Bruce TA. Physicians for the American homelands. Academic Medicine 1990;65 (12Suppl):S10-14.
Improving Rural Health
AHECS in Arkansas
J Rural Health 1990 Oct;6(4):523-6
Professional preparation for rural medicine.
Bruce TA
W. K. Kellogg Foundation, Battle Creek, MI.
Med Educ 1996 Mar;30(2):81-2
Medical education in community sites.
Bruce TA
Acad Med 1990 Dec;65(12 Suppl):S10-4
Physicians for the American homelands.
Bruce TA
W. K. Kellogg Foundation, Battle Creek, MI 49017-3398.
Academic health centers in the United States are in danger of becoming more and more irrelevant to the non-tertiary, primary health care needs of modern society. This paper explores options to respond to one segment that repeatedly has been demonstrated to be in distress: rural health care. Recommendations are made about selective recruitment into medical and other health schools to address the issue, early professional socialization, curricular reform, and the types of technical assistance that academic centers might well provide to rural practitioners and caregiver institutions.
"The appalling cost to both the physician and to the rural community of this mismatch has not been well described. The young physician and his family moves to the town in good faith, making a long-term commitment. Within weeks or months it becomes apparent that the expectations of the doctor, and sometimes the town, are not to be realized. The agonizing decisions then begin whether to sever the relationship... For the rural community the trauma is almost as great: it is easier in most instances to be perennially without a physician than to find one, go through the process of change in adapting to a new one, lose the doctor and start the entire cycle over again." - Tom Bruce in Improving Rural Health
Research in Rural Medical Education