Cecil G. Sheps Center for Health Services Research,
The University of North Carolina at Chapel Hill

October 2016
Summer is a time to relax, re-energize, revise and resubmit. Our team spent the summer scattered across our home state of North Carolina, Iowa, Mississippi, France and New Zealand. As a new season begins, we'd like to share what we've been up to for the last few months.

Contents:
Medical Education in North Carolina

Data show North Carolina is net importer of physicians

 
The majority of physicians practicing in North Carolina were educated in medical schools and residency programs outside of the state. A series of three briefs describes where NC physicians completed medical school and residency, and shows the contribution of the UNC-Chapel Hill School of Medicine to the state's physician workforce.
 

Where did North Carolina Physicians Complete Residency?
 
Trends in Residency Location for Physicians in Active Practice in NC, 2000-2014
Authors: Kathryn Lavoie, Jim Terry, Katie Gaul, Julie Spero, Erin Fraher
Date: June 2016 
Read the brief.
 
Where did North Carolina Physicians Go to Medical School? Trends in Medical School Location for Physicians in Active Practice in NC, 2000-2014
Authors: Erin Fraher, Kathryn Lavoie, Katie Gaul
Date: March 2016
 
Read the brief. countDocs
Manuscripts and Reports
 
Featured Product: Building a Value-Based Workforce in North Carolina
Erin Fraher and Tom Ricketts served as guest editors for a recent issue of the North Carolina Medical Journal, in which they issued a call to action to broaden the definition of the health workforce to include social workers and other community-based workers, retool and retrain the workforce to practice in new models of care, shift training from inpatient to community-based settings and increase accountability for public funds spent on health professions education.
    


Citation: Fraher E, Ricketts TC. Building a Value-Based Workforce in North Carolina.
North Carolina Medical Journal. 2016; 77(2): 94-8.

Other Recent Manuscripts and Reports 
Ricketts TC, Adamson WT, Fraher EP, Knapton A, Hirschl R, Abdullah F, Klein MD. (2016). Future Supply of Pediatric Surgeons: Analytical Study of the Current and Projected Supply of Pediatric Surgeons in the Context of a Rapidly Changing Process for Specialty and Subspecialty Training. Annals of Surgery. 2016 June 8. [Epub ahead of print]

Domino ME, Lin CC, Morrissey J, Ellis AR, Fraher E, Gaul K, Richman E, Thomas K. The Psychologist Workforce in North Carolina: Expanding Access for Patients in Rural Areas. Cecil G. Sheps Center for Health Services Research. The University of North Carolina at Chapel Hill. June 2016.

Gaul K, Moore J, Fraher E. Collaborating with Licensing Bodies in Support of Health Workforce Data Collection: Issues and Strategies. Health Workforce Technical Assistance Center, SUNY-Albany. May 2016.


Ricketts TC, Spero JC, Fraher EP. Counting Physicians in Specialties: By What They Do or How They Train. Journal of Medical Regulation. 2016 April; 102(2):13-20.
 
Newton W, Wouk N, Spero JC. Improving the Return on Investment of Graduate Medical Education in North Carolina. North Carolina Medical Journal. 2016; 77(2):121-27.

Spero JC. Running the Numbers: Does North Carolina's Health Care Workforce Reflect the Diversity of the State's Population? North Carolina Medical Journal. 2016; 77(2):141-45. 
 
Fraher E, Morgan P, Johnson A. Specialty Distribution of Physician Assistants and Nurse Practitioners in North Carolina. Journal of the American Academy of Physician Assistants. 2016; 29(4):38-43. 
HWRC 
Carolina Health Workforce Research Center

Created in 2013, the CHWRC is one of six national Health Workforce Research Centers funded through cooperative agreements with the National Center for Health Workforce Analysis in the Bureau of Health Workforce in the Health Resources and Services Administration (HRSA). The mission of the CHWRC is to conduct and disseminate timely, policy-relevant research on the flexible use of healthcare workers to improve the quality and efficiency of health care. 

