LETTERS: EFFORT TO TRAIN MORE RURAL DOCTORS

To the editor:

Jack Stapleton's Oct. 6 commentary ("Physician shortage poses rural Missouri health hazard") accurately described the health problems associated with limited access to physicians in rural Missouri. He lamented an impending crisis and noted "something must be done." Fortunately, several statewide initiatives are already in place and answering this challenge.

To repopulate rural Missouri with physicians, the educational pipeline must be influenced at several point. Rural youth with the appropriate skills and desire to return home should be recruited to health-professions schools. These schools must train a cadre of students for the rural areas where they are needed. Finally, an adequate infrastructure must be in place in rural Missouri to support their eventual medical practices. Several Missouri programs have been created in the last few years to influence this rural physician pipeline.

The pipeline begins at the junior and senior high levels. The state's regional area health education centers and the Kirksville College of Osteopathic Medicine are doing an excellent job of supporting students in this age group who have an interest in the health professions. Through a variety of enrichment academies sponsored by the state's Primary Care Resource Initiative for Missouri, students receive special training in the sciences and college preparatory instruction.

The Rural Medical Scholars Program at the University of Missouri-Columbia School of Medicine picks up the students in the pipeline at the college level. Designed to expose students to rural medicine and help maintain their interest in returning to a rural area after graduation, the program has three distinct but related components, all aimed at increasing the number of physicians in rural Missouri: The pre-admissions program that recruits talented rural students from regional colleges and universities and provides leadership training, the summer community program in which MU's medical students spend their only free summer during medical school participating in this rural experience sponsored by community hospitals and the Rural Track in which fourth-year medical students are placed with physician preceptors throughout the state.

The MU School of medicine is committed to increasing access to health care in rural Missouri. It is the No. 1 provider of physicians for Missouri and graduates more primary-care physicians than any other school in the state. Its family and community medicine department has traditionally placed 60 percent of its resident physicians in rural communities, twice the national average.

For the educational pipeline to flow smoothly and innovative programs to succeed, teamwork among health-care professionals is required. The support of communities, business, legislative bodies and government agencies also is essential. By working together, we can continue to make progress in improving health care for rural Missourians.

HAROLD A. WILLIAMSON M.D., Interim Chairman

Family and Community Medicine Department

University of Missouri School of Medicine

Columbia