Encouraging Health Professionals to Practice in Rural Areas

May 27, 2004

A select group of 18 physicians in rural communities throughout Arizona are spending part of their summer mentoring University of Arizona medical students.

For four to six weeks in June and July, the physicians volunteer as preceptors, or mentors, for students between the first and second years of medical school. The students work at the physicians' practice sites and reside in their communities.

The physicians are rural faculty members in the UA College of Medicine's Rural Health Professions Program, begun in 1997 by the Arizona Legislature to encourage medical school graduates to practice medicine in rural communities.

Students are matched with rural physician preceptors based on their specialty interests and community preferences. Physician specialties include family practice, pediatrics, internal medicine, obstetrics and gynecology and surgery. Thirty-four rural communities are participating in the RHPP, and additional sites will be selected throughout the state.

Communities and doctors hosting students this summer include:

  • Benson: Dr. Barbara Hartley, family medicine; Jess LeBlanc (June 14 - July 16)
  • Chinle: Dr. Bernard Birnbaum, family medicine; Del Yazzie (June 28 - July 23)
  • Cibecue: Dr. Steve Savoia, internal medicine, and Dr. Dianna Mahoney, family medicine; Victoria Fox (June 7 - July 16)
  • Cottonwood: Dr. Wendy Katzenstein, pediatrics; Ronael Eckman (June 7 - July 2)
  • Elfrida: Dr. Peggy Avina, family medicine; Autumn Stevenson (June 14 - July 16)
  • Flagstaff: Dr. Jerry Mohr, general surgery; Monica Gustafson (June 1 - July 9)
  • Kingman: Dr. Ismail Bokhari, medicine/cardiology; Danielle Guffrey (June14 - July 9)
  • Lake Havasu City: Dr. Brian Sabowitz, medicine; Kelly Dale (June 28 - July 23)
  • Lakeside: Dr. Daniel Neel, family medicine; Srijana Zarkou (June 1 - July 9)
  • Page: Dr. Darrell Bunch, DO, family medicine; Orlantha Whitehair (June 7 - July 16)
  • Payson: Drs. David Cluff and James Schouten, family medicine; Katherine Glaser (June 7 - July 9)
  • Pinetop: Dr. Edith Bailey, pediatrics; Jennifer Reece (May 31 - June 25)
  • Prescott: Dr. Adam Feingold, obstetrics/gynecology; Christine Menor (June 1-25)
  • Safford: Drs. Susan Jones and Shirley Rheinfelder, family medicine; Betsy LeRoy (June 1-25); and
    Dr. Lynn Smith, family medicine; Nick McKernan (June 7 - July 16)
  • Sedona: Dr. Devin Mikles, medicine; Renee Pedersen (May 31 - July 2)
  • Sierra Vista: DrJody Jenkins, general surgery; Lynn Munoz (May 31 - June 25); and
    Dr. Ralph Mayberry, family medicine; Cecilia Urquides (June 1-25)

The students will continue to work with their preceptors over the course of their three years of medical training, returning to the rural communities in their third and fourth years.

"This program helps nurture students' interest in a rural practice," says Carol Galper, coordinator of the Program in Community Responsive Medicine, RHPP.

"Many of the students grew up in rural towns in Arizona and have a desire to practice in small communities, perhaps even returning to their hometowns. Their RHPP experiences help them understand the unique health care needs of rural populations as well as strategies to address these needs, and help them decide about where they want to practice in the future."

By working side-by-side with a physician - consulting with patients, discussing lab results, helping to diagnose childhood ailments, observing surgeries - students learn about the unique health care needs of rural populations and how to meet them. By returning to the same community during each year of medical school, students learn to appreciate the area's culture and community character and begin to experience the lifestyle of rural residents.

Each year, 15 first-year UA medical students are selected for RHPP and given intensive preparation, including a course covering managed care issues, referral needs, the impact of poverty and lack of health care, environmental health concerns, the influence of culture and the role of physicians in rural communities. Cost savings this year allowed RHPP to select and send 18 students.

RHPP students learn to use telemedicine technology in communities that are linked to the Arizona Telemedicine Program -- a health care telecommunications network that allows rural physicians and patients to have real-time online medical consultations with specialists at the UA Health Sciences Center in Tucson. The system also allows physician preceptors and students to "virtually" attend grand rounds lectures at the UA College of Medicine.

Rural physician preceptors enhance their teaching skills through faculty development and continuing medical education programs conducted by the UA College of Medicine. To minimize disruption of their medical practices, the programs are offered regionally as well as through video links with AHSC provided by the UA Telemedicine Program and the Arizona Health Care Cost Containment System's Regional Behavioral Health Authorities.

Forty-eight students currently are participating in RHPP. The first group of 15 students graduated from the UA College of Medicine in May 2000. To date, 69 students have graduated after RHPP participation and are in their residency training programs.

"One of our first graduates, Dr. Shirley Rheinfelder, now is working with Dr. Susan Jones at a family practice group in Safford, and she will be precepting an RHPP student this year. RHPP really is coming full circle," Galper said.

For more information about RHPP, visit the website, http://www.medicine.arizona.edu/pcrm/RHPP/rhpp.html.