Projects in 2016-17 include
Access briefs from previous CHWRC projects here. service
Service Spotlight
 
Julie Spero presents at the NC Oral Health Summit
Disseminating data and analyses through presentations is a key role for our staff. In September, Julie Spero presented demographic and education data for dentists and dental hygienists practicing in North Carolina, along with information on strategies used by North Carolina and other states to address oral health needs. This information will be used by stakeholders to inform policy discussions and other activities to improve access to better oral health in the state.

Julie Spero. "
North Carolina's Oral Health Workforce: Challenges and Strategies." NC Oral Health Summit - Achieving Oral Health for All North Carolinia ns. Cary, NC. September 2016.
 
See more presentations here. macy

Erin Fraher participates in Josiah Macy Jr. Foundation Conference
Erin Fraher was one of 40 leaders in nursing, primary care, healthcare delivery, philanthropy, and academia brought together at a June 2016 Macy Foundation Conference to generate recommendations on how registered nurses could be deployed to help meet today's urgent needs in primary care. Recommendations from that report were just released at http://macyfoundation.org/publications/publication/conference-summary-registered-nurses-partners-in-transforming-primary-care.

Erin Fraher serves as co-chair of the planning committee for the National Academy of Sciences Global Forum on Innovation in Health Professional Education 
Erin and Warren Newton, director of the NC AHEC Program, are serving as co-chairs of the planning committee for the National Academy of Medicine's October 6th-7th Future Financing of Health Professional Education (HPE) Workshop .

 
News evan

Evan Galloway joins Program team as a data visualization analyst
Evan Galloway has joined our team to develop web-based, interactive visualizations for exploring health workforce data. He received his Master of Professional Science in Biomedical and Health Informatics degree from the University of North Carolina at Chapel Hill and his Bachelor of Science degree from the University of Washington. Be on the lookout for Evan's creations in 2017.

The Workforce Program welcomes new and returning students
Teaching and mentoring the next generation of health workforce researchers is an important part of our Program's mission. We have three graduate research assistants from the Department of Health Policy and Management at the Gillings School of Global Public Health lined up to work with us for the 2016-17 academic year.   
FutureDocs Forecasting Tool featured in newest Physicians Foundation Grantee Perspective
The Physicians Foundation featured the FutureDocs Forecasting Tool in a Grantee Perspective. The article highlights the value the FutureDocs Forecasting Tool has brought to federal and state policymakers, specialty societies, and physician practices. By using the model to view customized scenarios, these stakeholders are able to project the effect of changes in residencies, retirement rates, and NP/PA usage on the physician supply and demand for healthcare services by specialty, clinical service area, and geography.
Erin Fraher visits New Zealand to study demand-side workforce planning approaches
Historically, workforce research and planning efforts in the US have taken a supply-side approach that asks, "how many doctors, nurses or other health professions do we need?" New Zealand has taken a very different and innovative, demand-side approach that asks, "what are the patient's needs for care and how might health professional roles, regulation and education be redesigned to meet those needs?" In 2016, Erin was awarded a Junior Faculty Development Award and a University Research Council award from UNC Chapel Hill to assess whether New Zealand's approach could be adapted to health workforce research and planning in the United States. She spent the summer (NZ winter!) in Wellington, working with Health Workforce New Zealand in the Ministry of Health. Stay tuned as her work progresses.holmes
 
Mark Holmes appointed new director of the Sheps Center
We are pleased to announce that Mark Holmes, director of the North Carolina Rural Health Research Center and a collaborator with our workforce team, was appointed as director of the Sheps Center. He began his new role on August 1, 2016.  
Read the news release 
We want to hear from YOU
Have you used our data and research in your work? If so, please drop a note to  erin_fraher@unc.edu or k_gaul@unc.edu and tell us how our data, presentations, fact sheets or reports have been useful in your work. We'd also like to hear about the types of information that you'd like to see from our program in the coming year.
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