PUNXSUTAWNEY (TNS) — A tiny Jefferson County hospital will be the first clinical practice site for a new medical school that’s taking shape at Indiana University of Pennsylvania, extending a lifeline to a rural pocket of the state.
IUP and the 49-bed Punxsutawney Area Hospital signed an agreement Monday that will eventually allow 120 medical students to use the hospital for the on the job training part of their medical education, addressing a critical physician recruitment problem in rural Pennsylvania. PAH, part of the three health system Pennsylvania Mountain Care Network collaborative, will be the first of many clinical sites that IUP’s college of osteopathic medicine anticipates using, university president Michael Driscoll said.
“We are in a rural health care crisis,” Driscoll said.
Fourteen percent of Jefferson County’s population of 44,000 is impoverished — 20% higher than the state average — and 21% is over age 65, he said, and recruiting doctors to practice in small town Pennsylvania can be difficult. The university-hospital alliance will help address that need, PAH President Jack Sisk said.
Typically, medical students spend the first two years of their education in the classroom, then train at clinical sites the third and fourth years. IUP is seeking accreditation for the new medical school from the American Osteopathic Association, a three- to five-year process that’s occurring as PAH undergoes a $25 million expansion and renovation project.
The IUP-PAH affiliation also comes as a five-year-old program intended to help stabilize finances and improve care at rural hospitals starts to wind down. The Pennsylvania Rural Health Model, which gives small hospitals global payments for care from insurers to compensate for revenue variability, is scheduled to end in December.
Medicare will continue making global payments to the 18 participating hospitals for a few more years, including PAH, but commercial insurers are likely to drop out at the end of the year, said Hospital and Healthsystem Association of Pennsylvania President and CEO Nicole Stallings.
A full-service hospital is key to any region’s economic development, she said in an interview Monday.
“No company wants to locate where their employees can’t deliver babies and can’t get the care they need,” she said. “We think these issues really go hand in hand.”
Affiliating with a medical school is a unique way for PAH to assure its future at a time when many rural Pennsylvania hospitals are cutting services and closing. Most recently, Penn Highlands Healthcare’s 163-bed hospital in Elk County, shuttered its maternity unit May 1, creating a six-county swath of northern Pennsylvania without a hospital obstetrics unit.
Ridgway councilman Zack Pontious is among a group of residents who have been meeting with Penn Highlands’ executives to try to get the unit reopened. Economic development hinges on the availability of a full range of health care services, he said.
“We have a lot of people invested in our community who want to see it grow and be viable,” Pontious said. “We need an actual hospital, not a glorified Band-Aid station, for people to think about moving here or staying here.”
At the signing ceremony Monday, PAH Chief Medical Officer Clark Simpson said the closing of the unit in Elk County would result in higher mortality rates for expectant moms, an assertion that Penn Highlands’ officials have denied.
“For a man, it’s not a big deal” to have a hospital nearby that’s prepared for childbirth, Simpson said. “For women, it’s crucial.”
Among the services at PAH, which hospital president Sisk called a “small, little hospital in the middle of nowhere,” is an obstetrics unit, a service line Punxsutawney Area Hospital planned to continue. The hospital traces its roots to 1888.
Only 5% of medical students are from rural areas, Simpson said, and the “disparity is only getting worse.” The IUP-PAH affiliation is a way to introduce tomorrow’s physicians to the rewards of practicing in small towns.
Meanwhile, Harrisburg-based HAP is pressing the General Assembly for a $25 million general fund investment that could leverage $80 million in additional federal funds to help prop up struggling hospitals. Gov. Josh Shapiro has been developing a plan to address rural health problems, but Stallings said the $25 million is not part of his budget proposal, which is currently being negotiated.
“Long term, sustainable funding support is needed, especially in our rural communities,” she said. “That funding would be really timely. Now is the time to start action.”
