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Rural Texas Ramps Up For Obamacare By Recruiting Young Doctors

Lauren Silverman
For three months, Chelsea Berges will work at Comanche Community Clinic in west-central Texas, where she will get the chance to try out the lifestyle of a rural physician.

In rural Texas, finding a family practice doctor is no easy feat. There are dozens of counties without doctors, and the need for health care is only going to increase as more people buy insurance through the Affordable Care Act. So how do we convince recent medical school graduates to strap on their boots and take root in rural clinics? Give them a taste. Turns out, they often end up sticking around.

  In his green scrubs and sneakers, Will Griffin looks like a full-fledged doctor, but he’s actually a third year medical student at the University of North Texas Health Science Center’sCollege of Osteopathic Medicine. While most medical students head to a city like Dallas for experience, Griffin chose Eastland, a town of four thousand people, and one very famous horny toad named Old Rip.

“My wife and I both grew up in very small towns,” he says. “And that’s what we wanted to go back to.” Plus, he says, family practice in a small town gives you the opportunity for a lifetime relationship with your patients.

The Texas College of Osteopathic Medicine offers a select group of students the opportunity to try on the lifestyle of a rural physician. During their third year, they work and live in a rural Texas community under the supervision of a local physician. Here’s a map with photos of the class of 2015.

A Lifeline For Rural Patients

In communities like Eastland, patients rely on their doctors. Dr. Kevin Cunningham, who is also Griffin’s mentor, says there’s only one internist in the county, few specialists, and no OBGYN. Cunningham has treated just about everything, from brain tumors to rabies.

“We take out skin cancers nearly every week,” Cunningham says. “It’s 60 miles to the nearest dermatologist and so a lot of our elderly they can’t drive 60 miles, they can’t see that good or don’t have the money or the gas, so you end up doing a lot of things that maybe in the city they’re going to tell you you’re not going to do.”

 While life in rural Texas might sound romantic, the stats on rural health care are anything but. The three million Texans who live in rural areas are more likely to be uninsured, older, poorer and have higher rates of hypertension and diabetes. Add to that a serious shortage of physicians, and you’ve got a system of clinics desperate for relief, ramping up for Obamacare.

“In rural Texas our practices are already busy,” Cunningham says. “So if everyone gets insurance, where are they going to go for that medical care?”

Cunningham does want people in Eastland to sign up for health insurance and thinks Obamacare will ultimately improve access to health care in rural Texas, but he’s worried about recruitment.

The Affordable Care Act did add funding to its loan repayment program for students who commit to working in underserved areas, something both Will Griffin and his peer Chelsea Berges will take advantage of.

Class In Comanche County

  When Chelsea Berges started working at Comanche County Community Clinic in west central Texas, there was no cell phone service and internet was spotty. On the plus side, she gets to hunt – boar, pheasant, deer – and once a week there’s a video conference with the other students in the rural scholars program across Texas.

The students turn to each other for moral support, and share interesting cases.

"It’s funny ‘cause I already knew I wanted to do this,” Berges says, “And if you talk to a physician who’s making a lot of money and they ask you what you want to do and you tell them rural family medicine they just think ‘oh are you crazy?” They assume, Berges says, that there will be horrible hours and horrible pay – which isn’t true.

“If you do family practice in a city you’re probably going to be doing coughs, colds physicals all day long,” Berges says, “which I think is pretty boring.”

“Out here in the rural place you can do anything you want to do, because there’s no one else here that’s going to do it,” Berges says. “That keeps it interesting.”

So far Berges has gotten first dibs on procedures such as bone marrow biopsies, spinal taps, even colonoscopies.

Lauren Silverman was the Health, Science & Technology reporter/blogger at KERA News. She was also the primary backup host for KERA’s Think and the statewide newsmagazine  Texas Standard. In 2016, Lauren was recognized as Texas Health Journalist of the Year by the Texas Medical Association. She was part of the Peabody Award-winning team that covered Ebola for NPR in 2014. She also hosted "Surviving Ebola," a special that won Best Long Documentary honors from the Public Radio News Directors Inc. (PRNDI). And she's won a number of regional awards, including an honorable mention for Edward R. Murrow award (for her project “The Broken Hip”), as well as the Texas Veterans Commission’s Excellence in Media Awards in the radio category.