ESCOME OVERVIEW
The Challenge
Why spine? Among all medical problems, spinal disorders are the number one cause of disability and lost wages in the USA. Back and neck diseases represent the most costly medical condition for ages eighteen to fifty-five, and are second only to cardiac disease for all medical costs across all age groups. Virtually all spinal disorders (disc disease, stenosis, fractures, scoliosis, tumors, etc.) are universal in frequency and present major public health and economic burdens worldwide. For developing countries and their economies, these problems that severely impact the working productive segment of the population are especially important today.
First world countries (USA, Europe, etc.) have well established spine specialization and care is generally available. Developing countries (China, Central and South America, India, Eastern Europe, etc.) have good basic medical care, but there is a lack of specialized care. As these countries push for socioeconomic development, the need and desire for high-quality, specialized spine care is escalating. However, that care is often not available because residency spine training and fellowship opportunities are usually limited or nonexistent for the surgeons in the developing world. Consequently, there is a major shortage of doctors with appropriate training to respond to this extremely important healthcare need.
General Solution
The Emory Spine Center for Outreach and Medical Education (ESCOME) seeks to respond to the widespread lack of care for spine disease in enormous, under-served populations by providing high caliber spine training for doctors in developing countries and by assisting with the establishment of self-sustaining spine centers in those countries where appropriate need and infrastructure have been demonstrated. The program synergizes the unique contributions of Emory University (medicine, international education, political science, public health, and outcomes research), corporate sponsors (medical education, practice development, and interventional technologies) and other contributing Foundations. The solution reverses the typical paradigm of medical education ("observorships" or 1-3 day conferences) and medical outreach (U.S. physicians go overseas to hospitals that remain dependent). Over a three-year cycle, selected partner surgeons from developing countries will be brought to the U. S., paired with experienced spine surgeon mentors, and trained in fundamental or advanced spine care techniques through an intensive two-month curriculum. Upon returning home, the partner surgeons will establish centers for spine care with ongoing weekly support and quarterly visitations from their U.S. mentors. Because of the unique needs in medical education, enormous underserved population, urbanization and a rapid evolution in its healthcare system China is considered the optimal country to test this program's impact.