Center for the Future of Health Professions Feb. 2023 digest
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]
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.
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.
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.”
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!
Give back without giving money
Follow ATSU on social media
Following ATSU’s social media accounts is something you can do to help the University. By taking a little time to like, share, and engage with ATSU’s content, you are furthering the reach of ATSU and the work of its amazing alumni, students, faculty, and staff, all while raising the University’s profile.
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.
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.
1990s
Jeffrey Tipton, DO, ’90, Los Angeles, California, wrote and directed a movie titled “Lovers Leap,” which premiered July 29-30 in Hannibal, Missouri. The movie is a story inspired by the legend of Lovers Leap, which is a favorite sightseeing spot atop a bluff offering a panoramic view of Hannibal, the Mississippi River, and Illinois. A longtime writer, Dr. Tipton mostly writes screenplays but started making movies two years ago. The film was selected to be screened at film festivals this year before becoming available on major streaming platforms, including Amazon and Hulu.
Michael G. Saribalas, DO, CBSM, ABSM, ’92, was appointed to the staff of the Cleveland Clinic Neurological Institute Sleep Disorders Center as the center’s sole sleep psychiatrist. He also enjoys teaching students at Ohio Dominican University’s Physician Assistant program and is on staff at Ohio University’s College of Osteopathic Medicine.
Lancer Gates, DO, ’96, was voted president-elect for the Missouri State Medical Association. The presidential inauguration will take place April 1, 2023, in Kansas City.
2000s
Lt. Col. Matthew Pieper, DO, ’06, a Center for Sustainment of Trauma and Readiness Skills instructor at St. Louis University, received the Distinguished Flying Cross on Sept. 12, 2021. According to a story by Airman 1st Class Whitney Erhart, 131st Bomb Wing, published by the Air National Guard, Dr. Pieper received the award for life-saving measures he performed on a partner-force soldier while assigned to a joint medical unit in 2018 in northern Afghanistan.
Jodan D. Garcia, PT, DPT, OCS, FAAOMPT, ’09, was promoted to clinical professor at Georgia State University in the Doctor of Physical Therapy (DPT) program. Dr. Garcia is a graduate of ATSU-ASHS’ DPT program.
Paul Sibley, DO, FAOAO, ’09, was named chief of hand surgery at Lehigh Valley Orthopedic Institute in Allentown, Pennsylvania.
2010s
Andrew Kalthoff, DO, ’15, joined Mercy Health in Cincinnati as a sports fellowship-trained orthopedic surgeon and the Cincinnati Sports Medicine and Orthopaedic Center Fellowship as a faculty member. Dr. Kalthoff is a graduate of ATSU-KCOM.
Kelsey Davis-Humes, DO, ’16, was appointed medical director for Memphis Medical Services at Scotland County Hospital in Memphis, Missouri. Dr. Davis-Humes joined the medical staff at Scotland County Hospital and Clinics in 2019.
Peter Chung, DMD, ’18, joined Smiled Obsession at a new location in Steamwood, Illinois. Dr. Chung is a graduate of ATSU-MOSDOH.
Lisa Bosch, DMD, MPH, ’19, Edina, Missouri, was named a 10 Under 10 dentist by the American Dental Association for demonstrating excellence in the profession. A graduate of ATSU-MOSDOH, Dr. Bosch was also recognized as a 2022 Outstanding New Dental Leader by the Missouri Dental Association for her commitment to organized dentistry and her advocacy work for community water fluoridation.
2020s
Tasha Harder, DO, ’20, Flagstaff, Arizona, was named Resident of the Year during the annual Arizona Osteopathic Medical Association Awards. Dr. Harder is a graduate of ATSU-SOMA and resident at North Country Healthcare.
Kris Pyles-Sweet, DMSc, ’21, PA-C, MS, ’18, is serving a term as president of PAs for Tomorrow and is serving on the Government Affairs Committee of North Carolina Academy of Physician Assistants. Dr. Pyles-Sweet is a 2021 graduate of ATSU-ASHS’ Doctor of Medical Science program and a 2018 graduate of the Advanced Physician Assistant Education and Leadership program.
