Former docent speaks on internal medicine in global health

Dennis Palmer, D.O., a former docent presented the 2015 Goodson Lecture recently at the School of Medicine.
Former docent Dennis Palmer, D.O., presented the 2015 Goodson Lecture recently at the School of Medicine.

At Mbingo Baptist Hospital, a growing, 310-bed hospital in a rural region of Cameroon, Africa, nearly one in four patients admitted is HIV-positive. Dennis Palmer, D.O., a former UMKC School of Medicine docent, sees it on a regular basis as medical director of HIV/AIDS Care and Treatment at Mbingo.

“It is a very important disease and if you don’t treat it, people die with it,” said Palmer, who presented the 2015 Goodson Lecture at the School of Medicine.

Even in such remote settings, internal medicine physicians such as Palmer have learned how to manage cases of communicable diseases such as HIV and Ebola. But therein lies the rub for health care in underdeveloped regions of the world.

“One of our greatest issues is a shortage of trained physicians of any kind, trained internists, especially, in the developing world,” Palmer said.

To meet the challenge, health care providers in these areas have adopted a concept of task shifting. Lower-level staff takes care of many of the treatment tasks that trained physicians would normally perform.

In Cameroon, as throughout Africa, nurses provide a bulk of the HIV treatment, Palmer said.

Palmer was a docent at the School of Medicine from 1991 to 2004 and also served for a time as deputy assistant dean for years 1 and 2 medicine. In 2004, Palmer left UMKC and the United States to take on the roles of medical director for the Cameroon Project and field director for the North American Baptist Conference in Bamenda, Cameroon.

Nearly 40 percent of today’s health care in Africa comes from missionary medicine, Palmer said.

Eight years ago, he started the Christian Internal Medicine Specialization Program, a four-year internal medicine residency program, at Mbingo Baptist Hospital. Still in a growing stage, the program now has 10 internal medicine residents. Using a case-based curriculum, local faculty and volunteers help with the medical training.

Palmer said recruitment of people into the program has improved, and while he is generally pleased with the progress the program has made, there is still much to be done.

The infrastructure necessary for trained physicians to work at the same level  as those in the United States and other developed countries is lacking in Africa. For that reason, Palmer said, many African people leave their country to receive the highest quality of medical training possible, never to return.

“In the end, it won’t be (missionary physicians) who solve the health care problems in Africa,” Palmer said. “It will be the African people who do that.”

The Goodson Lectureship is an annual event that provides perspectives and information related to internal medicine. It was established in honor of William Goodson, Jr., M.D., who served as a docent at the School of Medicine from 1980 through 1982 and practiced medicine in Kansas City for more than 45 years.