COVER STORY : This Operation Is a Success : Drew Medical School Has Emphasized Primary Care to Underserved Areas for Years. Now Its Methods Are a Major Component of Health Care Reform.

HUNCHED OVER A METAL GURNEY, A SCALPEL gripped in his right hand, Luis Egelsee dissected a cadaver’s shoulder with surgical precision.

But surgery doesn’t interest Egelsee, 24, a second-year medical student at Charles R. Drew University of Medicine and Science. It’s too removed from the patient, he said. He prefers primary care because “that’s what’s needed in the (minority) communities.”

“You have more of a connection with the patient, their situation, their problems,” said Egelsee. “The issue is not just their health, it’s their lives.”

Many students at the private, nonprofit university share Egelsee’s philosophy of health care. Other medical institutions are beginning to understand that mission. After years of touting the importance of primary care to underserved communities, Drew’s emphasis on community-based medical care is at the cutting edge of health care policy.

With more calls for medical schools to shift from training specialists and increase the pool of general-care practitioners, Drew’s method of encouraging young physicians to provide basic medical care is seen as a major component of health care reform. That approach helped place Drew, the only historically black medical school west of the Mississippi, in the national spotlight last month after a visit by First Lady Hillary Rodham Clinton, who chairs the White House Task Force on National Health Care Reform.

“Drew is an American resource, not just a Los Angeles or South-Central resource,” said Drew’s president, Dr. Reed V. Tuckson, a member of the task force and a prominent advocate of education programs to introduce inner-city children to science and medicine. “The lessons we are learning here, the role we are playing happens to coincide with the needs of much of urban and rural America.”

Even as Drew is thrust to the forefront of the national health care debate, it continues to operate in relative obscurity at its small campus on 120th Street and Wilmington Avenue. At the tender age of 27--little more than infancy in medical school years--Drew is beginning to move beyond its growing pains, shaking off the image of a minor-league school among major-league institutions.

Founded to serve a predominantly African-American clientele, Drew is adjusting to a rapidly increasing Latino population. It is struggling with a budget deficit in excess of $3 million. Full accreditation for the university is at least two years away.

The one constant since its founding in 1966 has been its efforts to bring quality medical care to its community. As long as that remains its primary goal, Drew officials say, the university will thrive.

Much of the success of Drew’s schools of medicine and allied health is linked to support systems that students say lend the institution the feeling of a close-knit family.

That feeling as well as the school’s mission to serve traditionally underserved communities attracted David Maynard, a former gang member and high school dropout who will be entering his first year at Drew Medical School next month.

A fight with a rival gang years ago, which left a friend dead and Maynard with a fractured skull, prompted Maynard to opt for a change. As a patient, Maynard noticed there were few black doctors. Back in his Compton neighborhood, the dearth of medical facilities and doctors was sobering. Maynard vowed to help change the statistics.

After earning his General Equivalency Diploma, Maynard attended UC Santa Cruz and went on to receive a master’s degree in biology at Cal State Dominguez Hills before coming to Drew.

“This is the only place that seemed to care about me, to help me make my dream a reality,” said Maynard, 27.

Before applying to Drew, Maynard enrolled in the school’s medical school entrance exam program, a six-week course to prepare students for the test.

With every sentence, Maynard’s voice rose with an intensity and passion of one who longs to help his community.

“Everything here is me, it’s me learning about stuff I wouldn’t have found out elsewhere,” he said. “I’m taking this back to the people so nobody has to wonder where the black doctors are and nobody has to ask, ‘What’s Drew?’ ”

Named in honor of Charles R. Drew, the black doctor and scholar who pioneered techniques in blood plasma research, the university was founded in the wake of the 1965 Watts riots as part of a recommendation by the McCone Commission and at the urging of local black doctors who wanted a medical facility and educational institution in South Los Angeles.

It has mushroomed over the past two decades, growing from a few trailers and scattered offices to a full-fledged institution with its own medical and allied health schools. By 1988, it was operating out of two main administrative buildings and had set up a number of community-based organizations and educational programs, some of which have spun off into independent organizations.

The university has operated long enough as a complete institution to be eligible for full accreditation by the Western Assn. of State Colleges. A decision is expected in 1995.

Drew was incorporated in 1966 and accepted its first students to a post-graduate medical program in 1972; in 1981, its medical school opened its doors to its first class for the joint Drew-UCLA medical degree program. Today, Drew not only operates the post-graduate program along with the schools of medicine and allied health, it also oversees a medical magnet high school run by the Los Angeles Unified School District. It provides health care training to more than 500 students a year, most of whom are enrolled in its College of Allied Health.

In recent years, Drew’s medical school has made a move to grow its own doctors in inner-city communities through a “pipeline system” of educational programs to attract youngsters to the sciences and follow them through their youth. It has also developed about 50 community-based health, medicine and educational programs.

The pipeline system includes the 2-year-old Los Angeles Mentor Program, run by the Los Angeles Unified School District, the Saturday Science Academy, founded in 1987 for elementary and junior high school students, and the summer minority high school research apprentice program, which exposes teen-agers to research in biology, chemistry and physics.

“I think our kids are being damaged in non-nurturing environments. We have to allow for continuity from childhood to college and, statistically, this is a better route for them,” said Dr. Samuel J. Shacks, director of Drew’s Research Training Institute, which oversees three medical research programs for youths.

Although Drew’s approach to medical care has begun to attract national attention, it is relatively unknown on the home front.

Much of the local lack of awareness is because of Drew’s need for a significant alumni base and the resources to track its alumni, as well as for an official fund-raising arm. In June, the school hired Melvin Shaw, who was responsible for helping make the United Negro College Fund a household name, to boost its fund-raising and push Drew’s name in medical and philanthropic arenas.