Kimberly Sapre, DMSc, PA-C, CAQ-EM, ’21, founded and was appointed chair of the Virginia Academy of Physician Assistants’ (VAPA) Diversity, Equity & Inclusion Committee. Dr. Sapre is a member of VAPA’s Membership and Marketing & Communication committees. A 2021 graduate of ATSU-ASHS’ Doctor of Medical Science program, Dr. Sapre also serves on the Society of Emergency Medicine Physician Assistants’ Education Committee.
Stacy Scroggins, DMSc, PA-C, ’21, was selected to serve as the American Academy of Physician Assistants’ representative to the National Quality Forum’s Measure Applications Partnership Rural Health Advisory Group. Appointment to the national committee is highly selective, and Dr. Scroggins will be the sole physician assistant representing the profession. Dr. Scroggins is a 2021 graduate of ATSU-ASHS’ Doctor of Medical Science program.
Sandra Lindsay, DHSc, MBA, MS, RN, CCRN-K, NE-BC, ’21, the first person in the U.S. to receive a COVID-19 vaccine, received the Presidential Medal of Freedom on Thursday, July 7, at the White House. The recognition is the nation’s highest civilian honor and is reserved for individuals who have made exemplary contributions to the prosperity, values, or security of the U.S., world peace, or other significant societal, public, or private endeavors.
Dr. Lindsay serves as a critical care nurse and director of patient care services in critical care at Northwell Health’s Long Island Jewish Medical Center. She is a prominent advocate for vaccines and mental health for healthcare workers.
All six residents who completed ATSU’s Orthopedic Physical Therapy Residency (OPTR) program in September 2021 have passed their board certification exams. Now, the following residency graduates are board-certified clinical specialists in orthopedic physical therapy.
Clarke Antonio, DPT, ’20
Foothills Sports Medicine Physical Therapy, Phoenix, Arizona
Rainey Pain and Performance, Sierra Vista, Arizona
Steven Le, DPT
360 Physical Therapy, Maricopa, Arizona
Brittany Rose, DPT
Travel physical therapist with AMN Healthcare
The American Board of Physical Therapy Specialties coordinates and oversees the specialist certification process as the governing body for certification and recertification of clinical specialists.
“This group represents our 11th cohort of OPTR program residents at ATSU in Arizona. We are proud to now recognize them as advanced practitioners of orthopedic physical therapy who represent the values of ATSU alumni. We are grateful to the OPTR program faculty, clinical mentors, and clinical sites that helped prepare these residents for board certification.”
– Cory Manton, PT, DPT, OCS, CSCS, ’01
Director, OPTR program
Moving the dial on social mission: Ensuring health professions education meets the challenges of today
With powerful messages on the future of health professions education advancing health equity and social justice, the 2022 Beyond Flexner Conference was held March 28-30 at the Hyatt Regency in Phoenix. The three-day event, cohosted by ATSU and Arizona State University’s Edson College of Nursing and Health Innovation, featured keynote speeches and breakout sessions gathering leaders with a goal to bring about meaningful change.
“We also heard that our voice and our vote matter if we’re going to make a difference in the lives of others. The breakout sessions … and the (research) posters demonstrated meaningful scholarly ways that you are moving the dial to include advances in vaccine research.”
Daniel E. Dawes, JD, director, Satcher HealthLeadership Institute, Morehouse School ofMedicine
On understanding race and racism’s impact on health:
“Research is showing how little progress we are making in eliminating health inequities. Within healthcare and public health, we are awakening thanks to the groundbreaking research by many of you here today, to the ways that research has falsely looked at race as a biological attribute, rather than a social construct over centuries, contributing to systems of racism in healthcare delivery, education, housing, transportation, employment, and public health. At long last, medical, nursing, public health science, and more are declaring race is not just biological, but that racism has profound consequences for health.”
Kenya Beard, EdD, AGACNP, CNE, ANEF, FAAN,associate provost, social mission & academicexcellence, Chamberlain University
On eliminating racial bias in health professions curriculum:
“I remember sitting in the classroom and hearing time and time again, ‘If you are Black, you are more likely to have hypertension. If you are Black, you are more likely to be obese.’ What does that do to a student … what does that do to a 17 year old, hearing this narrative over and over? It was demoralizing, especially when there are only two or three people who look like you in the classroom, and whenever the teacher says anything that has to do with ‘Black,’ people get quiet and they look.”
