Thanks for your compliment. I am a facilitator at heart. I have reservations about Title VII use, but not the concept and funding. If we did better to target Title VII more directly to use for programs and faculty more directly involved in the underserved, we would not have to do this rescue each year.
If Bush and others knew how much potential we had for restoration and efficient med ed and health care, they would double this budget instead of CHC and J-1 and NHSC and all of the more expensive stuff that is fairly inefficient and steals resources from other states or nations.
Restoration concept at http://www.unmc.edu/Community/ruralmeded/restoration_with_links.htm given at canadian FP meeting to rural med ed group
my Title VII application was going to slow this year, hope for next
http://www.ruralmedicaleducation.org/cdmed.htm
I hope that this and other apps will begin to outnumber the sheer infrastructure stuff that is all too common in Title VII apps. These are but a few of the things that rural med ed and underserved emphasis could bring to family medicine and primary care, but we are not as welcome at the table as we might be.
Editor's note: I have shared reservations before at Title VII Concerns Title VII Funding Caution
You should also know that the critiques of the recent Title VII studies are very relevant to our problems. Controlling for the rural background students and the impact of changes over time, as mentioned by Dr Campos Outcalt in Family Medicine this month, might explain most of the Title VII results in the Graham Center study. Controlling for minority origin and increases over time is also a likely major factor, as it was in my study of rural graduation rates of FP residencies (fp programs with more minorities graduated fewer rural docs). Since we know from AAMC studies that minorities are 4 times more likely to choose underserved areas (40% vs 10%, actual locations after graduation), then these are urban underserved. Senior med students interested in towns of less than 10,000 as a practice location were 6 times as likely as their peers to be interested in practicing in a socioeconomically deprived area (60% vs 10%) - from my AAMC GQ 1995 study.
Desperate times
Faxed to The Honorable Lee Terry, also to Nelson and Hagel in Nebraska
Suggest you send some to yours, use examples or check out info
I would appreciate your assistance with funding for Title VII. I recently spend much of the past few weeks preparing a faculty development proposal that would hopefully be funded. This grant would train family practice and internal medicine faculty in specific methods to get more and better physicians to locate in rural areas.
Despite what many medical leaders will tell you, we do have rural medical education programs that do graduate physicians for underserved areas. You do this by selecting rural and minority background students with an interest in family medicine that are interested in returning to such locations. These students are usually not from professional parents and are lower on the socioeconomic scale.
They need to train in programs that emphasize primary care for underserved populations.
They need to have faculty that have support for such training. This is where Title VII is mostly needed.
A previous proposal funded by Title VII was the Minifellowship in Rural Family Medicine. This one faculty development program has assisted faculty in the development of over 20 programs in rural areas of the nation and it was responsible for the Rural Program of the Year award given to the UNMC Dept of Family Medicine in 2002 (by the National Rural Health Association) and also the Rural Educator of the Year (Jim Buechler who graduated from the minifellowship in 1991).
Rural medical education programs are perhaps the best rural economic development programs ever created. The Rural Physician Associate program in Minnesota has had a $30 million price tag since 1971, but it has graduated over 900 doctors and the graduates that chose rural practice in MN have delivered over 2 billion dollars in economic benefit to rural Minnesota alone, not to mention great reductions in shortage areas, improvements in education, and increased workforce in rural areas.
More importantly, the Title VII programs help develop young professionals. Young professionals are the key to restoring communities, states, regions, and other nations. Doing military actions is futile unless we plan to help towns, villages, communities, and nations to develop the young professionals that will go to shortage areas and bring hope to those without hope.
Thanks for faxing letters. I agree with you 100%.
Title VII is in bad shape - worse than ever before. If you know other people that should be involved, pass my original e-mail on to them. We need as many people as possible to contact The Hill right now. Keep up the good work!
Kerri
Kerri Connor Wade
Organizations of Academic Family Medicine
Government Relations Assistant
2021 Massachusetts Ave., NW
Washington DC 20036
T: (202) 986-3309
F: (202) 232-9044
oafmdc2@stfm.org