Dr. Shane Speights was a founding faculty member of the NYITCOM at A-State campus, and he was named dean in 2017. He is board certified in family medicine and completed his residency training at the UAMS Northeast Family Medicine Residency in Jonesboro.
Speights graduated with a bachelor’s in business administration from Henderson State University in Arkadelphia. He received his medical degree from Kansas City University College of Osteopathic Medicine in Missouri.
What percentage of NYITCOM’s Jonesboro graduates have remained in Arkansas to practice medicine? Are you satisfied with that figure?
At this point, more than half of our alumni are still in their residency training and haven’t committed to practice yet. Of our first three classes, we have about 60 graduates that have signed to practice in Arkansas. We’d always like to see that number increase, but we celebrate the fact that we now have alumni practicing in rural areas like Piggott, Wynne, McGehee, Highland, Mena and Crossett in addition to several in Jonesboro, Conway, Little Rock and northwest Arkansas.
Of those who have begun practice, a vast majority of our graduates who are from Arkansas are staying to practice here. We’re confident that our new Freshman to Physician Pathway program with Arkansas State University and our Pre-Med Pathway program with Henderson State will increase our enrollment of Arkansas natives, which will increase our number of graduates who commit to stay in state to practice.
What is the biggest misconception about osteopathic medicine?
I’d say it’s the fact that a D.O. degree is an equivalent degree to an M.D. We just have a different approach to training and practice. The curriculum at osteopathic schools is very similar to that of allopathic schools except that osteopathic physicians take additional coursework in assessing and treating musculoskeletal dysfunctions of the body. D.O.s can and do practice in any medical specialty.
Has progress been made getting more residencies in Arkansas’ rural areas that have the highest medical care gaps?
There’s been tremendous progress. Prior to 2015, residency training in Arkansas was only being done in academic institutions. When the two osteopathic schools opened, we helped a number of community hospitals throughout the state understand the need and opportunity that existed to start new programs. Over the last 10 years, there have been 26 new residency programs open in the state, accounting for more than 220 annual positions. The osteopathic schools were responsible for 20 of those new programs. There have been eight new family medicine programs and 10 new internal medicine programs open in Arkansas over the last decade.
However, to close the gap we need to be more intentional. Just look at our state health outcome data. We are not meeting the immediate needs of Arkansans. We have to rethink and reimagine how, and where, we educate physicians. Arkansas has the ability to lead in this area and set up a model for other rural states to follow. There were national accreditation changes in 2021 that now allow for physician residency training in smaller communities and rural areas. We need to capitalize on that opportunity to create a physician workforce pipeline that will meet our needs now and for generations to come. In fact, such a model could be deployed to fill other workforce shortages in needed communities like education, health care, manufacturing, technology and so on.
Most osteopathic students enter primary care fields such as family medicine, internal medicine and pediatrics. Why and what are the advantages of being a D.O. in those practices?
I think it has to do with how and where our students are trained. Most D.O. schools don’t own hospitals. Instead, we partner with community-based hospitals across the state and region, where our students rotate for their clinical training years of medical school. Because we train our students this way, they see those specialties differently than they would if they were in a large academic setting where referrals are readily available and the physician’s job just looks a lot different in those “front line” specialties.
The national data tells us that this training model significantly increases the likelihood of them wanting to practice in similar areas. To that, approximately 25% of our NYITCOM graduates choose family medicine compared to 8-10% nationally.
Part of osteopathic medical education is to teach physicians to look at the “whole person,” which has become a buzz word in recent years. From our stance, it is an approach to medical care where we work to fully understand the patient and all the factors affecting their health, not just their presenting symptoms. For example, if you saw me in clinic for a cough and runny nose, don’t be surprised if I ask what you ate for breakfast. What type of physical activity you get, how many hours of sleep you typically get, or do you feel more stressed at work/home than usual? We believe that proper nutrition, activity, sleep and mental wellness should be addressed at most clinic visits and that they represent the cornerstone of health. We still prescribe antibiotics and other medications when warranted, but it is in concert with addressing lifestyle changes.
Those approaches all lend themselves to primary care, and we are intentional about recruiting students who want to serve their communities and provide direct patient care in needed areas of our region.
What technological advancements in medicine are you most excited about?
Physician burnout is real, and it’s worsening the physician shortage in our state, not to mention the harm it causes to patients. Artificial intelligence (AI), and specifically Ambient AI, is rapidly changing the workload of the physician by removing barriers between the doctor and the patient. We are using it in our NYIT clinic and exposing medical students to it.
Another area that is being underutilized is telemedicine. We start teaching first year medical students on the use of telemedicine, and how it can be an asset to bring services to patients who otherwise would not be able to get them. They continue to get that education during their time at our school. We are actively working on a program to deliver the same education to resident physicians. The issue is that we keep getting in our own way, and have yet to truly incorporate it to serve the citizens of Arkansas. I suspect it’s because power and politics are at play. It’s unfortunate.
To be clear, our health care system is an absolute mess, and patients are suffering because of it. Anyone reading this can give me their story on how the system failed them or someone they know, and the issue doesn’t sit with the people working in health care. It’s a broken system. We are finally seeing some glimmers of hope in how technology can remove some of the obstacles to achieving good health. We just need to lean into those opportunities.
What leadership lessons have you learned from being the dean?
Most physicians will recognize this response: TNTC. That stands for “too numerous to count.” One of my mentors, Dr. Barbara Ross-Lee, who was the founding dean of NYITCOM at A-State, would always encourage me to “take the high road” and “seek the higher ground.” Regardless of the circumstance, regardless of the issue, regardless of the emotions you may feel, take a step back and look at what is best for the population you are serving (students, patients, employees, etc.). That virtually always reveals the right path to take. I’m grateful for that wisdom. It hasn’t always been easy, but it has served me well.
How is AI being used in medical education and practice?
AI adoption in health care is too slow, specifically in Arkansas, and it is unfortunate, but not entirely surprising. As a profession we are typically slow to adopt new practices, technologies and endeavors largely due to a fear of making a mistake – just ask a surgeon. That’s why the average physician practices medicine 10-17 years behind the current evidence. For the sake of the people in our state it needs to change, and having all four medical schools in Arkansas partner with every community physician, and hospital, could go a long way in addressing that need.
It’s no secret that the doctor-patient relationship is broken, and, as physicians, we are failing to deliver on our social contract with the population. We’ve all been burned on the promise that the electronic medical record would solve these issues. However, leveraging technology correctly can help improve care. We are using AI in our NYIT clinic space to help the physician be more efficient, and reduce the time spent in front of the computer. We are also working to incorporate the use of AI in our medical school curriculum, as well as in our institutional operations. I use AI in my own practice to ensure that I don’t miss something, and that I am practicing current evidence. It’s an amazing tool that every physician can, and should be, using. At some point, I can see it being negligent not to use it.
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