RMC Rural Health Roundtable Grow Your Own:

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RMC Rural Health Roundtable Grow Your
Own Alabama Approach
John R. Wheat, MD, MPH Professor of Community
and Rural Medicine University of Alabama
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(No Transcript)
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Alabama Rural Medicine Vision (since 1970) Based
on gubernatorial and legislative mandate

• Founding Dean William R. Willard, M.D.,
  (center) with U.S. Surgeon General Julius
  Richmond and UA President David Mathews (right)
  at a reception marking the establishment of CCHS.

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College of Community Health Sciences

• A new academic model for rural health
• Branch medical campus
• Medical education integrated with other
• university disciplines and resources
• Special Elements
• Family Medicine
• Community Medicine
• Behavioral Medicine
• Preventive Medicine

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Alabama Family Practice Rural Health Board
Legislative authority and funding for educational
initiatives to produce rural family physicians
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Pipeline Approach to Local Development
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(No Transcript)
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Principle 1 Start with completely rural students
(who are attracted to Family Medicine)
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Rural Medical Scholars Program Mission Produce
physicians for rural Alabama who are community
leaders
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Rural Medical Scholars Prematriculation
Curriculum  MS in General Studies, Rural
Community Health Specialization (AG)  
Required Courses (18 hrs)
HHE 500 Rural Environmental Occupational
Health (3 hrs) HHE 521 Epidemiology (3 hrs)
HHE 526 Biostatistics (3 hrs) HHE 542
Practical Issues in Behavioral Medicine (3 hrs)
HCM 573 Advanced Issues in Health Care
Management (3 hrs) HHE 585 Laboratory and
Field Experience (3 hr)  
Recommended Elective Courses CHS 522
Community Clinical Process I (3 hrs) CHS 532
Community Clinical Process II (3 hrs) BSC 550
Biochemistry/Molecular Biology I (3 hrs) CHS
590 Clinical Correlations in Biochemistry (3
hrs) ENH 621 Industrial Hygiene (3 hrs) ENH
680 Field Interdisciplinary Studies and Seminar
(1 hr) ENH 670 Occupational Safety and
Ergonomics (3 hrs) ENH 681 Interdisciplinay
Worksite Evaluation (1 hr)
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Principle 2 Continue rural contact (talk n rural)
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Principle 3 Family physician centered education
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Principle 4 Rural-based
curriculum
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Principle 5 Minimize urban-centered
education
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(Rural preceptors)
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RMSs in Tuscaloosa Family Medicine Residency
2006-2007
Chief Residents
Jennifer White
Archie Hooper
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(RMSs in Tuscaloosa Family Medicine Residency
Cont.)
Chief Residents
Jennifer White
Archie Hooper
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Outcomes
1. Promoting Family Medicine
RMSP and Family Medicine Residency
Selection Initial Residency Choice
Program (n) Fam Med
Other RMSP (38) 36.8
63.2 UASOM
(630) 5.4
94.6
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Outcomes 2. Rural physicians
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Outcomes 3. Grants and Publications
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Outcomes 4. Outreach/publicity
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Outcomes 5. Community Partnerships
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Outcomes
6. Constituency support
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Elements of Success

• Agenda set by state with legislation and funding
• Family Practice Rural Health Board Leadership
• Responsive academic unit
• Activated supportive rural constituency

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So, they are going home, now what?

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Who assures survival based on a.
Insurance/economic status? b. Number of
patients? c. Trust? d. Efficiency (clinical
and administrative)? e. Compatible
lifestyle? f. Professional connections?
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Four Survival Ideas

• Rural practice incubator?
• Stabilize reimbursement rates?
• 3. CHC to follow rural doctor?
• 4. Teleconferencing to include local
• providers?

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What responsibility do we have to broader rural
health policy?
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Growing
our own
In Alabama.
Yall Come.