Rural Health Care

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The University of Arizona College of Medicine’s Rural Health Professions Program is expanding. Dr. Jonathan Cartsonis talks about the need for health care professionals in rural communities.

RICHARD RUELAS: The University of Arizona college of medicine's rural health profession's program continues to expand. Here to talk the need for health care professionals in rural communities is Dr. Jonathan Cartsonis, director of the U of A college of medicine's rural health profession's program. Thanks for joining us this evening.

JONATHAN CARTSONIS: My pleasure.

RICHARD RUELAS: So describe the need for us, how dire is the situation in the rural communities?

JONATHAN CARTSONIS: Well, you know, I can give you antidotes that are vivid. Pregnant women who have to travel hundreds -- relocate hundreds of miles to be near a center where they can deliver their baby.

RICHARD RUELAS: Like relocate for days, weeks?

JONATHAN CARTSONIS: For weeks in anticipation of delivering a baby. And I can quote some statistics, and for instance, the feeling is that it would take about 750 primary care providers, primary care physicians to fill the gaps that we have in the rural setting. -- Anyway, so it's fairly severe.

RICHARD RUELAS: And so the program has -- is now -- how many doctors do you anticipate or how many people have gone through the program so far?

JONATHAN CARTSONIS: So, I would like to maybe tell you a bit about the program. We have something called a certificate of distinction. Medical students can pick a track in medical school to get additional education in a rural setting. We know if we place our students in a rural setting, and give them a significant amount of training in that rural setting, they are much more likely to come back and practice in that setting. So our drive in our program is really to get, to get future doctors to settle in rural Arizona and practice medicine and meet the needs of the state.

RICHARD RUELAS: And I guess it becomes a -- as people go into the field, maybe they are thinking of working at the big hospital, becoming a heart surgeon or something?

JONATHAN CARTSONIS: That's an interesting point. You know, I think that there are a number of students who come in with certain ideals about going rural, working in a primary care setting in the past. I think that it's less so now, that get swayed by the glamour of the hospital work setting.

RICHARD RUELAS: E.R. was not set in a small town.

JONATHAN CARTSONIS: No. It certainly wasn't, that's true.

RICHARD RUELAS: Neither was Grey's Anatomy.

JONATHAN CARTSONIS: No. And so, you are right, there are lifestyle issues. There is a glamour deficit. But, what I feel, and feel strongly about, is that when students experience rural Arizona, which is spectacular. They will be enthralled by the lifestyle in rural Arizona and want to practice there. I think that we will see that. We're early in the process, and this is our second year in our Phoenix program. And we're seeing more and more interest from our student body.

RICHARD RUELAS: How many people have come through it, at any level? I know you can do it for a year or do it for the entire four years, right?

JONATHAN CARTSONIS: So you know, there are opportunities for students to do a simple one month experience in a rural setting, and the certificate of distinction students, for those who are really committed and get something extra on their transcript for that effort. They will spend as long as five months, six months, in a rural setting during their medical education.

RICHARD RUELAS: So how many students?

JONATHAN CARTSONIS: How many students, I'm sorry. Our program is just, you know, it's the birth of the program here in Phoenix. And we have a total of five students at this point, and looking to expand very rapidly.

RICHARD RUELAS: The students are doing the entire four-year?

JONATHAN CARTSONIS: The entire four years, yes.

RICHARD RUELAS: Have you had a sprinkling of students who have gone to see what a rural community is like in their fourth year?

JONATHAN CARTSONIS: And we have students, exactly, who are excited about going in their fourth year and final year of medical school and checking out various sites that they would like to potentially return to. Really, I am trying to develop -- we are trying to develop opportunities for students. If they want to commit to this four-year program or if they want to sample pieces of it and see if it's right for them.

RICHARD RUELAS: It seems like if someone samples it, it gets them on the road to thinking maybe I will live in Safford or Nogales.

JONATHAN CARTSONIS: I think that's true. I do think that's true, and I think that it's true that there are students who come in with a conviction, that they want to go back to their hometown, for instance. And maybe they are swayed in that other direction towards the glamour of the big tertiary hospital. This is a way for us to maintain that fire. I think that fire to go back home and practice.

RICHARD RUELAS: And I guess that we can all relate it to our own industries, and working in journalism. I know if you work for a smaller newspaper you probably do everything, and if you work for a bigger newspaper, jobs are more segmented. I imagine the same thing would translate to a rural setting as a doctor?

JONATHAN CARTSONIS: I think you are absolutely right about that. And it's very satisfying, actually, for a certain breed of doctor to be able to do all that he or she was trained to do. You know, there is kind of a pruning process in the medical education world. You learn a lot of stuff in medical school, and in residency, you learn a lot of techniques. You really learn how to take care of people in a holistic way. There is a process when you get out of practice, get out to practice, on their own, you know, letting some skills go by the wayside. You don't use them for much, but in a rural setting, it's a prime opportunity to really take advantage of your full education and really help a community to its maximum.

RICHARD RUELAS: We can think of in the city, it's like well there is my doctor but he sends me to the ear guy and the throat and foot guy, in a rural setting, you are the person. You are the doctor.

JONATHAN CARTSONIS: That's right, yes.

RICHARD RUELAS: So those who have gone in, do they come back with that happiness? Is that part of the reason of the satisfaction? Is that they get to use all of their education?

JONATHAN CARTSONIS: Absolutely. That is one part of the satisfaction. I think that there is, on many levels, there is satisfaction. There is going back and taking care of the community where you grew up, for others, it's discovering the, you know, the fun of, you know, living near a rural community and being able to hike in the outdoors and experience beautiful Arizona. There are multiple levels of satisfaction.

RICHARD RUELAS: The certificate, if you go four years, what other certificates could you get? -- What is that on par with as far as in the medical school world?

JONATHAN CARTSONIS: So, it's a competitive world out there. There is a lot of competition to get into medical school. There is -- especially these days, a lot of competition to get into residency programs. These are where medical students get their additional training.

RICHARD RUELAS: It's hard to differentiate.

JONATHAN CARTSONIS: It is, a student could differentiate him or herself, and become a stronger candidate with the additional training, with this great rural training that we're offering.

RICHARD RUELAS: And really get to experience giving medicine to a community that really needs it, you are respected in the town, I mean, it's --

JONATHAN CARTSONIS: Exactly. I think that there is also an element of respect that a small town offers a professional, who has decided to stay there. And I think that it needs to be experienced, really, to, for the students to believe it. They need to be out there and see really what it's like to practice.

RICHARD RUELAS: And we'll try to get the mark, as well, the M.D. reruns back on the air to boost it.

JONATHAN CARTSONIS: I appreciate that.

RICHARD RUELAS: Dr. Jonathan Cartsonis, thanks for joining us.

JONATHAN CARTSONIS: My pleasure.

Dr. Jonathan Cartsonis

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