by Ryan Ori
Originally Appeared in the Peoria Journal Star September 23, 2008

To recognize Peoria’s level of medical sophistication, Dr. Sara Rusch simply looks to the sky.

“We have all these helicopters flying in and out for a reason,” said Rusch, dean of the University of Illinois College of Medicine at Peoria. “We do offer lots of care that’s not available elsewhere.”

Peoria serves as a regional referral center, meeting the advanced medical needs of 23 counties.

“I think Peoria doesn’t realize how good the speciality community really is here,” Rusch said. “I recruit people who come from other places throughout the country, and they tell me that we have an exceptionally good medical community.”

A combination of factors provides Peoria with a mix of medical specialists surpassing many similar communities.

Downtown not only enjoys the presence of two large, expanding hospitals in OSF Saint Francis Medical Center and Methodist Medical Center. Peoria also is rare in that it has a St. Jude affiliate and, within the walls of St. Francis, the Children’s Hospital of Illinois.

Among children’s care, central Illinois enjoys relative rarities in pediatric heart surgeons Dale Geiss and Randy Fortuna and pediatric neurosurgeon Julian Lin. Pediatric ophthalmologist Steve Lichtenstein of Illinois Eye Center, former chairman of the American Academy of Pediatricians Section on Ophthalmology, provides testing for retinopathy of prematurity in babies born at 30 weeks or earlier.

“It just means that we can take care of almost any problem that comes up with kids,” said Dr. Jim Hocker, medical director of the neonatal intensive care unit at the Children’s Hospital of Illinois. “We do have to occasionally send some things to Chicago or someplace like that. But in little old Peoria, if your child has some type of disease or surgical problem, almost always they can get treatment here. They don’t have to go to Chicago or St. Louis.”

Also Downtown are the University of Illinois College of Medicine at Peoria (UICOMP) and its new neighbor — the Illinois Medical Center, a 127,000-square-foot home to about 45 sub-specialty physicians.

One of the movers of that project is Dr. Andy Chiou, another example of a unique Peoria specialist. The Peoria native, a partner with Peoria Surgical Group, is one of just 2,500 board-certified vascular and endovascular surgeons in the United States.

“We’re doctors’ doctors,” Chiou said. “When doctors need help, they call the specialists. If you don’t have a good core of specialists, you would likely hemorrhage patients off to other communities.”

Chiou estimates Peoria’s medical community covers about 95 percent of patient needs, with only rare procedures — heart and liver transplants, for example — requiring a trip elsewhere.

“The strength of our specialists is reflecting overall the strength of where we rank as a health-care community,” Chiou said. “That has permutations across the board for our community as far as economics — who retires here, who moves back here, who raises their family here.”

Nevertheless, Rusch and Dr. John Halvorsen, UICOMP’s associate dean for community health, see problems ahead, not just here but everywhere as fewer doctors choose to become primary care physicians. The problem will be two-fold as baby boomers age: large numbers of primary care physicians reaching retirement age, and an overall bump in America’s senior citizenship.

Halvorsen, a proponent of primary care, wrote the initial grant to start the Rural Student Physician Program at UICOMP. In a decade since RSPP started, 76 percent of participants have gone on to practice in rural communities, where there are shortages of doctors.

But Halvorsen still sees the need for large-scale changes.

“A lot of medical students are choosing not to enter primary care for a variety of reasons,” Halvorsen said. “One of them is lifestyle. The perception is, there’s a number of specialties out there that will give them a better lifestyle where they can work a 9-to-5 job and not have to take calls as often. Furthermore, those jobs pay more. If I can make three times as much and have a more livable lifestyle, why not do that?”

By the time a budding doctor finishes undergraduate education, medical school, residency, and in some cases a fellowship, debt has accumulated. Rusch said the average indebtedness of a UICOMP graduate is about $180,000.

During three to seven years of residency, a doctor might make less than $50,000 per year while working 80-hour weeks.

“When you’re 24 or 26 and you have $150,000 or $200,000 in debt, are you going to get into a job that makes $100,000 a year or one that makes you $350,000?” Chiou said. “Sometimes there’s the decision-making right there.”

Halvorsen praises the quality of Peoria’s specialized physicians but believes surgeries are reimbursed disproportionately.

“How are we prioritizing how we pay for services in this country?” Halvorsen said. “We’re underpaying for cognitive services — doing the exam, looking at lab data, finding a solution and explaining it to the patient — and over-paying for procedural services. We need to balance that out in some way.”