There are more than 1,400 physicians practicing medicine in El Paso, but not all of them are MDs, or medical doctors.
Just over 100 are DOs – doctors of osteopathic medicine – but it’s unlikely that many of their patients know their doctor is any different from the rest.
The number of DOs in El Paso is likely to grow because two years ago in Las Cruces, the privately funded Burrell College of Osteopathic Medicine, or BCOM, accepted its first class of 162 medical students.
BCOM’s new dean is 67-year-old Dr. Don Peska, a DO who spent 13 years in private practice as a thoracic surgeon in Fort Worth before joining the faculty at the University of North Texas Health Science Center.
He became dean of NTU’s Texas College of Osteopathic Medicine in 2009 and retired in 2017.
He was doing consulting work that included accreditation inspections for the Commission of Osteopathic College Accreditation when BCOM called in February and asked him to step in as interim dean.
“After about a month, they asked if I would be interested in staying at least through final accreditation in the spring of 2020,” Peska said.
By then, Burrell College of Osteopathic Medicine expects to have four full classes and about 625 students. By comparison, Texas Tech’s Paul L. Foster School of Medicine’s enrollment is 414.
The largest group of Burrell’s 324 students comes from California with 67 future DOs followed by Texas with 54 and New Mexico with 33.
“What this means is doctors in this area aren’t only going to come out of the Foster School of Medicine,” said Tanny Berg, who recently arranged for Peska to speak to the El Paso Central Business Association. “There’s a good chance that more of them will stay in El Paso or places like Deming and Silver City.”
Peska now carries the titles of dean and chief academic officer of the for-profit medical school that investor Daniel Burrell funded with $85 million and built on the campus of New Mexico State University in Las Cruces.
It’s the first such arrangement in the U.S. because Burrell is only the second for-profit medical school in the country and it’s on the campus of a public university.
That’s an interesting marriage, some would say – but not Peska.
“It’s not a marriage; it’s a co-habitation. We are fully independent,” he said.
El Paso Inc. caught up with Peska by phone for an interview about the differences between DOs and MDs, how few people even notice and what having two medical schools could mean to El Paso and the region.
Q: Burrell is the second for-profit med school for osteopathy in the U.S. What was the first?
The first for-profit osteopathic school was Rocky Vista University College of Osteopathic Medicine in Denver.
Q: Your graduates will be doctors of osteopathic medicine, or DOs. Graduates of the Texas Tech Paul L. Foster School of Medicine will be MDs. How is medical training different at the two schools and are graduates regarded equally as physicians?
The core clinical and basic science education is the same. Every medical school has its own method of curriculum delivery. So while there may be some uniqueness to that, the content of that curriculum is going to be the same.
But osteopathic medical schools include, in addition to the clinical and basic science core, content that applies principles of osteopathic medicine. These principals include a holistic approach to diagnosis and treatment. That is a recognition that body systems are interrelated and can’t be treated in isolation from each other.
And, perhaps the hallmark is the inclusion of osteopathic manipulative medicine, which is the use of manual techniques that were part of the origin of the science in the late 19th century. They really have evolved into adjunctive methods of diagnosis and therapy that are in addition to what we recognize as modern clinical medicine.
Q: What do you mean by adjunctive methods of diagnosis and a holistic approach to medicine?
Looking first at the holistic approach to the patient is recognizing that body systems are interrelated and that when someone comes in, for instance, with respiratory symptoms, there may be more than just a lung problem but symptoms of other areas as well.
I wouldn’t say we are unique in this regard, but it’s become more of a concentration in osteopathic schools. We want to raise student awareness of looking at all of the patient, and not just the complaint that brought them into the office that day. Their medical problem may be related to something that is less obvious. That’s one part of it.
The part that is different from MD granting schools is the inclusion of manual medicine. For example, a patient who has pneumonia you can treat with an antibiotic and expect that will help clear up the pneumonia. But there is osteopathic musculoskeletal manipulation that can increase blood flow and lymphatic drainage of the chest, which accelerates the improvement of that patient.
Q: There are 1,345 MDs practicing in El Paso County and 103 DOs, according to the Texas Medical Board, so there are some DOs here. Where else can a student earn a doctorate in osteopathic medicine?
There are 39 colleges of osteopathic medicine in this country.
Q: Is this type of medicine and treatment similar to something you’d find somewhere else in the world?
From the standpoint of osteopathic manipulative medicine, it is uniquely an American invention. If you see the term “osteopathy” in Europe, those are usually chiropractors.
Q: How are accreditation requirements different for DO and MD medical schools?
While the accreditation requirements are nearly identical, the requirement for osteopathic medicine training is present for osteopathic schools. In the MD granting schools, like the Paul Foster school in El Paso, there is much more rigor attached to the availability of research in that environment. So many times the choice to open an osteopathic medical school is made by organizations that find it less costly because that active research requirement is minimal in osteopathic schools.
That is not to say research does not exist. My previous employer had about a $50 million research budget.
Q: When there are four full classes of medical students at BCOM in two years, how many students will you have?
648 minus 20 or 25 or so for various forms of attrition.
Q: Why would a student choose one type of medical school over the other – that is MD over a DO?
Generally, students are more apt to pick an MD school because of the availability. Outside of the Texas College of Osteopathic Medicine, TCOM, all of the Texas state universities are MD schools. So the cost is less. There is a greater public awareness of MDs.