Gary Cloud, PhD, MBA, vice president, strategic university partnerships, ATSU
On ways ATSU is working to keep providers in underserved communities:
“In Hometown Scholars, we ask the nation’s health centers and clinics to tell us who ought to be going to school, who ought to be tomorrow’s physician, dentist, physician assistant, and other professions for which ATSU offers programs. Also, we have a strategy of infusing talent into communities by moving to learning in place. Each new program we’ve started has a stronger version of learning in place, with the intent of infusing talent into communities. Today there are under contract 49 community health centers, from Hawaii to New York, where we have miniature schools going on, where some piece of the education is taking place. If you tie those two together, these health centers are in a position to say, ‘Here are the students in our community who have the right heart to come back and serve, and they are going to stay right here and learn for a piece of or, eventually we hope, all of their education.’”
Harriet A. Washington, award-winning medical writer & editor
On the importance of addressing both implicit and intentional bias:
“I think there is too much focus on implicit bias. I think I understand why. It’s more comfortable to discuss. It’s more comfortable to talk about a bias one is not necessarily aware of, the results of, for lack of a better adjective, innocent misunderstanding, than to acknowledge the existence of biases that are intentional. I don’t think we can afford to ignore the latter. I think we need to address both.”
Beyond Flexner Alliance officially changed its name to Social Mission Alliance as of Dec. 8, 2022.
Gary M. Wiltz, MD
Years on the board: 2013-22
Hometown: Franklin, Louisiana
Occupation: Physician and CEO, Teche Action Clinic
Dr. Wiltz celebrated 40 years of service at Teche Action Clinic this year. The native New Orleanian was assigned to the Franklin, Louisiana, clinic after graduation from Tulane University School of Medicine as part of his National Health Service Corps scholarship repayment. What began as a three-year commitment turned into a lifetime of service.
During his tenure at Teche, where he has served as CEO since 2003, Dr. Wiltz led the growth of the once-struggling clinic to become one of the country’s premiere federally qualified health centers. He has served on many boards and committees at local, state, and national levels, and through his association with the National Health Service Corps, he became a member of the National Association of CommunityHealth Centers (NACHC).
As a member of NACHC, Dr. Wiltz met Gary Cloud, PhD, ATSU’s vice president for strategic university partnerships & diversity, who had a shared passion for serving underserved communities. A few years later, after Dr. Wiltz spoke at a Healthcare Hero luncheon, Dr. Cloud asked Dr. Wiltz if he was interested in serving on the ATSU Board of Trustees.
“I was the first MD on the board of an osteopathic program,” Dr. Wiltz says. “There was some hesitancy on their part and my part, too, because I didn’t know how I would be received.
“The only reason I didn’t choose osteopathic medicine was because I wasn’t exposed to it as a premed student. As I developed experiences and came to appreciate the osteopathic tenet of body, mind, and spirit, I fully embraced the philosophy of osteopathic medicine.”
Since his time on the board, Dr. Wiltz has contributed his expertise, particularly in community health and policy, and served as chair from 2018-20. He says it is the best board he’s ever served on and he will miss the camaraderie with fellow members. As he departs, he has a great sense of comfort in knowing ATSU is in steady hands of a progressive visionary leader in Dr. Phelps, his team, and the board.
“I’ve gotten as much as I’ve given,” he says. “It has been one of the greatest privileges I’ve had in my long career.”
Paulina Vázquez Morris, JD, MBA, MHSA
Years on the board: 2013-22
Hometown: Phoenix, Arizona
Occupation: Attorney, Withey Morris PLC
Vázquez Morris has dedicated her career to service, even overcoming personal challenges to improve community health.
She was born in Chicago after her family escaped Cuba in 1960. She moved to Arizona to attend college and earned her undergraduate and law degrees from the University of Arizona. After practicing law with Kutak Rock, an international law firm, she attended Arizona State University to earn her master of business administration and master of health services administration degrees.
