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December 16, 2010   Email to Friend 

COUNTRY DOCS: Service To Ag Recipient Keeps Rural Pipeline Open
By Darryal Ray

Federation President Jerry Newby presents Service to Agriculture Award to Dr. John Wheat of the University of Alabama's Rural Health Scholars Pipeline program.
At age 13, he knew he wanted to be a doctor in rural Alabama, but didn't know what to expect. "I didn't know what to do, didn't know what a doctor was," Dr. John Wheat was saying. "I'd been to the doctor, but I didn't have any friends whose parents were doctors or anything like that."

All he had to go by were the few aging country doctors who had tended his colds and scrapes while growing up in rural Sumter County. "I had the sense then that all doctors were kind of old and hard to find," he says with a laugh.

Today, that's not always the case. Thanks to Wheat's efforts in combating physician shortages through the University of Alabama's Rural Health Leaders Pipeline Programs, it's getting easier to find a doctor in rural Alabama.

That's why Wheat, founder and director of those programs, was presented the Alabama Farmers Federation's highest award, the Service to Agriculture Award, at its 89th annual meeting last month in Mobile.

"Everybody needs a doctor who cares about them. For the people of rural Alabama, that doctor is Dr. John Wheat," said Federation President Jerry Newby. "Dr. Wheat has been rural Alabama's friend and advocate for many years, working hard behind the scenes to bring more doctors to small towns all across the state. Because of his focus and his determination, it's becoming easier to find a doctor in rural Alabama. Thanks to him, the health of Alabama's farmers and other rural residents continues to improve. Alabama needs more doctors like Dr. Wheat, and because of him, we're getting them."

Through the creation of programs like Rural Health Scholars, Minority Health Scholars and Rural Medical Scholars programs, Wheat has been working to address Alabama's shortage of rural physicians for almost two decades.

Today, 154 students from 52 counties have entered the Rural Medical Scholars Program, including 12 in the 2010 class that starts medical school this year. Eighty-four Rural Medical Scholars have graduated from medical school, and 38 are still in school.

The Alabama Farmers Federation believes so much in Wheat's work that, in 2004, it joined with Alfa Insurance in presenting the Rural Medical Scholars Program a $1.8 million gift that continues to accrue interest in an endowed scholarship for students.

The first recipient of that scholarship, Dr. Terry James, is now practicing family medicine in his home county of Winston in the small town of Addison. Behind him in the pipeline are five more Alfa scholarship recipients, including Dr. Dana Todd of Hale County, now in residency at UA Tuscaloosa Family Practice.

"The best estimate is that we're about 350 doctors short throughout rural Alabama, and that's just today," Wheat says. "That doesn't take into account that the ones out there now who may be 55- to 60-years-old and reaching retirement. It's going to get worse before it gets better."

Wheat and his six siblings and two cousins were raised on a fiveacre rented farm outside York where they milked cows and tended 50 chickens and a horse. "Then, Dad rented about 15 acres outside town and tried to raise cotton just because he'd always wanted to raise cotton," Wheat recalls. "He did not know how to farm with a tractor, and he didn't know how to watch his money either. So, after about a year and a half of that, mother pulled the plug on my dad's farming."

But the country way of life was already deep in Wheat's soul, and his love of the country and rural residents stayed with him throughout his service in the Navy, his studies and his academic career. "It's the people," he says of his motivation. "They're hard-working, and I know very few people involved in agriculture who are self-absorbed. Their whole mindset is that they are doing something for a greater good, whether it's feeding the country or whatever."

So, in 1989, when another public outcry came for better rural health care, Wheat was ready. Recruited by Dr. James Leeper of the University of Alabama, Wheat began traveling all over Alabama's rural byways in an effort to learn the reasons for the doctor shortages. "I heard from doctors, hospital administrators, mayors, nurses, farmers, and they all said the same thing: 'We need more kids from rural Alabama in medical school,'" said Wheat.

The finding gave birth in 1993 to the Rural Health Scholars program, which recruited Alabama's brightest 11th graders for a summer program where they could earn seven hours of college credit. "The Legislature loved it, the students loved it, the families loved it, we loved it; everybody loved it!" said Wheat.

