Winter Haven Hospital and FSU Closing Gap on Healthcare

Dr. Nathan Falk recites statistics easily, indicating he’s already done considerable research during his three weeks as the first program director for the Florida State University College of Medicine Family Medicine Residency Program at Winter Haven Hospital.

For instance, did you know that more people ages 18 to 64 are insured in Polk County than the state average, but “when surveyed, they have more difficulty accessing care and finding physicians than the U.S. average,” according to state and local data collected by Falk, 40, and information gleaned at last summer’s BayCare Community Health Needs Assessment Prioritization meeting.

A big part of that focuses on the number of primary care physicians per 100,000 residents, Falk says. The national average is 88. The Florida average is 80. But “Polk County is way off that mark at 51.”

He gives an example: 42 percent of people surveyed in the Winter Haven area got no prenatal care in their first trimester of pregnancy compared to 17 percent, the national average.

Winter Haven Hospital and Florida State University (FSU) announced early this year they were forming a partnership to recruit doctors to do their residencies in Polk County. That followed a study commissioned by the hospital’s foundation to figure out how to solve the primary-care physician shortage and to help improve health care availability in the area.

Steve Nierman, president of BayCare’s Winter Haven Hospital, says the partnership is moving ahead. “Winter Haven Hospital’s new family medicine residency program is in the development phase and progressing nicely. Our counterpart, Florida State University, has been a strong partner and we’re excited to have achieved our first milestone – hiring Dr. Falk as the program director.”

Falk, who received his medical degree from the University of Nebraska Medical Center College of Medicine, says it’s the perfect partnership.

“The chance to partner with FSU, which is really a mission-driven organization in terms of access to health care and the health-care disparity, (is a) perfect fit (for) Winter Haven and Polk County,” he says. “The health-care needs in this area, particularly around primary care being one of the highest needs identified, seemed like a real good mission fit between those organizations.”

Falk, who most recently was medical director and associate program director for the Florida Hospital Family Medicine Residency Program in Orlando, said the residency program “will provide direct access to care” as faculty members and residents take on patients, adding to the number of primary care physicians here.

“We will start to provide a pipeline of new primary care physicians to the county (Lakeland – Winter Haven MSA) via our graduates,” said Falk, who served in the Air Force and was also in private practice. “We will graduate six physicians each year, and the goal is to keep 75 percent in Polk County and Central Florida to practice. It’s really the only way we’re going to be able to start to close that gap. Surveys suggest 75 percent to 80 percent of residents go on to practice where they trained.”

The program will have six residents in each class, starting in 2020. If there’s a need for more than six — the national average — in the three-year program, he will try to find funding to expand, he says.

Four main tasks remain:

• Falk must develop a curriculum to become accredited by the Accreditation Council for Graduate Medical Education. “You have to have the curriculum, especially in family medicine, where they have to learn pretty much everything. I’m designing the three-year curriculum for them to get skills in in-patient, outpatient, pediatrics, orthopaedics” and more.
• He must hire faculty, predicting that number will be six to eight. “I’m in the process of recruiting core family medicine faculty who will be the ones who work in the new family medicine clinic. They will see patients there.”
• He must recruit volunteers. “I’m meeting with local physicians of all specialties to try to recruit volunteer faculty,” seeking everyone from cardiologists to obstetricians to surgeons, Falk says. Volunteers will see patients in their own facilities. “I’ll have as many of them as will have us. I sent a letter and have a number of people so far who have been really excited and committed to work with us.”
• The new academic training facility must be completed. The residents’ facility will be part of the Winter Haven Hospital campus, but located about a mile from the main hospital at the Outpatient Behavioral Health building at 1201 First Street South. The behavioral section was just renovated, allowing construction of the training facility to begin. Nierman says construction is on track, and Falk says the expected opening date is July 1, 2019. Falk thinks being next to the behavioral clinic is critical because the community health needs assessment showed access to mental-health care also came in as an area of concern. “A lot of mental-health care can and really should be managed on the front line by primary care physicians. That’s a big area of interest by the family medicine training organizations.”

Beyond all those items on the director’s to-do list, he also wants “to form partnerships with other community groups and help them in patient-care needs, educational needs, interactions with the community,” Falk says. “I want to form partnerships so we can all help take care of the population of Polk County.”