathy, to form the Kirksville College of Osteopathy. The College’s two libraries were then combined and housed at the ATSCOS building. Since then, the library has experienced a series of moves, expansions, and renovations, and now includes two other branches on the Arizona and California campuses.

Students listening to televisions with headphones. Museum of Osteopathic Medicine, Kirksville, Missouri [2010.02.974]
Students listening to televisions with headphones. Museum of Osteopathic Medicine, Kirksville, Missouri [2010.02.974]

Today, the library is home to 250,000 e-books, 20,000 e-journals, and more than 100 databases. The three libraries have a shrinking print collection of just under 50,000 volumes with the majority housed in the Kirksville library and archive. The Mesa, Arizona, library was opened in 2002 with only 2,000 volumes, and the Santa Maria, California, library was opened in 2021 with only 10 books, highlighting the library’s evolution from a print-based library to a digital one.

student in Arizona library studying
A student studying in the Arizona campus library.

The library also boasts an impressive 3D printing program, which began in 2015 with the purchase of its first 3D printer with funds from the ATSU Spark Tank grant.

“We’ve come a long, long way,” says Debra Loguda-Summers, the library’s public services and 3D print services manager.

From 2015-21, the library has printed more than 12,100 3D models for student and faculty research, not including the face shields and masks printed during the COVID-19 pandemic. Since the program’s inception, the library has increased its printing services to students and faculty by more than 3,600% and expanded to four printers and two designated computers. Those interested in using these services have access to a diverse selection of 3D files and software, and the ability to create STL/OBJ files from CAT scans and MRIs.

ballistic gel cervical model
A cervical injection model encased in ballistic gel

“In the coming years, the ATSU library will focus on open access, open education, and open science,” says Hal Bright, MLS, AHIP, university library director and ATSU-ASDOH librarian liaison. “We are establishing a digital institutional repository for open data and open access for faculty and student research, transforming our subscriptions to allow faculty and students to publish through immediate access, and providing open-science models at lower costs. We also try to acquire as many textbooks as possible, including open-education textbooks, to lower student costs. These initiatives will allow ATSU to meet student needs by promoting a more equitable situation for all students and will make ATSU research more accessible and reachable to all scientists across the various professions we represent among staff and faculty.

“We want to continue meeting the learning and research needs of faculty and students, especially considering the rising costs among students, the open-access data requirements being established in 2025, and open access U.S. government publishing requirements coming into effect in 2025.”

folding DNA model
A folding DNA model

Keep up with the latest alumni and University happenings

ATSU News, the University’s updated news portal, was launched in 2021 with the goals of keeping the greater University community informed, highlighting alumni accomplishments, promoting student and program activities, and more. In addition to the stories on the ATSU News feed, you will find current and past issues of Still Magazine, messages from the president’s desk, scholarly activity, updates from the Museum of Osteopathic Medicine, and a place to submit story ideas. Visit atsu.edu/news today!

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From now through October 2023, ATSU is celebrating the Museum of Osteopathic Medicine’s accreditation from the American Alliance of Museums and rededication to the osteopathic profession. Help ATSU recognize those osteopathic physicians, friends of the profession, institutions, and organizations that are special to you or someone you know. By honoring them or yourself with a namesake plaque on the Honor Wall, you are supporting the museum and sustaining the world’s repository of osteopathic history.

The Honor Wall will be unveiled during Founder’s Day 2023. Please consider honoring those who have contributed to the growth of the osteopathic profession, preservation of osteopathic history, and education of tomorrow’s physicians.

Wall of Honor recognition levels

Platinum $50,000 and above

Gold $25,000-$49,999

Silver $10,000-24,999

Patron $5,000-$9,999

Friends $1,000-$4,999

For more information, please contact Brad Chambers, director of development, at bradchambers@atsu.edu or 660.626.2180. To give online, please visit giving.atsu.edu/honor-wall

For Martin Sobieraj, DMD, MS, FAGD, ’07, the decision to create the first endowed scholarship by an ATSU-ASDOH graduate was a simple one – it was a chance to give back to an institution from which he has been given so much.

“ATSU made me who I am today,” he says, “which is a great dentist.”

Dr. Sobieraj recently signed a $25,000 gift agreement to create an endowed scholarship for ATSU-ASDOH, also providing annual gifts of $1,000 while the endowment grows. He hopes the scholarship will help recognize and support the School’s students, as the endowment focuses on awarding those who excel during their third-year clinicals and demonstrate professionalism throughout their four years at ATSU-ASDOH.

“As part of ATSU-ASDOH’s inaugural class of ’07, Dr. Sobieraj exemplifies our foundational mission to graduate dentists who are the heart of the profession, providing compassionate care for others, in particular the underserved,” says ATSU-ASDOH Dean Robert Trombly, DDS, JD. “His generosity in the establishment of this scholarship will assist our current students as they learn to provide compassionate care for our patients, and inspire others to pay it forward for the benefit of all members of our communities.”

Born and raised in Portland, Oregon, Dr. Sobieraj was attracted to healthcare fields at an early age and was accepted to both dental and medical programs. Dentistry won out because he felt he could more quickly address the needs of his patients through oral healthcare services.

“What changed my mind was being able to take someone out of pain immediately, without drugs. You have tooth pain? I can get you out of pain,” he says.

Dr. Sobieraj initially went to school close to home at Oregon Health Sciences University, but during his second year, his father-in-law, a Gilbert, Arizona, resident, was paralyzed in a serious vehicle accident.

He relocated to Arizona to help during the difficult time and met with ATSU-ASDOH leadership to seek a transfer. It was granted, and while his move was caused by tragedy, it put Dr. Sobieraj into a career-changing situation.

At ATSU-ASDOH, he says, faculty placed an emphasis on developing relationships with patients to provide them the highest level of care. It went far beyond anything he’d previously been taught about patient care.

“To do any treatment, you have to be able to talk to your patients and explain yourself, and build trust with your patient,” Dr. Sobieraj says. “That was the biggest thing they taught me.

“It was the best experience I’ve had in my life. It changed everything.”

He also developed lifelong friendships with his classmates, many of whom met regularly in what they called “CCU5.”

“That’s where a bunch of us would go to work on our hand-eye coordination and play video games. That was my favorite,” Dr. Sobieraj says with a laugh.

“We bonded really well.”

Today, Dr. Sobieraj owns his practice, Beautiful Dentistry, in Tempe, Arizona, and tries to give back to his community and provide care to the underserved as often as he can. He says the need for oral healthcare providers in Arizona is immense, as is the need for those who can provide affordable services.

“At ATSU-ASDOH, we took care of the underserved population,” he says. “It’s ingrained in me that a lot of people don’t have insurance, or money to pay for care, so we have to be there to help them as much as we can do it.”

He hopes his fellow graduates will follow his path in providing a gift to the School, growing the next generation of dentists to help address oral healthcare needs in Arizona and across the country.

Learn how you can support students through the Sobieraj Family Endowment – Clinical Excellence Award at ATSU-ASDOH, or by establishing a similar endowment. For more information, please contact Karen DeCarlo, director of development, at kdecarlo@atsu.edu or 480.219.6105.

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