Nearly two-thirds of areas with a shortage of primary health care professionals are in rural communities. With support from the Pulitzer Center and in collaboration with the Global Health Reporting Center, William Brangham visited a hospital and a medical school in West Virginia doing their part to train the next generation of rural doctors. It's for our series Rural RX.
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Amna Nawaz: Nearly two-thirds of areas with a shortage of primary health care professionals are in rural communities.
For decades, federal programs have offered incentives to try to correct the problem, with limited success.
We visit a hospital and a medical school in West Virginia doing their part to train the next generation of rural doctors.
With support from the Pulitzer Center and in collaboration with the Global Health Reporting Center, William Brangham reports for our series Rural Rx.
Dr. Aaron McLaughlin, WVU Rural Family Medicine Residency Program: Good morning. Good morning, pharmacy team.
William Brangham: At Jefferson Medical Center in West Virginia, Dr. Aaron McLaughlin is helping train a new kind of doctor for a very particular population.
Dr. Aaron McLaughlin: Our mission in residency is to train physicians to go out and practice full-spectrum family medicine in areas that are desperately needing it.
Are we ready to go?
William Brangham: Dr. McLaughlin says it's about preparing this next generation to work in rural America, out in communities where people are often sicker, where they live farther away from care, and where they have far fewer resources to deal with their medical conditions.
Dr. Aaron McLaughlin: When those resources aren't next door, then that provider has to accommodate for that. And they have to make some changes to their practice and try to limit how many times they're sending patients four hours away to see a specialist.
William Brangham: Right.
Dr. Aaron McLaughlin: And you can't do that sometimes in rural areas. There is no referral there.
William Brangham: You're the one.
Dr. Aaron McLaughlin: You are the one that's going to be managing this patient's problem, even though it may be something that is out of the scope of what some people might think family medicine does. But, in that area, you are now the specialist.
Dr. Adam Polinik, Resident, WVU Rural Family Medicine Residency Program: It is a big challenge. It's a big commitment. It's a lot of extra learning, a lot of late nights, a lot of early mornings.
William Brangham: Dr. Adam Polinik is one of the young residents learning this new expanded definition of family doctor. He's in the Rural Family Medicine Residency Program at West Virginia University.
Dr. Adam Polinik: And it teaches you to be very versatile. And I think, that for a family doc in particular, that's really important.
William Brangham: And you like that idea?
Dr. Adam Polinik: I do. I don't like relying on other people. I don't like using two doctors, when one will do.
William Brangham: Nationally, Dr. Polinik is an outlier; 99 percent of medical residency programs, where doctors train, are located in cities and suburbs.
But, since where doctors train is often where they end up practicing, that leaves rural communities high and dry. Rural America has 20 percent of the country's population, but only 10 percent of its doctors.
The Government Accountability Office estimates that addressing this shortage just in the next two years will take an additional 20,000 primary care physicians. But the trend is moving in the opposite direction. Since 2010, at least 136 rural hospitals across the country have closed their doors.
Dr. Linda Boyd, West Virginia School of Osteopathic Medicine: I would love to see more doctors practicing in rural areas and underserved areas.
William Brangham: Dr. Linda Boyd is vice president for academic affairs and dean at the West Virginia School of Osteopathic Medicine in Lewisburg.
Dr. Linda Boyd: The data is very clear that, that if you put one doctor, primary care doctor, into a rural area where there previously was none, the health indices for that entire community go up.
William Brangham: The school was founded 50 years ago specifically to address this shortage of doctors in rural West Virginia. James Nemitz is the president of the school.
James Nemitz, President, West Virginia School of Osteopathic Medicine: Part of what I have seen as successful here in West Virginia is growing your own, having people come from the area, they go to medical school in the state, they end up going to their residency in the state, and they end up staying, because their families are here and they love the people and the land.
William Brangham: Training for doctors of osteopathic medicine or, D.O.s, is similar to that of M.D.s, but with more focus on lifestyle and environmental factors.
Leaning on osteopaths to solve this shortage might seem unconventional, but they already make up 11 percent of the physicians in the U.S.
Dr. Linda Boyd: The perceptions of — about osteopathic medicine have come a long way since I started in medical school in the '80s. The — we now make up 20 percent of the medical students in the United States. So we're becoming a much larger profession, and not so much a minority. There's a lot more D.O.s all over the country practicing in all specialties.
William Brangham: The school offers a unique program that gives students 20 weeks of specialized training while they're still in medical school.
Dr. Linda Boyd: We have a rural track called the Rural Health Initiative that recruit students who are from a rural area or — and/or have a strong commitment to practice in a rural area, because some students come in and say: That's what I want to do. I want to be a country doc.
And they are assigned to some of the smaller hospitals around the state that are considered a rural area and that can provide those rural opportunities for them in training. And so they're working alongside doctors who've committed to this life, and they are working in that environment.
And they get to see that you can practice high quality of care in a small hospital in a rural town.
William Brangham: Travis Steerman and Abundance Hunt both grew up in West Virginia, and are both students in the Rural Health Initiative at the West Virginia School of Osteopathic Medicine.
Abundance Hunt, Student, West Virginia School of Osteopathic Medicine: When I decided that I wanted to do med school, I wanted to come home. I never really even considered anywhere else. This has always been home.
Travis Steerman, Student, West Virginia School of Osteopathic Medicine: There's a mental health crisis in West Virginia, a drug crisis in West Virginia, an addiction crisis in general in West Virginia.
William Brangham: Steerman was a coal miner for 13 years. Now he wants to be a psychiatrist.
Travis Steerman: Do your part, stay here, help the communities that raised you, give back to them, and help them.
William Brangham: As part of their training, Steerman and Hunt are learning about the body of water not far from the Lewisburg area.
Abundance Hunt: So we came out here to Blue Bend and to Anthony Creek to see what the water quality was. It's important because this is the water that people are going to be drinking, consuming that is a big part of their health.
Water is most of our bodies, so it's important what we're putting in it and we should know what's in that water.
William Brangham: Drema Hill oversees the school's community engagement through the Center for Rural Community Health. The center offers funding to local people and teaches lessons that aren't part of a standard medical school curriculum, like extensive learning about nutrition and helping senior citizens to do chores.
Drema Hill, West Virginia School of Osteopathic Medicine: We bring the community in and we ask them: What's the need? And we listen to them.
And then we develop programming around that, instead of it being the other way around.
Abundance Hunt: I think that it's just that there's so much more to medicine than just going to the doctor, and that there's a lot to do with the trust and the relationship that they have, especially with rural physicians. They are a big part of the community. They are who people trust, they look to.
And so I think it's more important than ever to have those people in the community that people can trust.
William Brangham: Soon enough, these doctors will graduate, set up their own practices, and hopefully continue building those bridges.
For the "PBS NewsHour," I'm William Brangham in Lewisburg, West Virginia.
Amna Nawaz: And that report was the last installment in our Rural Rx series.
But you can see all of them online and more, including William sharing some of the common threads he and the team found speaking with rural patients and doctors across five different states.