“I am proud and blessed to be a first-generation American,” Vázquez Morris says. “I have been blessed with a beautiful career and life.”
Throughout her career, she has served as general counsel and administrator to three governors, general counsel to the Arizona Board of Regents, and counsel to a hospital corporation. She was elected by more than 60,000 voters in Maricopa County to serve on the Special Healthcare District Board where she was elected chair twice and helped save the county’s healthcare system and safety net. She even ran for Congress and received endorsements from many business leaders, law enforcement, first responders, and the Arizona Republic.
Then, after her son survived treatment for osteosarcoma, her family worked tirelessly on the Right To Try (RTT) initiative and legislation.
“Under RTT, terminally ill Americans have access to experimental treatments here in the U.S.,” Vázquez Morris says. “We were honored to have stood with the president when he signed RTT into federal law.”
In 2013, Vázquez Morris brought her expertise to ATSU when she was nominated to the Board of Trustees. Using her diverse skill set, she served on several committees, particularly contributing to real estate matters.
“Serving on the ATSU board has been among the highlights of my community service,” she says. “I believe in the ATSU mission of preparing healthcare professionals to provide whole person healthcare through body, mind, and spirit. My sons, Diego and Mateo, and I will truly miss my service on the board.”
Welcome, new members
Kimberly G. Perry, DO, MBA, MHCM, FACEP, FACOEP, ’91
Hometown: St. Louis, Missouri
Education: Salve Regina University, ATSU-KCOM, and University of Phoenix
Occupation: Regional chief medical officer, SSM Health
Felix M. Valbuena Jr., MD, DABFM, FAAFP
Hometown: Bloomfield Hills, Michigan
Education: University of Notre Dame, Universidad El Bosque, and Harvard Business School
Occupation: Chief executive officer, Community Health and Social Services Center
Happy New Year! The Center for the Future of the Health Professions will post its first monthly op-ed column for 2023. 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 Filling the Need for Graduate Nursing Education, authored by Bobbi Winter, DHSc, MBA, MSc, MSN. Dr. Winter lives in Scottsdale, Arizona, has been an RN for 42 years, and has developed nursing, medical, and dental continuing education content for the past 25 years. She has taught graduate nursing, healthcare administration, and business courses since 2015. In addition to a diploma nursing degree, she completed a BA in healthcare administration at Graceland University, an MBA focused on quality and lean from New England College, an MSc in health systems management from New England College, an MSN in nursing leadership from Loyola University, and a DHSc with a certificate in fundamentals of education, at A.T. Still University.
Dr. Winter has extensive clinical nursing experience where she held multiple positions in inpatient and outpatient care. She is an entrepreneur who in addition to starting several healthcare related businesses, was a home health administrator for 11 years, served as Chair of the Wisconsin Homecare Organization, acted as the Wisconsin representative to the Medicare Advisory Board, and chaired numerous state reimbursement committees. Later in her career she worked in medical/RN staffing, where her last position was as vice president of Western U.S. Operations for a large international company. There she oversaw a $55+ million budget and more than 10,000 employees in 12 states. In addition to teaching, she is currently president/CEO of a dental laboratory in Irvine, California, where she also manages her husband’s prosthodontic practice and lecture business.
There is no argument that this country has an overall shortage of healthcare professionals. This is especially critical for the nursing profession. The U.S. has experienced nursing shortages throughout the past century, but the magnitude of the nursing crisis has increased since the COVID pandemic. Dr. Winter addresses this issue in this short essay.
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. Bobbi Winter
Filling The Need for Graduate Nursing Education
There is an overall shortage of healthcare professionals, but the situation is especially critical for nursing. More than one million registered nurses are expected to retire by 2030. At the same time, the nation’s aging population will increase the strain on an often-overwhelmed U.S. healthcare system (National League for Nursing, 2021). In addition, the SARS-CoV-2 pandemic exacerbated the current shortage of nurses, often leaving them overwhelmed, exhausted, and unsupported by management. As a result, many have left bedside nursing for less stressful positions or resigned from the profession altogether.