But there are students who select osteopathic medicine specifically as their preference. When I was at TCOM and had data to work with, I knew that a quarter of my students selected that school and turned down an appointment at an MD-granting school in the state.
They found the curriculum appealing along with the philosophies behind what we were offering. Sometimes, they found Fort Worth appealing. It’s a very individual decision. Roughly a quarter of students in the country are selecting osteopathic medicine.
Q: Are DOs more likely to become family practitioners? I know MDs often want to go on to specialties that are more lucrative.
We would generally find that half to 60 percent of DOs will go on to primary care – family medicine, pediatrics, internal medicine or OB-GYN compared to under 20 percent of MDs.
Q: How is it that Burrell came to Las Cruces and to the campus of New Mexico State University – a public institution? It’s an interesting marriage.
It’s not a marriage, it’s a co-habitation. We are fully independent. We lease the premises that we occupy. We also provide within our fees access for our students for certain services on the NMSU campus.
Q: That includes the dormitories and other services, doesn’t it?
I do believe there are some students who are in student housing. It also provides access to health services, recreational facilities on campus, libraries and things like that.
Q: At Burrell College, tuition is $45,000 to $48,000 a year. That’s very expensive. How do students afford it?
Actually, it is lower than the median for a private medical school in this country. They do it with student loans if the family doesn’t have the resources. There are student scholarships we are able to award through the supporting foundation that we have.
Q: Tuition at the Paul Foster medical school is $18,000 a semester. Why so much less?
They receive state formula funding, generally, of about $47,000 per student, per year.
Q: So you are not out of line with private medical schools even though you are for-profit?
Correct. And you should probably recognize that Texas is exceptionally low for state universities. For many state medical schools, the tuition I believe is above $30,000 a year. So when you compare us to state (medical) schools in general, we are not that high.
But I will also say medical schools are the greatest source of revenue for state universities that have them. Much of the revenue that comes in for a medical school can be diverted to support other programs on campus. So because we have no other programs that we are diverting our resources to, our actual operating expenses are pretty much using the same total funds.
Q: Are scholarships available for Burrell students?
We have a variety of scholarships that are provided by members of the community and a supporting foundation at the state association level. The Burrell family themselves have presented us with a number of full-ride tuitions for students.
Q: Are the academic standards for admission to Burrell are pretty much the same as medical schools like Foster or Baylor?
Our mean undergraduate grade point average is near a 3.5, so we have excellent students. Their scores on medical college admission tests, which is a nationally standardized test, are going to be a few points lower than more established schools. But they are well within the range that we feel the student will be successful. We know that historically from other schools.
Q: What will it mean to have two medical schools in the region?
It means you increase the likelihood of being able to recruit physicians to enhance the health care workforce in this region. The reason is you now have another school that’s building post-doctoral programs and residency programs. And we know that the graduates of those programs are likely to stay in the area where they train.
Because of our mission, we have more students from the region who are being accepted to our medical schools and staying local. And we are training in hospitals where they were not previously training in. So this community benefits.
Q: Paul Foster medical school has affiliations with University Medical Center and now with Providence in Northwest El Paso. Where will your students train?
We have affiliation agreements with UMC, but our principal teaching hospitals in El Paso are going to be at Del Sol and Las Palmas as well as the psychiatric hospital related to Mesilla Valley Hospital. We are also using Memorial Medical Center and Mountain View here in Las Cruces as our primary teaching hospitals. Their doctors are our faculty.
Q: Will your graduates be more likely to stay in this region and the smaller cities like Deming or Silver City that could probably use more family physicians?
To the extent that we’re seeking to recruit from those communities for our students, it is for that very reason with the hope they will come back here. Even if they have to leave the area for their training after graduation, we hope they’ll come back here because this is home.
To the extent that we can continue to grow new residency programs so they don’t have to leave at all, we know there’s a greater opportunity for that to happen.
Q: Is there a possibility of future research collaboration between the Burrell and Paul Foster medical schools?
I’m going to say that is inevitable. What often happens is that once we reach our full accreditation and are seen as established, we will gain more respect from the faculty and administration at Paul Foster and in their willingness to work with us where it’s beneficial to both of us.
Q: Would you tell us about yourself? How did you come to be dean of the school?
I’m 67 years old, a native of Brooklyn in New York. I went to osteopathic medical school in De Moines, Iowa after graduating from Brooklyn College. From De Moines, I went to the Detroit, Michigan area where I did my medical clinical training as a student and stayed and did residency training in general surgery and then in cardio, thoracic and vascular surgery.
I stayed in the region and practiced for a time before moving with my family to Fort Worth, Texas where I continued my practice of thoracic surgery. I was in Fort Worth for 35 years. I spent the first 13 years in private practice and then the next 22 years at the University of North Texas Health Science Center where I began as faculty and rose though the ranks to gain a full professorship.
I served as program director for our residency training and then as assistant dean for clinical education, associate dean for academic affairs and then associate dean for educational programs and finally dean of the Texas College of Osteopathic Medicine until my retirement in 2017.
Q: But you didn’t retire.
I retired from my service to the state of Texas at that time. After a short period doing consulting work, including accreditation inspections for the Commission of Osteopathic college accreditation, I was contacted by Burrell College.
Email El Paso Inc. reporter David Crowder at firstname.lastname@example.org or call (915) 534-4422, ext. 122 and (915) 630-6622.