Rural Health: Homegrown Doctors

Nov 1, 2017

All year long the APR news team has been looking at rural health across the state. One of the major problems is that rural residents lack access to medical care. A big reason for this is a lack of doctors. However, there is an effort underway to try to address the issue. The University of Alabama has something called the rural medical scholars program and it is bringing the next generation of doctors who will be practicing in rural Alabama.

A lazy barn cat keeps at least one eye on the chickens scratching around a farm in rural Perry County. This is where we met Hannah Zahedi. She grew up in and around Marion. Life on this farm in rural Alabama looks like something out of the TV classic “Green Acres.” But Zahedi says she watched another show that gave a hint as to where she wanted her life to go… 

Third year medical school student Hannah Zahedi
Credit Stan Ingold / Alabama Public Radio

“I was a fan of “Gray’s Anatomy,” but that didn’t really lead me there. All throughout college I told people I wanted to do medicine and it kinda just became a self-fulfilling prophecy. I shadowed some really good doctors who solidified that idea in my mind and I haven’t really thought of anything else sense.” 

Zahedi talks like a veteran farm hand. But, she’s also a third year medical student at the University of Alabama. Zahedi is part of the school’s rural medical scholars’ program. The hope is that she will take what she’s learned, go back to her rural hometown, and practice. Which doesn’t seem to be the problem here.

College City Drugs in Marion, Alabama. The only pharmacy in town.
Credit Stan Ingold / Alabama Public Radio

Rural health advocates in Alabama say Perry County needs Zahedi badly. It’s currently one of seven counties in the state with no hospital. Zahedi says she knows she can help here, since she’s a local…

“I think it’s a trust issue. They know you’re from the community and have roots in the community then you’ll care more about the community. You can come in as an outsider, it just takes longer to get acclimated to the community and show them that you’re invested in them.”

However, she has to graduate first and that includes using a dummy to train with defibrillators to restart a patient’s heart. Nursing and medical students train on devices like these at DCH medical center in Tuscaloosa as well as in the classroom at the University of Alabama.

 Dr. John Wheat heads up the rural medical scholars program and each rural town he points to is being served by one of his medical school graduates.  

Dr. John Wheat, Director, Rural Scholars Programs at the University of Alabama
Credit Stan Ingold / Alabama Public Radio

“The rural scholars program is built on the theory that the kind of young doctors who will find it comfortable and attractive to go into rural practice are young doctors who grew up in such areas and had their values informed by rural Alabama.”

Alabama has a lot of ground to make up. A study by the Alabama Department of Public Health shows every rural county in the state has a doctor shortage. For Dr. Wheat, it’s a trickle of medical school grads against a flood of communities in need. 

“We have about 10 or ten average per year that come for a five year course of study and the mission of this program is to produce physicians for rural Alabama who are leaders in developing healthy communities.”

Wheat says graduates from the Rural Medical Scholars Program do more than just give check-ups and set broken bones.

“They also are one of the most, if not the most educated person in the community and the community looks to them to engage in the decisions made in many arenas of life, be it spiritual, education, health, business and so on.”

Speaking of business, Wheat says a doctor can help bring that to a rural area too-- and he has an example in mind--Dr. Lee Carter in Autauga County.

“It’s been interesting to watch him set up a practice and then to watch a pharmacy come in and then to see a new restaurant be built and to see the little town start growing and to see actually a small factory starting to be built there, this little town of about 500 people.”

Dr. Alexis Mason
Credit Stan Ingold / Alabama Public Radio

Dr. Alexis Mason has her practice at the Pickens County Family Practice Center. She’s a product of the rural medical scholars program. And, once Mason served her post graduate residency, she moved to the small town of Gordo west of Tuscaloosa. Mason says the choice was personal…

“So when I was three years old I was run over by a riding lawnmower. Wasn’t supposed to live, walk, run, do a whole bunch of things. God blessed me to do that and during that process when I was three, I started telling people at that time “Hey this is what I want to do, this is how I want to help people.”

 Mason says helping means things like arranging transportation so patients can get the treatment they need. The Alabama Department of Public Health says sixteen percent of rural residents in the state don’t have a car. 

Pickens County Family Practice Center

“I’ve had some patients to actually say “yeah I have to pay a friend or cousin to bring me here and have to try and finagle a way to another place to get an x-ray, to get an ultrasound, to get labs drawn. Fortunately we can do a lot of that here because we have x-rays and labs, but that isn’t always the case.”

Dealing with obstacles to medical care isn’t a theory for Dr. Mason. She grew up in rural Alabama and watched her family struggle if someone became sick.

“It was still quicker for my parents to get off work and come and get me and take me to the hospital than it was for any emergency crew or doctor to get to me. So that’s one of the reasons why I think it’s important for someone rural because we understand those barriers to healthcare a little bit more from the rural aspect. I think when you come from a rural setting you understand what those barriers are in a different way that someone from the outside.”

Getting doctors to practice in rural communities is one issue, keeping them there is another. The University of Alabama reports fifty percent of their graduates wind up in urban communities where they can make more money. Mason sees this, but she’s resisting the temptation.

“I’ve had offers before to go practice in larger cities. And we get information all the time to “come here, you’ll get more money, more benefits,      a, b, c and d, a whole lot of things extra, however I feel like this is where the lord has me right now.”

           Back in Marion, Hannah Zahedi shares Mason’s outlook. She likes the quieter life in rural Alabama.   

Sidewalk drawing in front of Perry County Courthouse
Credit Stan Ingold / Alabama Public Radio

          “I just like the small town feel, people really seem to care for each other and whenever there is a crisis the community comes together and cares for each other. I think it’s a good, wholesome place to raise a family, at least a little bit more than the cities and be a little less exposed to things you might worry about.”

            Advocates of the Rural Medical Scholars program hope that will keep more graduates moving back home.