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The prestigious recognition is bestowed on University of Arizona alumni who have uniquely demonstrated a commitment to an academic college's success and mission through professional achievement, service or support.

Dan Derksen, MD, professor of public health and family and community medicine, has been named the College of Medicine – Tucson’s 2019 Alumni of the Year. The honor is bestowed annually by the University of Arizona Alumni Association.

Dr. Derksen completed his bachelor’s degree and medical degree and at the University of Arizona. He then went on to complete his residency in family medicine at the University of New Mexico (UNM).

After spending 25 years as a faculty member at UNM, Dr. Derksen returned to Tucson as a joint tenured professor in the Mel and Enid Zuckerman College of Public Health and the College of Medicine – Tucson.

Today, he serves the UA Health Sciences Associate Vice President for Health Equity, Outreach and Interprofessional Activities. In this role, he collaborates across the UA campus, and with stakeholders and partners statewide, to build on activities that promote health equity – including social, economic, demographic and geographic factors that affect health outcomes. 

Over his 30 years in academics, Dr. Derksen’s service, research and educational activities include collecting, translating, analyzing and reporting data to inform legislative, regulatory and program policies to improve health equity; increasing health insurance coverage; reducing the number of uninsured; narrowing health disparities; and ensuring a well-trained and distributed health workforce to meet the state’s and nation’s needs. 

For his expertise on health care policy, Dr. Derksen has been interviewed dozens of times by national and international news outlets, including U.S. News and World Report, FOX News, the Associated Press and MedPage Today. 

In a nomination letter to the UA Alumni Association, Interim Dean Irving Kron, MD, wrote, “Since our founding over fifty years ago, the UA College of Medicine —Tucson has focused on medical care in underserved populations, including border communities, Native American communities and less-developed countries. It is clear that Dr. Derksen truly believes in this mission and passes it on to our students every day.”

Dr. Derksen will be recognized on Thursday, Oct. 31 during the UA’s 2019 Alumni of the Year Awards Ceremony.  

The prestigious recognition of Alumni of the Year is bestowed on UA alumni who have uniquely demonstrated a commitment to an academic college’s success and mission through professional achievement, service or support. 

For more information about alumni affairs at the College of Medicine - Tucson, contact Jill Hall at ghall@email.arizona.edu.

Arizona is in dire need of physicians, and the need is greatest in rural areas. The Health Resources and Services Administration estimates that the state needs 563 primary care physicians to eliminate the current shortage and will need 1,941 physicians by 2030.

The University of Arizona College of Medicine – Phoenix is committed to inspiring and training medical students to one day practice in a rural setting to help underserved populations. Through the Rural Health Certification of Distinction (COD), third-year medical students can get first-hand exposure to rural health care, receive one-on-one instruction with physicians and have direct contact with patients.

“One in 10 physicians practice rural medicine, even though two in 10 Arizonans live in a rural setting,” Director of the Rural Health Professions Program Jonathan Cartsonis, MD, said. “Rural populations experience more chronic diseases like diabetes, cancer and heart disease. This is related to the fact that more elderly are living in rural communities than urban. Students need to know this. As a medical school, we have the obligation to train physicians all over the state and where they are most needed.”

The Rural Health Professions Program COD recognizes students who demonstrate a strong commitment to future rural medical practice. Students who are a part of the program have clinical exposure experiences that are outside the norms of general clinical surroundings.

In order to earn the certificate, students must model their course of study around rural health topics, including requirements like scholarly projects, on-going seminar series, recurring meetings with mentors to discuss issues surrounding rural health and a four-week summer rural pre-clinical experience. These experiences are bolstered by a minimum of 15 weeks of rural clerkship experiences from a variety of specialties.

The program had its first graduating class in 2017, and so far four students have earned the COD.

This year, five graduating students met the requirements: Lauren Dominick, Nathan Goff, Omar Hussain, Charles Smith and Michael Wasserman. They will graduate as part of the Class of 2019 during the Commencement ceremony on Monday, May 6 at 3:30 p.m. at the Orpheum Theatre, 203 W. Adams St., Phoenix.

