Planting Seeds for the Next Crop of Rural Doctors

A 1991 movie called “Doc Hollywood” stars Michael J. Fox as a soon-to-be plastic surgeon who crashes his car in rural South Carolina and finds himself doing community service as a doctor serving the quirky residents of a rural town. Fox’s character experiences treating everything from an infected toe to a fish hook impaling and a near fatal heart attack. That kind of exposure eventually makes his character return to the small hamlet for a permanent position.

Exposure to medicine in a rural setting is behind the National Center for Rural Health Professions’ RMED program. It's based at the Illinois College of Medicine in Rockford. RMED is offered as a supplement to the MD curriculum. Students have experiences and assignments that focus on rural health care, family medicine and community-oriented primary care techniques.

OSF HealthCare Western Region Chief Operating Officer Roxanne Crosser, who is also interim president at OSF St. Mary’s Medical Center in Galesburg says RMED students also spend 16 weeks of their final year of med school, learning under an experienced physician.

“One of the advantages of being part of the University of Illinois Rural Medicine program is they have the opportunity during their medical schooling specifically to do rotations within our organization and I think once they connect with our physicians in our community, there is that higher potential of coming back to rural America,” according to Crosser.

Population growth and aging population are driving a demand for more health care providers, especially in rural areas at a time when lots of physicians are retiring. The Association of American Medical Colleges says by 2032, the population over 65 will nearly double and the population under 18 will grow by 3.5%. That translates to a shortage of as many as 55,200 primary care professionals and 65,800 specialty care physicians.

Not everybody wants to live in a big city and that’s where the RMED program comes in. Students such as Jennifer Main, a third-year student in the RMED program in Rockford. Main is from Galesburg and first began thinking of a career in medicine when she had a minor accident in high school. Her doctors, like the ones who cared for her entire family, we so compassionate and made a personal connection.

“They gave us their cell phone numbers. They were so personable and down to Earth. It was very charming you know,” Main shared. “It made me feel comfortable as a patient going to them but also my mom and dad who would accompany me to these appointments – they knew these people.” She added, “We went to the same schools with their kids. It was a good, comfortable feeling of knowing them.”

While a small town is home to her, Main also feels her 19 cohorts in the RMED program in Rockford are like her family. Main says the close-knit group jokes about common experiences.

“’Oh my gosh your high school had that? So did mine … Bring Your Tractor to School Day, holy cow!’ It’s such a different experience (living in Rockford) but it feels so homey to me,” she offered in describing one of the best aspects of the program. 

So far, Main has completed clinical rotations of specialties at three Rockford-area hospitals and she has experienced training at two other hospital systems in Champaign. She has learned about the complexities and constant change in health care, including varying electronic health records. 

Dr. Josh Carpenter, a hospitalist at Saint Mary Medical Center in Galesburg sees patients who have been admitted to the hospital for care, ranging from infants in the neonatal unit to some of the oldest residents in the region as part of his expertise as a family doctor. He’s a RMED graduate and has been practicing in the same hospital where he was born, in the same community where he was raised.

Carpenter often finds himself caring for patients who have family members he’s treated previously so sometimes they know him before he knows them. According to Dr. Carpenter, that instant recognition creates a therapeutic bond. He points out, often patients’ anxiety is reduced because they already trust him.

“When you’re able to break that wall down quickly and work on the problems at hand, you’re able to come up a care plan and they’re more likely to follow it,” he said.

Carpenter first heard about the rural medicine education program during a high school Biology class. He embraced the idea of becoming a well-rounded physician in a community that might not have sub-specialty support. During his fourth-year internship in Galesburg, Carpenter learned he loved the everyday-is-different, problem-solving aspect of rural medicine.

As an active member of the American Academy of Family Physicians, Dr. Carpenter has been the go-to resource for Western Illinois Congresswoman Cheri Bustos about the challenges facing medical professionals and facilities in rural areas. The AAFP has several proposals to improve patient access to quality care close to home, including transforming national curriculum for all family medicine physicians.

“It’s really important we set up programs that expose these physicians to the specialists but in a way that they’re able to care for a majority of these disease processes to decrease the burdens on the patients,” he suggested. 

Carpenter believes patients shouldn’t have to travel far or make multiple appointments with specialists to get care for some of the top health problems facing most Americans.

Currently, about one-half of medical students enrolled in the MD program at the U of I College of Medicine Rockford are part of the Rural Medical Education program. The program has 30 sites and it’s one of the most successful rural medical education training programs in the United States with nearly 75% of the program’s 300+ graduates returning to practice in rural areas after completing their training.

OSF St. Mary Medical Center recently received recognition for its commitment to RMED and its three-year, $15,000 pledge to the Dale H. Flach Endowed Professorship in Rural and Family Medicine Fund to support rural, inter-professional education and research. Flach is credited developing the RMED program while he served as dean of Student and Alumni Affairs for the college.