Halverson trains physicians in Cox Family Practice Residency

Like many health care professionals, Salute to Health Care honoree Larry Halverson, MD, seems a bit uncomfortable talking about himself. He'd much rather talk about his patients or how he's helping to train a new generation of physicians through the Family Practice Residency program, at Cox Medical Center North.

Halverson, who attended medical school at the University of Oklahoma, began practicing in 1978 as a family physician in Aurora.

In 1987, he was asked to serve on an advisory board for Cox Health Systems, which was exploring the feasibility of establishing a family practice residency in Springfield. Later that year, Cox Health Systems launched the Family Practice Residency program, and Halverson was appointed to serve as its director.

Since its inception, the Cox Family Practice Residency program has trained 67 family practice physicians. Approx-imately 60 percent of these residents go on to practice medicine in small towns located predominantly throughout southwest Missouri.

Rural needs

"There's a real need out there right now for more family physicians who can treat a wide range of problems," Halver-son said. "Rural communities have a hard time attracting specialists, so patient care in those areas tends to suffer. Having so many specialists also has fragmented patient care. The trend these days, which is being promoted by the proponents of managed care, is to move back toward having all of your health care needs managed through a primary physician."

According to Halverson, Cox's Family Practice Residency Program has developed an outstanding national reputation, and each year many medical students apply to the program.

"We've done a great job attracting students, especially if you stop to consider that there's no medical school here in Springfield," Halverson said. "We've been able to attract students from Harvard and from schools located in Minnesota, North Carolina, California you name it."

Twenty-four residents participate in the Family Practice Residency's three-year program, which provides a broad-based curriculum. Nine faculty members who are practicing family physicians supervise residents. Four other faculty members are specialists, and these specialists provide residents with training in areas such as obstetrics, internal medicine, and psychiatric care and mental health counseling.

Innovative health methods

Residents also are exposed to innovative management methods that are being used in the health care field.

In fact, the residency program was instrumental in helping implement a computerized medical record system at the clinic in 1996.

According to Halverson, the system allows multiple health care professionals to view a patient's record simultaneously. Having a computerized record system also allows different health care professionals who are treating the same patient to view what medications have been prescribed by other physicians, which has gone a long way toward preventing any drug interactions.

In addition to training family physicians. Halverson oversees the patient care provided through the Family Practice Residency Program. Halverson estimated the clinic treats between 3,000 and 3,500 patients each month. Many of these patients have no health care insurance or use Medicaid or Medicare to pay for their care.

"We see everyone here, regardless of their ability to pay," Halverson said. "Many of these people have been underserved medically.

As a result, they have a host of health care problems, many of which could have been prevented or lessened had they received treatment earlier."

Funding challenge

Getting the funding needed to provide good quality health care to patients has continued to be a challenge, according to Halverson.

Currently the Family Residency Pro-gram receives funding from a variety of different sources. Patient care reimbursements for treatment continue to provide the biggest source of funding, Halverson said, while Cox Medical Centers covers the overhead costs of housing and equipping the clinic.

The clinic also receives funds through Medicare. Occasionally, the state of Mis-souri will provide funding. Private re-search grants also help finance the facility.

To offset the financial ups and downs, the Family Residency Program recently started an endowment fund. Halverson believes the new endowment fund will play a vital role in providing funding for the clinic in the coming years, as government funding continues to dwindle and Medicare and Medicaid reimbursements are reduced.

Despite the cutbacks and funding challenges, the Family Practice Residency program has continued to serve the needs of many north Springfield residents. Halverson said he's also working hard to increase behavioral health care services, which often aren't covered under individual and group health care plans.

Senior residents also are required to conduct their own community-based health care project.

These projects have seen residents implement everything from smoking cessation programs to drives to immunize children who live in the surrounding community.

Community outreach

"I'm very proud of the community outreach work we've done here," Halverson said.

"Our residents don't just develop programs and implement them. They go out into the community and analyze what health issues need to be addressed, and then they develop a program to meet those needs."

Despite the many demands on his time, Halverson still finds time to treat patients in his own private practice. He also serves on committees for the Mis-souri Academy of Family Physicians and at the national level for the Society of Teachers of Family Medicine.

Locally, Halverson has served on numerous committees for the Greene County Medical Society. He also is a member of the board of directors of Primrose Healthcare, which is the physician-hospital organization for Cox Health Systems.