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ARIZONA CAPITOL TIMES | GUEST OPINION | Heather Carter, Jim Rounds | May 2, 2019

Arizona’s doctor shortage isn’t just hurting our health. It hits our wallets, too

Anyone who has been or will be a patient should be concerned about Arizona’s severe shortage of doctors and nurses. They should also be concerned that the shortage may be limiting the state’s economic potential.

In most discussions about building a stronger Arizona economy, policymakers and economists discuss tax rates, economic development programs and regulations. But the provision of a quality health-care system is just as fundamental to economic growth.

Our concern is the current shortage of doctors and nurses across the state will eventually translate into slower economic growth. This would mean fewer new jobs being created in every county, lower levels of income for many, and a declining quality of life for residents.

How bad is Arizona’s doctor shortage?

Arizona is one of the fastest-growing states for overall population growth and at the same time, a leader in elderly population growth. This demographic, which brings retirement money to communities and buys second homes and cars and other things, will require quality health care services.

The state is also a leader in attracting new businesses and encouraging new ones to be formed. Many will locate to the bigger cities, but others will prefer a more rural lifestyle. These businesses and entrepreneurs examine a long list of community attributes, heath care quality among them, before growing roots.

The people in the trenches are seeing the same things that we are seeing as policy professionals. According to the University of Arizona Center for Rural Health, every county is experiencing a severe shortage of doctors and nurses, and increases in costs and decreases in quality.

That same policy brief indicates that Arizona ranks 44th nationally in primary care physicians at 77.9 per 100,000 population and meets just 41 percent of its primary care physician need.

How SB1354 addresses the shortage

The Arizona Legislature is considering Senate Bill 1354 to alleviate the state’s health care workforce shortage. The bill provides support for five programs — Graduate Medical Education, the University of Arizona Medical School, primary care provider loan repayment, medical student loan repayments, and nurse training. All of these programs will move the needle on the shortage.

Graduate Medical Education, commonly known as physician residencies, has not been state-funded in a decade, thus leaving matching federal funds on the table. Senate Bill 1354 will contribute $20 million, matched by approximately $47 million in federal funds — a total of $67 million would become available to the GME account.

We know the vast majority of doctors practice where they do their residency. The problem is that Arizona simply doesn’t have enough medical residencies. Only 42 percent of Arizona’s medical students remain in the state after graduation, as reported by the Association of American Medical Colleges.

But when they train in Arizona, they stay in Arizona. According to Dr. Bharat Magu, chief medical officer at Yuma Regional Medical Center, nearly all medical students who finish the hospital’s post-graduate training stay in-state, and 67 percent stay in Yuma.

We often need to be reminded how the smallest changes in our overall rate of growth, both in income and jobs, can have a dramatic impact on state and local finances.

This issue matters.

If passed, this initiative will improve the well-being, both economic and physical, of all Arizonans.

Sen. Heather Carter is vice chairwoman of the Senate Health and Human Services Committee.

Jim Rounds is an economist and president of Rounds Consulting Group, Inc.

AZHHA NEWS | Greg Ensell | April 23, 2019

Arizona Bill to Combat Severe Physician Shortage Will Drive State’s Economy and Patient Access to Care

PHOENIX—April 23, 2019—The Arizona Hospital and Healthcare Association (AzHHA) commissioned a study to ascertain how the passage of a legislative proposal to combat the state’s severe physician shortage would affect the economy and patient access to care. The result of the independent economic-impact study, released today, shows “significant positive economic impact” to the state and expanded patient access to care over the next ten years if Arizona Senate Bill (SB) 1354 is passed.

The bill would enable hospitals across the state to increase the number of post-graduate physician residents they train through state funding that was cut more than a decade ago. The study, prepared by Rounds Consulting Group, Inc., shows that increasing the number of physician residents at three rural hospitals alone would result in 845 new high-paying jobs and $911 million in economic output over ten years.

