national rural health day

The Rural Health Longitudinal Integrated Clerkship brought three third-year medical students to Payson in April — Celina Virgen and Maryssa Spires, along with Luke Wohlford (not pictured).

National Rural Health Day is November 19. It is a day to celebrate the Power of Rural. According to the National Organization of State Offices of Rural Health (NOSORH) it’s not just a day, it’s a movement.

Twenty percent of Americans live in rural communities and rural areas like Payson and they are facing a doctor shortage. With a community close to 60% retirees, it is more important than ever to recruit and train doctors, as one in four practicing physicians intend to retire within the next five years.

The community is fortunate to have a collaborative force working for its rural health.

Dr. Alan Michels and Dr. Judith Hunt have long been champions for rural health education in Rim Country.

Michels is the founder and CEO of Ponderosa Family Care and Chief of Staff of Banner Payson Medical Center. He is also medical director of the Rural Medical Collective, a partnership involving Ponderosa Family Care, the University of Arizona College of Medicine-Phoenix, Banner Payson Medical Center, MHA Foundation, and the Payson Christian Clinic.

Hunt is an internist and pediatrician who initially recruited and trained Michels, showing him the charms of small town physician life. Hunt grew up in rural America.

The partnership has made rural health in Payson fertile for growth and innovation. “Arizona is in the bottom forty for rural doctors. Payson is positively changing that direction,” says Hunt.

The two doctors have worked together for years to form relationships with non-profits, reaching out to groups across the state along with national organizations to help further the cause of strengthening rural healthcare and rural medical education.

The collaboration has resulted in three medical students from the University of Arizona College of Medicine-Phoenix spending nine months in Payson through the Rural Health Longitudinal Integrated Clerkship (LIC). The three third-year students, Luke Wohlford, Celina Virgen, and Maryssa Spires, arrived in Payson in April beginning with COVID-19 efforts, screenings, telemedicine, and eventually progressing to in-person visits. Utilizing telemedicine they have had the opportunity to assist with patients who needed treatment by specialists beyond the scope of the resources available within Payson.

One of the reasons for implementing the Clerkship is that traditional medical education was missing the mark, Michels felt; especially when it came to rural medical education. The typical length of time a student had in a traditional medical education model was only 4 to 8 weeks. As a medical student, typically during your medical rotation, you might see a patient for abdominal pain, Michels explains. You would send him off for a scan, and then maybe never see him again, because you would be off to your next rotation by the time the patient’s results were back.

Not so with the LIC model. Here students spend nine months and can follow patients through the course of their treatment plans, allowing a much richer experience, immersed in the rural community environment. Michels believes it is a step forward in medical education.

Telemedicine makes it possible to bring the nation’s, and even the world’s, best resources in clinical medicine to patients and medical education for local students to the rural community.

The process began in the early 1990s notes Michels, but the COVID-19 pandemic created a need that demanded rapid innovation. Telemedicine has thankfully evolved quickly enough to meet that need.

The integrative aspect of the clerkship is intended to give students an immersive experience not only into clinical medicine in a rural setting but an accurate view of small town community living. Students are encouraged to develop relationships and become involved in life outside of medicine in the hope that they will see themselves practicing medicine in a rural environment. They come to understand relatively quickly that doctors in Rim Country really know their patients, which is perhaps different from the urban medicine they might be accustomed to. The partnership has proved to be a mutually beneficial pairing, with patients forming close bonds with “their medical students.”

The relationship of the Collaborative became more solidified in early October with the ribbon cutting celebrating the opening of the new University of Arizona College of Medicine-Phoenix Ponderosa Family Care Rural Health Clinic in Payson. The clinic is now open and is home to groundbreaking new technology that will not only teach medical students but will also be used as a training center for existing rural physicians in practice currently throughout the country, both in person and via telemedicine.

The Rural Medical Collective will use the clinic for tele-visits and training simultaneously, combining the very best of both healthcare and education technology.

Another of the exciting projects championed as a result of the collective is the container home project that provides housing for the rural medical students who come to study here in Rim Country. MHA Foundation funded the container home project. It is just in the beginning stages and is sure to expand from this solid start. According to the MHA Foundation, they hope to host not only University of Arizona College of Medicine-Phoenix medical students, but also visiting students from other programs.

All of the programs and projects due to this collaborative effort will benefit not only Rim Country residents but will have a lasting impact for rural healthcare.

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