The U.S. has experienced nursing shortages throughout the past century, but the magnitude of the nursing crisis has increased since the pandemic. The shortage is exacerbated by the use of more complex technology to deliver care, including growth in telehealth, expanding nurse practitioner ranks, the movement of nurses into nonclinical careers, growing practice authority, and expanding healthcare services to settings other than acute care hospitals. To address nursing shortages, healthcare leaders have tried numerous strategies, including increasing the class size of nursing programs, expanding the use of less educated and trained personnel, and shortening or accelerating the time needed to obtain a nursing degree.
Graduates of shorter associate degree programs have increased. However, research has repeatedly shown that hospitals with a higher percentage of nurses from baccalaureate and graduate nursing programs have better patient outcomes (Porat-Dahlerbruch et al., 2022). In addition, research suggests that obtaining a BSN or graduate degree prepares RNs for greater professional responsibility and more complex practice (National Academies of Sciences, Engineering, and Medicine, 2021). In 2010, studies conducted over the past two decades on nursing education prompted the Institute of Medicine to recommend that the nurse workforce achieve a composition of at least 80% with a BSN or higher qualification by 2020. Unfortunately, we have yet to reach that goal.
Replacing nurses who are retiring or dropping out of the profession is a daunting task. While the pandemic stimulated an increased interest in the nursing profession and the number of applicants applying to nursing schools, 91,938 qualified applicants were denied admission to a baccalaureate or graduate nursing program in the U.S. in 2021 due to a lack of program capacity and nursing faculty (American Association of Colleges of Nursing [AACN], 2021). According to a survey of nursing schools conducted by the AACN in October 2022, a shortage of qualified faculty was the main reason for not accepting applicants. In addition, there were 2,166 full-time faculty vacancies at 909 baccalaureate/graduate schools when the survey was taken (AACN, 2022). Vacancies were highest (84.9%) for programs where a doctorate is preferred (or required) to teach. In 2021 alone, 9,574 qualified applicants were turned away from master’s programs and 5,169 from doctoral programs (AACN, 2022). This is especially troubling since nurse practitioners, who require a graduate degree to enter practice, recently ranked as the fastest-growing occupation with a projected growth rate of 46% between 2021-31 (U.S. Bureau of Labor Statistics, 2022).
Earning an advanced nursing degree provides other opportunities besides working as a clinical practitioner. While some clinical and management positions may be attainable with a Master of Science in nursing (MSN), a Doctor of Nursing Practice (DNP) can provide students with the advanced skill set and knowledge to pursue more competitive career paths, including those in the C-Suite. In addition, it enables them to be innovative practitioners and act as change facilitators throughout the industry by developing strategies that help institutions deliver high-quality healthcare, reduce costs, and improve patient outcomes.
To address the need for additional graduate nursing opportunities, A.T. Still University began accepting students into its DNP program in 2020. There is a crucial focus on admitting students with diverse backgrounds who will reflect the populations they serve and are prepared to promote health in their communities. To expand students’ ability to be leaders while advancing scientific principles, the online program focuses on strategic organizational leadership and educating professional nurses to translate evidence-based practice into various employment and practice settings. The program is staffed by a diverse and highly qualified adjunct nursing faculty working to ensure students are well-prepared to take their place as leaders in their areas of interest. The faculty’s focus is to produce qualified professional nurses by mentoring the students through the development and implementation of their chosen clinical projects, with the overall goal of improving health outcomes, especially in underserved populations.
Faculty work closely with students and their preceptors to develop solutions to problems or deficits in a specific area of quality concern as they design and implement their DNP project in organizational systems leadership or practice management specialization. ATSU adjunct faculty, under program chair Karin Polifko, are incorporating innovative learning principles to ensure the program meets the criteria for accreditation by the Commission on Collegiate Nursing Education. DNP faculty review and adjust curriculum in response to changes in practice standards and to incorporate the AACN’s re-envisioned Essential Series, which includes the elements and framework for developing nursing curricula for competency-based education and assessment. This will ensure equitable learning experiences for all students and achieve a consistent level of competency in primary care, coordination of care, public health, and population health management.