The benefits of educating additional physician residents aren’t exclusively economic. Arizona’s primary care physician (PCP) shortage is one of the worst in the nation, meeting only 42% of the state’s PCP needs, according to the University of Arizona Center for Rural Health. SB 1354 would also help eliminate the physician shortages that result in this limited access to care for patients statewide.

Additionally, the bill lessens the issue of physicians leaving Arizona after graduation because they are unable to secure the limited amount of in-state residency positions.

“Physicians stay where they train after graduation,” says Ann Marie Alameddin, President and CEO of AzHHA. “Almost 75% of medical students who finish post-graduate training in Arizona stay in Arizona. This means state funding for physician residencies will move the needle on the state’s physician shortage and be a game-changer for rural communities.”

In addition to restoring funding for physician residencies, SB 1354 also helps alleviate the physician shortage by appropriating state funds to four other programs: the University of Arizona Medical School, primary care provider loan repayment, medical student loan repayments and nurse training.

TUCSON MEDICAL CENTER | 04/17/2019

Benson Hospital is pleased to announce significant investments in the healthcare technology available at the San Pedro valley hospital.

“The capital investment is critical for Benson Hospital to continue to provide life-saving care to our community,” said Teresa Vincifora, RN, chief operating officer, Benson Hospital. “We are fortunate that several groups recognized the critical needs and collectively allowed us to bring nearly $200,000 of new capital to Benson.” 

The investments include:

Rural Cardiac and Stroke Program Funding

Benson Hospital was awarded $133,000 by the TMC Foundation to invest in technology and invest in programing to support its Cardiac and Stroke Program. As a critical access hospital and a sole community hospital for the extended Benson area, Benson Hospital is a critical link for patients experiencing the signs and symptoms of stroke or heart attack. The ability to rapidly respond and, when appropriate, triage to the next level of care is critical to saving brain and heart muscle. TMC Foundation funded the acquisition of a new portable X-Ray machine and a coagulation analyzer to enhance patient care and offer medical providers more detailed diagnostics. This could potentially reduce the need to transfer patients to Tucson, allowing them to receive emergent and aftercare in Benson. However, in the critical event when a patient requires more specialized care, the data captured by both enhance patient information on the receiving hospital's end. Additionally, the funding will support cardiac and stroke screenings and education in Cochise County.

Addition capital investments also include a new conference room with audio-visual equipment provided by TMC HealthCare. This new room will be used for internal meetings and community programming.

CT Power Pressure Injector

At its April meeting, the Benson Hospital Auxiliary approved the majority of funding for a power pressure injector used to provide contrast for our computed tomographic (CT scans) in the Benson Hospital Imaging Department. The contrast pressure injector is like a plunger that pushes the contrast media out of the syringes into tubing attached to a patient's vascular system. The power injector is a complex medical device that is a part of imaging procedures that can help improve diagnosis, treatment, and, ultimately, patient outcomes. Injecting contrast media into the bloodstream of patients enables visualization of various pathologies through X-ray, computed tomography, or other medical-imaging modalities. Contrast delivery is most effective and efficient using a medical device called a “power injector” that can be programmed to deliver specific amounts of contrast agent at specific flow rates. 

Arterial Blood Gas Machine

This equipment measures the amount of oxygen and carbon dioxide in a patient’s blood. This test is critical in identifying certain medical conditions including kidney failure, heart failure, uncontrolled diabetes, hemorrhage, chemical poisoning and more. The San Pedro Valley Hospital Tax District provided the $13,000 to purchase this vital technology. 

“It’s a little cliché to say that it takes a village, but in rural healthcare today, it truly does,” said Julia Strange, CEO, Benson Hospital. “The decision of the citizens in the San Pedro Valley to support the hospital district; the dedication and vision the Benson Auxiliary brings to their work every day; and the commitment of the TMC Foundation has provided funding to bring life-saving technology and programming to the Benson community – together have allowed us to make significant investment in our clinical programming that will serve the broader community for years to come.” 

