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Program helps state rural areas get doctors

By Kate Brumback
Associated Press Writer

MONTGOMERY — As a physician in a rural area, Dr. Deanah Maxwell knows there are times she’ll be stopped in the grocery store or at church for advice — sometimes not even medical advice. But for her, that’s half the appeal of being a small-town doctor.

The Tuskegee native plans to return to her hometown, with its population of under 12,000, to set up practice after finishing her residency in Tuscaloosa.

But Maxwell acknowledges that the increased social obligations that come with being a rural doctor aren’t for everyone.

“When you go back into a rural area as a professional, you can’t just go back as a person in that profession,” Maxwell said. “People look to you for guidance in areas other than, say, just medicine, so there’s a greater sense of responsibility.”

To help prepare for the role, Maxwell has participated in the Rural Health Leaders Pipeline programs at The University of Alabama.

The programs, like similar ones elsewhere in the country, recruit students from rural areas, give them specific medical training and help prepare them to be community leaders.

Expanding and improving rural health care is a cause that is dear to program founder and director Dr. John Wheat, who received the Distinguished Educator Award from the National Rural Health Association in May.

Opportunities for care

“I am a product of rural Alabama, and I am very much aware of the different opportunities to get medical care that exist there versus in urban and suburban Alabama,” said Wheat, who grew up mostly in rural Sumter County outside Livingston.

Dale Quinney of the Alabama Office of Primary Care and Rural Health said that in 2006 there were 907 primary care physicians in Alabama’s 55 rural counties and 2,137 primary care physicians in the state’s 12 urban counties.

Primary care physicians are those who work in family practice, internal medicine, pediatrics and obstetrics-gynecology.

Dr. Donald Kollisch of the Rural Health Scholars program at Dartmouth College in New Hampshire said the ratio of patients to doctors is about twice as high in rural areas as it is in urban areas nationwide.

He said rural areas account for about 20 percent of the country’s population but only have 10 percent of the nation’s doctors.

Wheat said studies have shown that students from rural backgrounds are more likely to live and work in rural areas than students who are not from a rural area.

The pipeline program begins targeting rural students long before they are eligible to enroll, putting on puppet shows and presentations in rural elementary schools to make children aware of the different medical professions that exist.

Motivation

Another reason for the early start is to motivate rural students to work hard to get the grades that will allow them to enroll in the program down the road.

Wheat said many rural children don’t feel higher education is even an option for them as they are bombarded with statistics showing high rates of failure among rural students.

“We decided we needed to start early to break through that and to let them know they can, that they have a shot, and can make good on their dreams,” Wheat said.

He said rural physicians typically end up making about the same amount of money as those in big cities. But rural doctors, he said, generally end up having to work longer hours and to perform a greater variety of services.

Because rural areas tend to lack specialists, Wheat encourages medical students who plan to work there to do extended residencies and to do more internships to gain experience in as many different types of medicine as possible.

The Rural Health Leaders Pipeline is actually a group of three different programs, each designed to help a specific group of rural students.

Since 1993, the Rural Health Scholars program has selected 25 high school students each year to participate in a five-week program the summer after they finish 11th grade.

The students live on The University of Alabama campus and take courses for college credit. They also attend presentations and go on field trips to expose them to the different medical professions.

As of last August, 364 students had participated in the program. Of those students, 23 were in medical school or had medical degrees. Others had entered nursing, health care management, dentistry, pharmacy and public health careers.

The Rural Medical Scholars program, started in 1996, each year accepts 10 medical school students who have lived in rural Alabama for at least eight years and who are interested in practicing in rural areas. The program is five years long, instead of the typical four, because it includes a year of policy and leadership training.

Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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