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September 14, 2009   Email to Friend 

Rural Medical Scholar Returns Home
Darryal Ray

Dr. Terry James
The speed limit on the "main drag" through town is 35 mph and there's only one traffic light, but Dr. Terry James spent most of the summer in the fast lane.

That's not an easy thing to do in Addison, Ala., population 711. But within a matter of weeks, James wrapped up his medical residency, moved into a new home, started his own family practice in the town's only medical clinic and got married. "I feel like my head is spinning sometimes," the 31-year-old doctor confessed just a couple of weeks before his Aug. 1 wedding.

Even so, when things settle down (and all things eventually do in this sleepy Winston County town), the first recipient of the Alfa Rural Medical Scholarship Award will feel right at home.

For it was in Arley, not much more than a stone's throw away, where James grew up, attending Meek High School, tending cows and showing heifers on the FFA circuit. "We 'd drive all over the state to walk 'em around the ring," he says. "If you were lucky, you took home a check. If not, you just burned a trip.

"It was good for me to grow up in that kind of environment," he adds. "I learned a lot of responsibility at a young age. I learned the value of hard work, and how to be a good person and a good man. Kids that grow up in rural country life -- a large majority of them -- really grow to love that life."

Which is exactly why James decided early on to pursue family practice medicine, a discipline that requires a much broader range of medical knowledge but also allowed him to return to his rural roots and care for those who've known him all his life.

Of course, it's been a long trip home. It was in 2001 that James was chosen to receive the first Alfa Rural Medical Scholar Award, which paid for 80 percent of his medical school in return for his promise of practicing family medicine in a rural area for four years.

The Rural Medical Scholars Program, an ongoing effort by the University of Alabama's College of Health Sciences to help bring health care to rural Alabama, has turned out 30 primary care doctors in rural areas since its establishment in 1996. The Alabama Farmers Federation and Alfa Insurance recognized the value of the program, and, in 2004, presented the program with a $1.8 million gift that is now accruing interest in an endowed scholarship fund for students.

James was recognized during a June 20 ceremony at UA's Bryant Conference Center, an event attended by Alabama Farmers Federation President Jerry A. Newby, and Pickens County Federation President Harold McCool and his wife, Diane. During the ceremony, Newby stressed the importance of bringing health care to rural Alabama.

Today, our rural areas are lagging behind, but if we move more of these outstanding young people out into those areas and they begin to work, our medical services are going to greatly improve," Newby told the gathering of residency graduates. "You have given so much of your life to help other people have a good life, and that's a great calling."

James says rural health care in small towns such as Addison, where wages are low and unemployment high, presents its own set of problems, including high rates of uninsured. "There are a lot of people who don't seek care until it's a major problem because they can't afford it," he says. "Things that could have been treated earlier and not been a problem, the uninsured put it off until it's really a major problem."

He says the current battle being waged over health care reform could have a major impact on rural areas. "If there were an easy solution, someone would have found it," he says. "I think physicians have a responsibility to keep expenses controlled, but a lot of this is dictated by political legislation. So, everyone has to take a part in the legislative process and what's going to happen with our health care because everybody has a role to play. Unfortunately, with the dollars and cents, it looks like everyone is going to have to tighten up a little bit."

Resources at small rural clinics are already limited, making rural health care even more susceptible to any funding cuts. "You know that the ambulance is going to be awhile," says James, noting that the closest emergency room is almost 30 miles away in Cullman, where he also works for Cullman Primary Care. "In Addison, if you call an ambulance, it's going to be 30 or 40 minutes before you see them."

As a primary care physician, James knows he won't earn as much as colleagues who specialize in more urban settings. That's OK, he says, "I don't do medicine for the money.

"It is a trade-off to some degree," he admits. "But I can live in the country, I can be close to my family, I can have my own farm. That was a big thing for me. I'd like to raise my family on a farm because I think it teaches a lot of values. I like the adventure of not knowing what's going to happen day to day. I like the variety of patients that you see in family practice, and I especially like helping the people I grew up around."

Of course, that also can be a two-edged sword, he says with a smile. "I've had to learn that some of the people who knew you as a kid or knew your family are going to love you just based on that; some are going to think you aren't a good doctor just because they knew you," he says. "That's just one thing you have to deal with."

James, whose father, Wendell, is retired from the National Guard and whose mother, Deborah, he credits as having prayed him through more than one exam throughout medical school, says the Alfa Rural Medical Scholarship is making a difference in the quality of rural health care.

"I kind of feel like I was a test subject," he says. "Hopefully, some day funds will be able to cover all 10 Rural Medical Scholars each year because we definitely need more physicians in rural areas. I think you're going to find one of the keys to health care reform and keeping costs low is preventive medicine. We're going to have to do a better job of preventing illnesses, getting screenings done, and finding things earlier so we can give our intervention. That's the major role of the family practice. I can't say enough about what Alfa and the Farmers Federation have done. It's made a world of difference in what I can do."


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