When physical therapist William Mackley, D.PT. began private practice in North Platte, Neb., in 1997, his patients included school children to middle-age adults. But today 25 percent of the people coming to his office are age 55 or older, one of the fastest growing age groups in Nebraska. Advancing his knowledge about the medical needs of America’s aging population seemed good common sense.
That’s why he is now the first health professional in Nebraska to complete the Geriatric Mini-fellowship offered through the University of Nebraska Medical Center’s Nebraska Geriatric Education Center (NEBGEC). Dr. Mackley completed the distance learning program in June and eventually will be followed by more than 100 other health professionals in the state currently enrolled in the program.
“We are excited to have our first completer,” said Jane Potter, M.D., section chief of geriatrics, professor of internal medicine at UNMC, and president of the American Geriatrics Society. “There are over 100 individuals enrolled in the mini-fellowship. The number of enrollees has exceeded our expectations and suggests that health care providers in the state see geriatrics as enormously important and a huge and growing need in their practices.”
UNMC received a five-year, nearly $2 million grant from the Department of Health and Human Services to educate and train health professionals and faculty members across the state in geriatrics and gerontology. The training is available to professionals in medicine, nursing, physician assistance, pharmacy, physical therapy, social work and advanced practical nursing.
“Unfortunately because of the loss of federal funding in last year’s budget, we will only be able to support fellowships through the summer of 2007,” Dr. Potter said. “We are trying to get the word out that those who are enrolled should make plans to complete the requirements in the next year.”
The curriculum includes a mini-fellowship program that consists of 80 hours of interdisciplinary and discipline specific training, with the option of taking an additional 20 hours of faculty development. Other training activities include master’s preparation in gerontological nursing and geriatric social work.
In 2000, 12.4 percent of Nebraska’s population was over age 65. In Nebraska rural areas it was 18.6 percent. By 2020, the number of people age 65 and older will climb to 22 percent in Nebraska’s rural areas. At the same time, 46 percent of Nebraska’s 93 counties are medically underserved.
Dr. Mackley, the son of Bill and Janet Mackley of Stapleton, Neb., is a 1979 graduate of St. Patrick’s High School in North Platte. A football and wrestling athlete, he earned a bachelor of arts in general studies from the University of Nebraska at Omaha (UNO) in 1992; a bachelor of science degree in biology and exercise science from the University of Nebraska at Kearney in 1993; master’s degree in health education in 1997 from UNO; and his doctorate in physical therapy from Creighton University Medical School in 1997.
“I found about the NEBGEC from UNMC brochures,” Dr. Mackley said. “I really hadn’t thought a lot about the special health issues among the elderly until reading about this program. “Although only a quarter of my practice was seniors, we see a lot more total joint replacements, for example, and this is definitely going to be a growing trend. Boomers want to have a more active lifestyle in their senior years and they are seeking medical treatments that provide for and encourage a higher level of activity throughout their retirement years.”
Dr. Mackley’s praise for the program is not just in the education he obtained, but the ability to complete the program using UNMC’s nationally acclaimed distance learning systems. NEBGEC is an “at-your-own-pace’ curriculum, Dr. Mackley said. He initially took two days of course work in Omaha, including a full day of physical therapy education. He had to return to Omaha only one other time in the year it took to complete the program. His other studies were completed through tele-health sites, online modules and elective course work, and an overnight trip to Grand Island three times (every four months).
“There may be some concern by practicing professionals that this program is going to take up too much of their time, especially for those people like myself with an extensive family life,” said Dr. Mackley, who has three children, ages 12, 10, and 9. “But I never felt I had to put in an extraordinary amount of time.”
Dr. Mackley said a person can go through the online modules fairly quickly, adding that although the modules are mostly designed for physicians, they proved quite good for physical therapists.
“We learned a lot more about studying the skin of older individuals for health indicators, for example, and more about orthopedics,” he said. “The biggest benefit of the program for me is the pharmacology component. It really opened my eyes to how much attention we need to pay to the medications seniors are taking and how those meds affect their rehabilitation.”
Dr. Mackley also believes it can never hurt health professionals to gain an early personal perspective on their own aging. While every person will age, each will do so differently. Some will age gracefully, possibly live a very long time and be incredibly active. Others may not be as fortunate.
“Perhaps one of the most surprising things I learned came from Dr. Pat Hageman (director of UNMC Physical Therapy Education),” Dr. Mackley said. “Pat’s presentation showed me that a lot of health professionals are subconsciously taking it easy on our senior patients, when in fact they need us to push them harder. We think because they are old they can’t work harder towards rehabilitation and therefore we don’t encourage them towards a maximum effort. In doing so, we are actually under serving those who rely upon our expertise.
“NEBGEC proved to be a really good investment to both my career and personal development. I recommend it highly. And for those going through the program now, keep at it. You’ll be finished before you know it.”