Even though applicants are being turned away from graduate nursing programs, the ATSU DNP program has been slow to recruit students. The key to accomplishing program goals will be to develop strategic partnerships with local and regional healthcare organizations and undergraduate nursing programs to cultivate a conduit to improve staffing in critical areas of need. The ATSU-CGHS nursing program is committed to recruiting students and expanding access to graduate nursing education where there is a rich history of interdisciplinary education and preparing students to understand the needs of our increasingly diverse and often underserved patient populations.
Institute of Medicine. (2011). The future of nursing: Leading change, advancing health. National Academies Press.
National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020–2030: Charting a path to achieve health equity. The National Academies Press. https://doi.org/10.17226/25982.
Porat-Dahlerbruch, J., Aiken, L. H., Lasater, K. B., Sloan, D.M. & McHugh, M. D. (2022).
Variations in nursing baccalaureate education and 30-day inpatient surgical mortality.
This month, The Center for the Future of the Health Professions will post the last monthly op-ed column for 2022. 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.
We will start this month’s digest off with a hearty congratulations to Dr. Leonard B. Goldstein, a member of the steering committee for the Center for the Future of the Health Professions, for his co-authorship of the textbook “A Guide to Dental Sedation” published in 2022 by Quintessence Publishing Company. This book was published as a reference guide for dental students and practicing dentists to bridge the gap between classroom instruction and the actual application of various sedation methods in different specialties. Congratulations, Dr. Goldstein!
This month we are stepping out of our comfort zone of discussing the health professions offered by ATSU. This month features a discussion of Podiatric Medicine: Past, Present, & Future by Dr. Larry Zonis, DPM. Dr. Zonis practices in Scottsdale, Arizona, and is affiliated with HonorHealth Shea Medical Center. He graduated from Temple University with a Bachelor of Science in biology in 1968 and subsequently completed his podiatric medical education at the Temple University School of Podiatric Medicine (formally known as Pennsylvania College of Podiatric Medicine) in 1972. Upon completing his residency at the St. Luke’s and Children’s Medical Center, he moved to Arizona in 1974. Dr. Zonis has been proudly serving the communities of Mesa, Phoenix, and Scottsdale, Arizona, for the past 49 years. He is a fellow of the American College of Foot and Ankle Surgeons and a diplomate of the American Board of Foot and Ankle Surgery.
Dr. Larry Zonis, DPM
Dr. Zonis’ current focus is treating his patients compassionately and professionally. He provides comprehensive medical and surgical care for various foot and ankle conditions, including common to complex disorders and injuries affecting people of all ages. He is qualified to detect early stages of diseases that exhibit warning signs in the lower extremities, such as diabetes, arthritis, and cardiovascular diseases. In addition, he manages foot conditions that may threaten a patient’s overall health.
According to the U.S. Bureau of Labor Statistics, there are approximately 11,200 employed podiatrists in the U.S. Employment of podiatrists is projected to grow 2% from 2021 to 2031, slower than the average for all occupations. Despite limited employment growth, about 300 openings for podiatrists are projected each year, on average, over the decade. Most of those openings are expected to result from the need to replace workers who transfer to different occupations or exit the labor force through retirement.
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
To understand podiatry is to define podiatry. Podiatry is a specialized branch of medicine that deals with diagnosing and treating lower extremity diseases and deformities, primarily of the foot and ankle.6
Notoriously and historically, in the United States, podiatry can be traced back to Isachar Zacharie, a non-formally trained British chiropodist. He was a friend and confederate of Abraham Lincoln4 and was utilized as an envoy to “open peace talks with the Confederate government.” He was also Abraham Lincoln’s private foot specialist.5, 8
Chiropody is a Latin word indicating the treatment of the hand and foot. Podiatry is also Latin-based but is more specific to the foot. Ergo, the change in name from chiropody to podiatry, at least in the United States. The term chiropody was coined by the British in the 18th century and is still utilized in England today.6, 7 In the United States, the name was changed in 1961 to be more reflective of the profession.