Benson Hospital is a community-focused hospital with inpatient and outpatient services. Along with inpatient and skilled nursing care, the hospital is proud of its Level IV Trauma Emergency Department that is staffed with physicians 24/7, its outpatient services that include infusion therapy and wound care treatment, as well as the primary care clinic on Fourth Street and the retail care clinic located in the Safeway store.

Indian Health Service | by Tina Tah, IHS Senior Nurse Consultant

The Indian Health Service launched the Baby-Friendly Hospital Initiative in 2011. Four of the 10 IHS hospitals that have been designated as Baby-Friendly have recently achieved re-designation, indicating their ongoing commitment to promoting a healthy start for babies.

Baby-Friendly hospitals focus on increasing breastfeeding initiation and duration using quality improvement processes to improve breastfeeding rates through new maternity care and infant feeding practices. Exclusive breastfeeding protects against obesity and type II diabetes , conditions to which American Indians and Alaska Natives are particularly prone.

At the IHS we are proud to be a part of this global effort to provide better support for breastfeeding mothers in maternity wards. The initiative was introduced in 1991 by the World Health Organization and the United Nations Children’s Fund at a time when worldwide breastfeeding rates had fallen to alarmingly low levels, and commercial interests had seeped into maternity care practices. The Baby-Friendly Hospital Initiative was created to reverse that trend by changing some standard practices in the maternity ward, the setting which is most influential in a mother’s decision to initiate breastfeeding and helping her establish lactation and achieve ongoing breastfeeding success.

IHS Baby-Friendly hospitals encourage the broad-scale implementation of the Ten Steps to Successful Breastfeeding   and the International Code of Marketing of Breast-milk Substitutes. These guidelines were developed by a team of global experts and consist of evidence-based practices that have been shown to increase breastfeeding initiation and duration. U.S. facilities that achieve these high standards of care are designated as “Baby-Friendly” by Baby-Friendly USA, the authority for the BFHI in this country.

Achieving Baby-Friendly designation is an important part of the journey, but it is not the endpoint. Routine data collection, monitoring of practices and quality improvement activities are vital to ensuring that the Baby-Friendly standards are maintained. Facilities are responsible for ongoing adherence to the most currentGuidelines and Evaluation Criteria   .

IHS facilities that are designated as Baby-Friendly are required to be surveyed and re-designated every five years. The process to become re-designated can take up to two years.

IHS congratulates the four facilities that have completed re-designation:

• Claremore Indian Hospital
• Phoenix Indian Medical Center
• Quentin N. Burdick Memorial Health Care Facility
• Zuni Comprehensive Community Health Center

The Baby-Friendly Hospital Initiative has become the standard for obstetrical care in the Indian Health Service. The Indian Health Service credits patient satisfaction, promotion of mother-baby bonding, successful breastfeeding, and outstanding patient care as key factors in these successful results.

Related content:

Promoting Health through Breastfeeding 
IHS Breastfeeding Toolkit 
IHS Breastfeeding Promotion and Support 
United States Breastfeeding Committee  

Ms. Tina Tah is a public health nurse and the senior nurse consultant at IHS headquarters. She has been actively involved in efforts to promote and sustain the health promotion breastfeeding initiative since 2011 as a means to improve the services to American Indian and Alaska Native communities. She retired as a captain from the Commissioned Corps of the U.S. Public Health Service.

By LURISSA CARBAJAL | Cronkite News | Apr 5, 2019

MORENCI – It’s just before sunrise as Maggie Phillips wakes her three children in the darkness.

The oldest, Jaxon, a second-grader, is headed to school. For the two youngest, Phillips packs clothes, snacks and toys for the hour long trip to the methadone clinic.

Jesse, 3, runs around the small room he shares with his brother, Jayson, 4, looking for his favorite Spider-Man jacket. All three are dressed and ready by 7:30 a.m., when the school bus arrives for Jaxon. Phillips, Jayson and Jesse say goodbye as he climbs aboard.