Tuckson, a former commissioner of health care for the District of Columbia, has already spread the school’s name and efforts in speaking engagements across the nation. “One of the frustrations of this job is to know what a beautiful jewel this is, but to have so few people know,” Drew’s president said.

Its medical school and College of Allied Health are the university’s hallmarks.

The medical school, which admits about 25 students each year, is accredited through its affiliation with UCLA. Students attend UCLA for the first two years, and return to Drew’s campus for the last two years of medical school.

There are usually an equal number of men and women attending Drew’s medical school, with an average age of 26. Although many students are matriculating straight from college, others have spent years out of school in other careers.

About 85% of the students are from California. All tuition fees and financial aid for the Drew-UCLA Medical program are the same as UCLA’s and are handled through that school. Yearly tuition is about $4,000 for Californians and $11,700 for out-of-state students.

At the College of Allied Health, one of only two allied health schools in the state, tuition for full-time students is $800 per semester for the physician assistant program.

In the vestibule of the medical school’s administrative building, sun-bleached photos and newspaper articles of Charles R. Drew cover the walls. In another room, large frames hold pictures of each of the medical school’s graduating classes. In all of its programs and classes, the majority of students have been African-American, keeping with the founders’ original hopes.

But times have changed.

Today, more Latinos than African-Americans live in Drew’s surrounding South Los Angeles community. And although half of its students are still African-American, the ranks of Latinos in the classes are growing.

“We take our designation as a historically black institution very seriously,” said Elaine Williams, assistant dean of the College of Allied Health. “But we try to be inclusive of everybody because we are aware of the change in demographics.”

The percentage of Latino faculty members at Drew falls far short of the percentage of Latino students, which worries Williams and other administrators. About 100 students attend Drew’s medical school, with about 52% African-American, 33% Latino, 13% Asian-American and 2% Anglo. Of Drew’s faculty, most of whom work at King-Drew Medical Center, 50% are African-American, 29% are Anglo, 17% are Asian-American and 4% are Latino.

At the College of Allied Health’s physician assistant program, about 77% of the students are African-American, 11% Latino, 6% Anglo and 5% Asian-American. About 78% of its faculty is African-American, 2% Latino, 16% Anglo and 4% Asian-American.

Egelsee, who is Latino, said he would like to see a push for more Latino faculty and students, but adds that their limited presence has not diminished his experience at Drew. “The professors here have a concern for all of the students who go to the school, no matter who they are,” he said.

It is the common vision that faculty and students share that is important, the student added.

For Long Bach of Pomona, Drew’s attraction had its roots in his family history.

At 31, Bach left a nine-year career as an engineer for medical school. He chose Drew because it was the only institution that would offer his father--a doctor in Vietnam--an internship through its post-graduate program after the family fled to the United States in the 1970s.

“At Drew, I have a chance to study with brilliant people who can help and teach me through their diverse backgrounds and knowledge. I couldn’t think of a better place,” Bach said.

Unlike the medical school, which requires students to have graduated from high school and college, the College of Allied Health also works with people who have not gotten that far or have dropped out of school.

Supporters and several officials at the university say the allied health school is Drew’s closest link to the community.

“We believe in talent development here,” Williams said. “A person could not go directly from Jordan Downs housing project to Drew Medical, but they could come straight to the College of Allied Health and we’ll work with them.”

Some graduates of the College of Allied Health finish a physician assistant program and go on to medical school.

The road of higher education has been bumpy for Drew.

In 1988, financial and administrative problems left the school with a $3.8-million deficit and forced the layoffs of more than 50 employees. Reports by independent auditors of mismanaged funds left the school with a tarnished image.

The deficit has been whittled to $3.3 million today and will be erased by 1995 through budget tightening, staff reduction through attrition, and funding, said Stanette Kennebrew, vice president and chief financial officer at Drew.

Much of the school’s funding comes from tuition and fees, private gifts and grants. The school also receives funds through grants and contracts with the county for its post-graduate medical program and state contracts for its medical school.

Tuckson insists that past problems will not be repeated nor deter Drew from its goals to improve and expand the school. But with a strapped economy and dozens of medical schools battling for a small pool of funding, the university may continue to struggle.

“People with money ought to come and work with us here,” Tuckson said. “We need people to give us money for our programs, to endow a chair of community medicine for us, to give our students a scholarship of support.”

Shaw, Drew’s new director of development, is hopeful that money will begin to flow into the university once its fund-raising efforts get off the ground.

Shaw plans to start an annual fund-raising campaign for the university and establish a Friends of Drew society to bolster the university’s coffers.

“I know there’s no money out there, but if we can get board members and supporters to just talk (Drew) up, that’s a good start,” Shaw said. “The climate is perfect for this university right now. The issue is so real, and that’s health care, from the White House and corporate America to our communities.”

For Tuckson, meaningful changes at Drew happen daily. Take the case of Patt Slaton of Watts, a student in Drew’s coding specialist program at the College of Allied Health.

“For the first time I feel like I won’t just have a job, I’ll have a career,” said Slaton, 39.

For 15 years, Slaton worked as a data processor with Northrop Aircraft before she was laid off last year. A relative referred her to Drew’s coding specialist program, which trains people to read hospital files and other health-related forms. The free program was started through a grant as part of the federal Job Training Partnership Act.

“I didn’t think it was possible to get this kind of knowledge without having to pay for it and to go to school for years,” Slaton said during a study break. “It really gives us all a chance.”

On the Cover

First-year medical students from Drew University gather to perform and observe a lower-limb dissection on a cadaver at the UCLA School of Medicine in Westwood.

The joint medical degree program with UCLA, along with Drew’s post-graduate medical program, College of Allied Health and its myriad other programs, are helping to transform Drew from a little-known institution to a major medical and educational resource in South Los Angeles.