Treatment of foot disorders can be traced back to ancient Egypt. However, the practice of podiatric medicine has changed and evolved dramatically since the last half of the 20th century. Back in the day, podiatrists were relegated to conservative treatment that included the trimming of corns, calluses, and toenails. In addition, local anesthesia was minimally utilized, and surgery, as we know it today, was not performed.
The scope of education has expanded from 90 to 120 hours of undergraduate education, consisting of studies comparable to pre-medical school admissions. There are currently 10 podiatric medicine schools within the United States’ continental borders. Once a student has been interviewed and admitted to a school of podiatric medicine, four years of intense medical education follow. The Doctor of Podiatric Medicine (DPM) degree is conferred upon all graduates. The courses are often concomitantly taken with students matriculating in osteopathic or allopathic medical schools.9, 10
The podiatric curriculum includes, along with basic sciences, courses in dermatology, pathology, radiology, infectious disease, wound care, neurology, orthopedics, podiatric medicine, anesthesia, surgery, trauma, physical medicine and rehabilitation, and behavioral sciences. Postgraduate education includes three to four years of clinical training and rotations through multiple hospital/clinical facilities. The scope of podiatric practice varies from state to state, according to the prevailing state laws. States do require postgraduate education, which is amply provided by the profession. Not all podiatrists are certified as surgeons, just as not all MD/DO physicians are not surgically certified. Many podiatrists are qualified in podiatric pathology, dermatology, and forefoot and rear foot surgery. Podiatry is now an accepted and integral part of lower extremity wound care, working closely with internal medicine, infectious disease specialists, and orthopedic and vascular surgeons. Podiatrists are involved in clinical research to advance wound healing. They provide a significant portion of diabetic foot care and limb salvage. Podiatry provides postgraduate CAQ (certified advanced qualification) boards to those who wish to obtain advanced certification. Podiatrists participate and provide leadership to hospital staff and teaching facilities, advancing medical care.11, 12
Podiatry has come a long way since the “corn and callus” days, becoming a welcomed addition to the worldwide medical community.
The future: Pluses and minuses
Type 2 diabetes is increasing, resulting in foot complications that lead to poor quality of life and increased cost of living. In 2019, 463 million people worldwide were living with diabetes, and this is estimated to increase to 700 million by 2045. Unfortunately, four out of five diabetics live in low- or middle-income countries where podiatry services are usually lacking.1 In addition, up to 70% of all non-traumatic lower leg amputations occur in patients with diabetes.2
Podiatry plays a significant role in the prevention of many lower extremity ulcers. With early assessments, treatments, and timely referrals, amputations can and will be avoided.
Challenges faced by podiatrists in Arizona include:
Arizona Health Care Cost Containment System (AHCCCS) (Medicaid) was not paying for podiatry services.
A scope of practice issues, especially surgery above the ankle.
A significant success in Arizona was in 2014 when podiatrists were deemed as physicians in addition to MDs, DOs, naturopaths, and chiropractors.
There are currently ten colleges of podiatric medicine:
Arizona College of Podiatric Medicine at Midwestern University
Barry University of Podiatric Medicine
California School of Podiatric Medicine at Samuel Merritt University
Des Moines University College of Podiatric Medicine and Surgery
Kent State College of Podiatric Medicine
New York College of Podiatric Medicine
Temple University School of Podiatric Medicine
Western University of Health Sciences College of Podiatric Medicine
Dr. William M. Scholl College of Podiatric Medicine at the Rosalind Franklin University of Medicine and Science
University of Texas, Rio Grande Valley
While podiatric physicians find their practices encroached upon by other professionals seeking to expand their patient bases and services provided, and despite this turbulent climate, podiatric medicine is well equipped for survival and the ability to survive. By holding on to the basic tenets of practice necessary to satisfy a growing and demanding patient population, safeguarding and continuing to embrace services vulnerable to the encroachment of others, and moving toward parity with allopathic and osteopathic medicine, podiatric practices can be well assured that the future remains vital for their chosen profession.
![Students listening to televisions with headphones. Museum of Osteopathic Medicine, Kirksville, Missouri [2010.02.974]](https://atsu-news.atsu.edu/news/wp-content/uploads/Library-historical-2010-02-947-768x699-1.jpg)
