Fresh out of medical school, Dr. Melissa Eppinger wanted to make a difference in patient lives. Her determination brought her to Dover-based Bayhealth, which recently started graduate education programs in family medicine and internal medicine.
“We are part of the first class, which is an amazing opportunity,” said Eppinger, who is from East Hanover, N.J. “From day one, we’ve had great one-on-one experiences with all of the attendings, which allows me to have a higher level of understanding of different diseases.”
She also appreciates Bayhealth’s two hospitals — including the new Bayhealth Hospital, Sussex Campus — and the Bayhealth Family Medicine practice in Dover, which held its ribbon-cutting ceremony in July.
Residents are recently graduated doctors who do not yet practice independently. (The term “intern” is outdated.) With only eight residents in each class, Eppinger gets more time with patients. “I hope that it better helps patients and helps me become a better physician,” Eppinger said.
Bayhealth, in turn, hopes the young physicians will continue working for the health care system upon their residency’s completion.
Filling the ranks
According to data released by the Association of American Medical Colleges, the United States could experience a shortage of between 37,800 and 124,000 physicians by 2034, including shortfalls in primary and specialty care.
Meanwhile, the U.S. population is projected to grow by 10.6%, from about 328 million to 363 million. The number of those aged 65 and above, who are at a greater risk of chronic disease, is expected to swell 42.4%.
Delaware already feels the pinch as out-of-state retirees continue to flock to new housing communities in Kent and Sussex counties.
To recruit physicians, Bayhealth started the family medicine and internal medicine residencies. (Family medicine covers the age spectrum, while internal medicine focuses on adults ages 18 and up.) A surgical residency will begin in 2022.
“There is a lot of data that shows that physicians tend to stay where they trained,” said Dr. Brintha Vasagar, program director of the family medicine residency at Bayhealth.
To be sure, more than half of family physicians practice within 100 miles of their residency program or in the same state, according to a 2015 study. “It makes a lot of sense,” Vasagar said. “You put down roots, you get to know the community, you fall in love with it, and you want to stay.”
Along with the eight family medical residents, there are 13 internal medicine residents. The numbers increase as the program continues. For instance, there will be 24 family medicine residents when classes in the three-year program are at capacity.
However, Bayhealth will not expand each class anytime soon. The Accreditation Council determines the cap for Graduate Medical Education.
While the residencies could benefit Bayhealth’s recruitment efforts, they are already impacting the Dover economy. “It’s not just doctors who make a clinic run,” Vasagar notes.
Thus far, the graduate education program has hired 40 employees, including faculty, administrative team members and front desk staff and medical assistants for the practices.
Meeting the need
When full, the family medicine residency program will help handle 30,000 annual patient visits. The internal medicine program will provide 20,000. Those numbers are significant given that Kent and Sussex counties have less than one primary care physician for every 2,000 people.
The new Bayhealth Family Medicine Practice in Dover offers such services as prenatal care and delivery, medication-assisted therapy for addiction and mental health counseling. “The convenience factor can’t be overstated because of the range of patients the practice can see,” Vasagar said.
There is an embedded licensed professional health counselor, and a pharmacist advises patients who might be on up to 20 to 30 different medications.
Work-Life Balance
The residency training is rigorous, but on the website, the curriculum also stresses life skills, stress reduction and wellness.
“We know that physician burnout and, frankly, physician suicide has become more of an issue,” Vasagar said. “Wellness needs to be something we all think about.” A behavioral health counselor is part of the core faculty.
At least once a week, the residents gather for self-discovery exercises and to learn about each other. They may meditate, do yoga or simply get fresh air. There is a fun factor, as evidenced by their visits to ax-throwing venues and an escape room.
“It helps build a stronger team,” Eppinger emphasized. “And a stronger team translates to better patient care.”