Phillips straps her younger sons into their car seats and pulls out of the driveway for their once-a-month trip to Safford. The round trip is long for kids, but it’s half as long as it once was – Phillips used to travel all the way to Tucson, every day, for months, until Community Medical Services opened a year ago.

She has to get there before the clinic closes at 11:30 a.m. If she misses her appointment, she has to make the same trip the next day, or suffer drug withdrawals and miss another chance to beat her addiction.

“I have kids. I want to be sober for them,” said Phillips, 29, a homemaker whose husband stays behind to work. “The treatment helps me stay sober. It’s helped me be where I’m at today.”

Fighting opioid addiction always is tough, but it’s even tougher for rural residents who live miles from treatment clinics. Most clinics in the U.S., built in response to the heroin epidemic of the 1970s, are in big cities. These days, drug abuse has expanded to the suburbs and rural areas but the facilities to treat it have lagged because of funding shortages and the stigma around drug-treatment facilities.

In Arizona, 12 clinics treat addiction with methadone – a synthetic opioid used for decades to stabilize users and minimize withdrawal symptoms – but most are in the Phoenix area.

Tucson and Safford each has one clinic to serve the rest of Arizona outside metro Phoenix, meaning that many rural residents seeking medication for opioid addiction must travel hundreds of miles.

Advocates and opponents wrangle over whether methadone is the gold standard for treatment, if it merely substitutes one drug for another, or whether other treatments, including therapy and medication, are better.

For Phillips, who was once reluctant to take methadone, it’s a necessary step on an exhausting journey to recovery. She said not taking methadone plunges her into darkness.

“That’s the worst place I’ve ever been in my life,” she said. “I’d rather give birth every day for the rest of my life than ever feel withdrawals or feel sick again – it’s awful.”

In 2016, the opioid crisis in the U.S. cost more than $56 billion in law-enforcement costs, emergency-room visits, lost productivity and premature deaths, according to the Centers for Disease Control and Prevention.

Even as deaths have quadrupled over the past decade, the CDC says the number of people in methadone treatment has ticked up by less than 25 percent. Arizona health officials have recorded nearly 20,000 overdoses and nearly 2,800 deaths since 2017.

Phillips has struggled with opioid abuse since she was 15, starting with prescription pills before moving on to heroin. Her life to sobriety began when she was 20 and discovered she was pregnant with her first child, Jaxon, and decided to get sober. Phillips said she stayed away from drugs for a couple of years but relapsed after she was given medication to treat an injury.

Phillips started her methadone treatments when she was 25 and pregnant with her second child. She was reluctant at first, believing she would just be replacing one drug for another.

“I was like, ‘I really don’t want to do the methadone,’ and there was this awesome nurse that explained everything to me.”

Methadone imitates how opiates act within the brain, changing how the brain and nervous system respond to pain. It lessens the symptoms of opiate withdrawal and blocks the euphoric effects of such opiates as heroin, morphine and codeine. The right dose of methadone can eliminate withdrawal symptoms without causing the patient to feel high.

“I never wake up and go, ‘I can’t wait to take my methadone.’ It’s just part of the day, like drinking a cup of coffee,” Phillips said.

Clinics like the one in Safford usually are open for six hours a day, closing by noon or, at the latest, early afternoon. But at least Phillips has her 2014 Chevrolet Impala to drive to the clinic once a month.

“We encounter a large majority of our patients having transportation issues, and living here in a rural area like Safford, Arizona, you don’t know where they’re coming from,” said Keith Jeffery, clinic manager for Community Medical Services.

When patients first start treatment, they must visit the clinic every day – a travel time of one to four hours. Several months later, the trips may decrease to twice a month, later falling to once a month.

Patients spend nearly $50 per week just on travel costs, and they often have to drive backroads. The lack of transportation leads to patients missing treatments, which results in more relapses.

“They can be coming from any of those small towns, so the travel can be treacherous at times,” Jeffery said.

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