by Candi Helseth
In Western New York’s Wyoming County, where residents quip that there are more cows than people, the Thiel Hospitality House and Learning Center provides a bed for anyone with a health-related need — medical students doing rural rotations, hospital staff on call, outpatients and patients’ families — even the local veterinarian. Additionally, the Thiel House’s high-tech computer center connects health care professionals to distance learning education and telemedicine consultations. Built by Western New York Rural Area Health Education Center (R-AHEC) following a community needs assessment, with seed money from a local farmer-investor, the Thiel House meets the national AHEC goals of “connecting students to careers, connecting professionals to communities and connecting communities to better health.”
In 1971, Congress developed the AHEC concept to strengthen the supply and distribution of quality primary care providers in rural and underserved areas. The National Area Health Education Center Organization (NAO) works closely with 55 AHEC programs and 245 AHEC centers across the nation, according to Andy Fosmire, president of NAO and director of the Northwest AHEC in Enid, Okla. All share a common purpose: to recruit students to health professions, work as liaisons to provide clinical training opportunities, and focus on retaining practicing professionals in rural and underserved areas.
Situated near the Wyoming County Community Hospital in Warsaw, N.Y., the Thiel House, which also houses R-AHEC offices, provides infrastructure for all three focuses, said CEO Dr. Kenneth Oakley. Summers, teenagers move in for a health careers camp where they job shadow professionals and volunteer at the nursing home. Year-round, families with hospitalized loved ones and outpatients need overnight lodging because there are no motels within 30 miles. Medical students, who supplement the hospital’s workforce, would not otherwise be able to do rural rotations since there is no place to live. And hospital professionals are more apt to stay in an isolated area when they have easy access to ongoing education and interaction with medical peers.
“The Thiel House connects students, professionals and the community,” Oakley asserted. “One of my richest moments was the sunny afternoon I dropped by there and found parents whose son was in the mental health unit, the emergency medicine doctor on call that weekend, and three medical students, conversing over wine and cheese on the patio. When students connect with the human side of medicine, it becomes a far more personal experience that’s more likely to make these students want to practice in a rural area.”
Fosmire said research demonstrates that students exposed to rural health care training are more likely to work in rural locations. Nationwide, AHEC centers have a wide latitude in building programs that meet specific regional needs and still fall within the AHEC “pipeline,” which Fosmire explained as “programming that exposes students to a variety of heath career options, to foster life-long interest in science and math and ultimately to steer students into health care professions in rural or underserved locations, and then to train and retain those professionals.”
On the rural, largely Native Hawaiian island of Molokai where 7,253 residents live, Huli Au Ola AHEC’s school-based health education and occupation programs begin in kindergarten and continue through 12th grade.
“Many of our kids have never left the island,” Director Rosie Davis said. “We get kids involved in science and math activities and excited about all the career possibilities. We bring in professionals to our island to talk to our kids. The kids don’t know about all the options they have in health care and there is an assumption that only rich people become doctors and nurses. There are strong family and cultural bonds here, so if we can get these kids to go to college they’re likely to come back here to use that education.”
Programming integrates the Native Hawaiian culture into the health care emphasis. Native healing practices and fishpond environmentalism are among classes in a summer health careers program that includes hands-on training such as CPR classes. The program also brings health professionals from outside the island to introduce students to the vast choices in health care professions. Another summer camp, The Robotic Program, focuses on math and science activities and introduces students to the use of robotics in medicine.
Huli Au Ola AHEC is only in its third year and other Hawaiian Islands have already requested that programming be extended to include them, Davis said. Two students from the first year’s classes have returned to Molokai to work with Huli Au Ola AHEC. The community college nursing class enrollment has expanded by 20 students a year. Four AHEC students now in college are majoring in research, robotics and medical fields.
“When we can recruit students close to home and get them into health professions, these students are more likely to return as adults to practice in that rural area,” Fosmire said.
As a registered nurse working in rural Georgia, Christina Hardy appreciates the medical education opportunities provided by Three Rivers AHEC, which cosponsors a wide curriculum of professional training opportunities that include webinars, continuing education classes and other distance learning opportunities, as well as hands-on training at community sites.
“You need to keep current but it’s hard to keep up when you’re already working and then you have to drive 50 miles each way just to take a class,” said Hardy, who has completed continuing education credits online and is currently enrolled in an online program to attain accreditation as a family nurse practitioner. “With the time element and money it takes, it would be very difficult to do this if I couldn’t do so much of it online. Three Rivers really does a lot for the area in terms of educational opportunities.”
Webinars are Three Rivers’ most recent and most in-demand educational outreach tool, said Director Kathy English. One of the most popular options is “lunch and learn” webinars where health professionals can tap into programming from their offices. When Three Rivers collaborates with another organization to present live health care conferences, they also produce a webinar that can be accessed later by professionals who were unable to attend.
“We have witnessed a decline in employers’ financial support helping employees obtain training and staff development,” English said. “For some of these rural providers, going away for continuing education is very expensive and practically out of the question because it leaves the clinic so short on staff. Yet many of these rural professionals are required to meet accreditation requirements to maintain their licenses.”
Three Rivers AHEC serves 28 west Georgia counties, 18 of them rural. In 2010, 1,605 health care professionals participated in continuing education and distance learning experiences. English said 87 percent of continuing education participants in their service area needed the education for licensure requirements. Thirty-seven percent live in rural counties.
The Bureau of Health Professions [as of 2014, the Bureau of Health Workforce] in the Health Resources and Services Administration funds AHEC programs through grants to medical schools and advanced education consortiums. These program offices oversee AHEC centers within their states, which are each governed by a local advisory board, Fosmire explained. Approximately 120 medical schools and 600 nursing and allied health schools work collaboratively with AHEC centers throughout the United States. In April, NAO hired Robert Trachtenberg as its executive director to lead its previously all-volunteer organization.
“Partnering with other organizations eliminates duplication and uses combined resources more efficiently,” English said. “We partner with high schools to get students into Academy programs, then we partner with the medical school and other health care profession programs in efforts like our Anchor pipeline program to get these students educated or trained in our area. And wherever we can, we partner with professional organizations to provide that continuing education for health professionals, which is essential to our retention focus.”
“When you look at the data over the last 10 years, rural counties continue to lose the most population,” Fosmire said. “The folks living out in those areas still need access to quality health care. I think all health care providers serving rural and underserved areas are looking for partnerships to strengthen their practices. If someone reads this article and says, ‘Hey, we would like to do pipeline programs!’ I’d tell them, ‘Go to the NAO website and look for your closest AHEC center. You should find a receptive person on the other end that wants to work together with you.’”
Back to: Spring 2011 Issue