But rural physicians sounded a warning. "They said, 'This theory of getting them through school quick sounds good but doesn't work. When you get out here, it's kind of lonely, and so you need to be mature and have a lot of medical knowledge because you're going to see more things than a city doctor sees.'"

That gave rise to yet another part of the pipeline -- the Rural Medical Scholars Program. Established in 1996, the program accepts 10 qualified students from rural areas each year. Admission is based on academic achievement, character, and leadership qualities. Eligible applicants have lived in a rural Alabama county for at least eight years and have taken or registered to take the Medical School Admission Test.

"They have to prove to the admissions committee that they have at least eight years of rural background growing up in Alabama, and present themselves in such a way that the committee would say, 'No doubt about it -- this kid wants to be a family doc,'" said Wheat. "The chip on your shoulder that you had as a rural kid that says, 'City folks get all these things and all these amenities, and we got the short end of the stick. We ought at least have our own doctors!' It's that kind of mentality I like to find in students I'm interviewing. If I can detect that kind of attitude, I've got me a live one!"

"The doctors we want are interested in YOU," he added. "They are interested in you personally, in your family and your community, interested in all that. We want doctors to get involved in the schools, on the bank boards, as deacons. They're involved in the community. They're people persons. That's what we're looking for."

But even rural students often lack knowledge of farming -- something all would-be country doctors must learn under RMSP. "The first thing they need to know about is the nature and culture of farming," said Wheat. "They need to know why it is that a farmer will forego medical care because of working out on a farm. They need to know the farming mindset."

Enlisting the help of Sam Wiggins and other agents with the Alabama Cooperative Extension System, Wheat began sending students with agents to visit farms. "It's been a good relationship," Wiggins explained. "I told the farmers they should view the students as future leaders and therefore, influential in speaking up for agriculture wherever they are. And the more they know more about agriculture, a better advocate they could be."

Before long, Wheat said, he noticed that the students were learning valuable information not taught in medical school. "I thought, 'I bet we can learn a lot more from them,'" he said. "'Let's have some sort of purposeful research effort to try to learn from the farmers what doctors ought to know to take care of them better.' So, we got some graduate students and some funding, and we started having focus groups with the Extension agents and the farmers. That's been very rich information. "None of these students would have chosen to spend a year of graduate work learning about rural public health -- which is what they're learning -- if I didn't force them to," he added. "That's part of the pipeline -- they get to go to medical school because they plan on doing all this. We are finding that when they get back here, in comparison with their peers, they are much more mature, more seasoned."

As an example, Wheat points to Russ Allinder, a student from rural Jefferson County who is researching grain bin safety and health issues on the Pickens County farm of Mike and Annie Dee. "Look at Russ -- he's not a green behind-the-gills, first-year medical student. He's going to be set and solid."

"It's broadened my vision," said Allinder. "I never really thought how big agriculture was to a small town rural community, but I just bought into Dr. Wheat's idea of agromedicine."

Wheat hopes others will, too.

Not long ago, he says, small towns couldn't count on recruiting ANY doctors for their communities. Now, he says, "Give me two Rural Medical Scholars and I'll produce one rural family physician out of it -- guaranteed. We know there will be at least five a year. Now there's something to recruit from. We should have at least 40 students a year in a program like this. Then, we'd have 20 a year that we could tell for sure would be rural docs. Then, you can start filling up the state with rural doctors."

To reach that goal, Wheat is hopeful of establishing a Center for Agromedicine whose mission would be to train physicians for rural practice, including agricultural medicine, as well as develop scientific information for the farm.

"We don't just need a center -- we need a center that recognizes and builds on the work that was done before. And we need a center that builds on what we've done with agro-medicine, builds on Extension and builds on the Alabama Farmers Federation and all those kinds of existing cultures," said Wheat. "They've got centers for heart health, they've got centers for diabetes, they've got centers for toenail trouble, they've got centers for everything... but what turns me on is agriculture and agricultural medicine!"

For more information on the Rural Medical Scholars Program, visit http://tinyurl.com/37gw4bz.



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