The costs of King Coal expansion

To the editor,

Having moved to the Hay Gulch area nearly 20 years ago, your Retooned illustration from the Jan. 29 issue really hit home with me and the other local residents. We have lived in peaceful co-existence with the King I Coal Mine in the 70 years it existed, and we had very few problems living together in this part of La Plata County.

The mine was acquired by the international conglomerate, GCC Energy of Chihuahua, Mexico, in 2005, and they shut down the old mine and moved to the new King II site. They are only now starting to go through the required permitting process. They plan a major expansion that is doubling the size and coal output. When compared to just a few years ago, they have increased semi-trailer truck traffic from around 50 trips per day to as many as 270 trips per day along County Road 120 and Highway 140 down to Gallop, N.M.

These trucks represent a danger to other drivers along the route since they have been observed speeding through school zones, and there have been several recent roll-overs spilling coal over the road. The company has promised the county to help pay for road repairs from a small fee per ton of coal hauled, but it appears none of those funds have been paid yet. In the mean time, the roads continue to sustain the massive wear and tear from all the trucks hauling thousands of tons of coal per load. This will end up costing all county residents to subsidize the hauling of coal by GCC Energy.

The other main concern of Hay Gulch residents is water use and the waste water produced by the King II mine. They have obtained rights to millions of gallons of water from the La Plata River with what appears to be little regard to the other residents of the county. If there is a short fall in their water needs, they plan to make up the difference with underground well water from a tenuous aquifer. Even though we’re in the midst of a decade-long draught, the effects of draining millions of gallons of water from this aquifer has yet to be studied. The chances that this dries up the wells of the homeowners who depend on this water is a real concern.

We residents of Hay Gulch urge the rest of the citizens of La Plata County to contact the county commissioners and Planning Board to tell them that our county is not the place for a massive coal mine expansion. The immense water use, unrelenting semi-trailer truck traffic, the noise, water and air pollution will effect all of us. We are advocating commonsense and reasonable use of our natural resources for the benefit of all county residents.

– William T. Williams, Hesperus

Random reader thoughts

To the editor,

The world is out there and it is merciless. It will beat you and beat you and beat you again; so as to shape you. Into what? I do not know; but if you are being beaten into a form that is not of your own cast, it is your duty not to comply. For it must be hard to live a happy life with no spine.

– Bob Page, Durango

Modernizing medical education

To the editor,

America is suffering from a shortage of primary care physicians. And with the national patient population expanding and fewer doctors choosing to be generalists, the shortfall is only getting worse. By 2020, there will be a shortage of an estimated 45,000 primary care doctors.

Reforming graduate medical education would help address this problem. Established in 1965, the current system is outdated and inefficient. It doesn’t meet the health-care needs of our nation. Voters must urge Congress to repurpose a small portion of current funding toward new training models that fix the shortfall and meet patients’ needs.

A July report from the Institute of Medicine demonstrates that many graduate medical education programs fail to provide enrollees with the knowledge and skills needed to provide high-quality care outside the hospital. Newly minted doctors struggle with even “simple procedures” commonly required in office settings.

The main cause of this is that the bulk of the average doctor’s residency takes place in a large teaching hospital. That’s a unique environment with many advantages. But it bears little resemblance to outpatient clinics where most care is delivered, particularly in rural and low-income areas.

Fortunately, some organizations are taking steps to address these flaws.

Consider the Wisconsin Collaborative for Rural Graduate Medical Education which connects medical school residents to local clinics. The initiative exposes residents to the realities of medical care outside the confines of a hospital. Residents enjoy a higher level of personalized interaction and gain a better understanding of how to provide quality, culturally competent care.

Likewise, teaching health centers link primary care providers to clinics and health centers in underserved communities. Their graduates are almost three times more likely to practice in underprivileged areas.

Smartly, the Affordable Care Act includes funding for expanding teaching health centers throughout the country. In 2014, the federal government allocated grants to 60 centers, enabling them to train 550 additional doctors.

Another successful model for improving medical education is through osteopathic postdoctoral training. These partnerships enable medical schools, hospitals and community health care facilities to pool their academic and research resources for graduate medical education.

Across the country, this model is working. In fact, 40 percent of these osteopathic residents are choosing generalist disciplines of family medicine, internal medicine and pediatrics. At more traditional programs, just three in 10 physicians choose primary care.

Right now, Medicare allocates more than $13 billion annually to finance graduate medical education. Distribution of those funds is based on an outdated formula that’s biased toward traditional teaching hospitals and neglectful of innovative models like regional cooperatives, training health centers and OPTIs.

Sustained funding needs to flow to these initiatives. Modernizing the graduate medical education system will provide the flexibility to address workforce and patient needs in an evolving health-care system.

– Dr. Barbara Ross-Lee, vice president for Health Sciences and Medical Affairs, New York Institute of Technology

A healthy eating conundrum

My dietary

confusion and irony

tofu with bacon

– Ernie Wells, Durango