At age 13, he knew he wanted to
be a doctor in rural Alabama,
but didn’t know what to expect.
“I didn’t know what to do, didn’t
know what a doctor was,” Dr.
John Wheat was saying. “I’d been
to the doctor, but I didn’t have any
friends whose parents were doctors
or anything like that.”All he had to go by were the
few aging country doctors who
had tended his colds and scrapes
while growing up in rural Sumter
County. “I had the sense then
that all doctors were kind of old
and hard to find,” he says with a
laugh.Today, that’s not always the
case. Thanks to Wheat’s efforts
in combating physician shortages
through the University of Alabama’s
Rural Health Leaders Pipeline
Programs, it’s getting easier to
find a doctor in rural Alabama.That’s why Wheat, founder and
director of those programs, was
presented the Alabama Farmers
Federation’s highest award, the
Service to Agriculture Award,
at its 89th annual meeting last
month in Mobile.”Everybody needs a doctor
who cares about them. For the
people of rural Alabama, that doctor
is Dr. John Wheat,” said Federation
President Jerry Newby. “Dr. Wheat
has been rural Alabama’s friend and
advocate for many years, working
hard behind the scenes to bring
more doctors to small towns all
across the state. Because of his focus
and his determination, it’s becoming
easier to find a doctor in rural
Alabama. Thanks to him, the health
of Alabama’s farmers and other rural
residents continues to improve. Alabama
needs more doctors like Dr.
Wheat, and because of him, we’re
getting them.”Through the creation of programs
like Rural Health Scholars,
Minority Health Scholars and Rural
Medical Scholars programs, Wheat
has been working to address Alabama’s
shortage of rural physicians
for almost two decades. Today, 154
students from 52 counties have
entered the Rural Medical Scholars
Program, including 12 in the 2010
class that starts medical school
this year. Eighty-four Rural
Medical Scholars have graduated
from medical school, and
38 are still in school.The Alabama Farmers
Federation believes so much
in Wheat’s work that, in 2004,
it joined with Alfa Insurance
in presenting the Rural Medical
Scholars Program a $1.8
million gift that continues to
accrue interest in an endowed
scholarship for students.The first recipient of that
scholarship, Dr. Terry James, is
now practicing family medicine
in his home county of
Winston in the small town of
Addison. Behind him in the
pipeline are five more Alfa
scholarship recipients, including
Dr. Dana Todd of Hale
County, now in residency at
UA Tuscaloosa Family Practice.”The best estimate is that
we’re about 350 doctors short
throughout rural Alabama, and
that’s just today,” Wheat says. “That
doesn’t take into account that the
ones out there now who may be 55-
to 60-years-old and reaching retirement.
It’s going to get worse before
it gets better.”Wheat and his six siblings and
two cousins were raised on a fiveacre
rented farm outside York where
they milked cows and tended 50
chickens and a horse. “Then, Dad
rented about 15 acres outside town
and tried to raise cotton just because
he’d always wanted to raise cotton,”
Wheat recalls. “He did not know
how to farm with a tractor, and
he didn’t know how to watch his
money either. So, after about a year
and a half of that, mother pulled the
plug on my dad’s farming.”But the country way of life was
already deep in Wheat’s soul, and his
love of the country and rural residents
stayed with him throughout
his service in the Navy, his studies
and his academic career. “It’s the
people,” he says of his motivation.
“They’re hard-working, and I
know very few people involved in
agriculture who are self-absorbed.
Their whole mindset is that they are
doing something for a greater good,
whether it’s feeding the country or
whatever.”So, in 1989, when another public
outcry came for better rural health
care, Wheat was ready. Recruited by
Dr. James Leeper of the University
of Alabama, Wheat began traveling
all over Alabama’s rural byways in
an effort to learn the reasons for
the doctor shortages. “I heard from
doctors, hospital administrators,
mayors, nurses, farmers, and they all
said the same thing: ‘We need more
kids from rural Alabama in medical
school,'” said Wheat.The finding gave birth in 1993 to
the Rural Health Scholars program,
which recruited Alabama’s brightest
11th graders for a summer program
where they could earn seven hours
of college credit. “The Legislature
loved it, the students loved it, the
families loved it, we loved it; everybody
loved it!” said Wheat.But rural physicians sounded a
warning. “They said, ‘This theory
of getting them through school
quick sounds good but doesn’t work.
When you get out here, it’s kind of
lonely, and so you need to be mature
and have a lot of medical knowledge
because you’re going to see more
things than a city doctor sees.'”That gave rise to yet another part
of the pipeline — the Rural Medical
Scholars Program. Established in
1996, the program accepts 10 qualified
students from rural areas each
year. Admission is based on academic
achievement, character, and
leadership qualities. Eligible applicants
have lived in a rural Alabama
county for at least eight years and
have taken or registered to take the
Medical School Admission Test.”They have to prove to the
admissions committee that they
have at least eight years of rural
background growing up in Alabama,
and present themselves in such a
way that the committee would say,
‘No doubt about it — this kid wants
to be a family doc,'” said Wheat.
“The chip on your shoulder that
you had as a rural kid that says,
‘City folks get all these things and
all these amenities, and we got the
short end of the stick. We ought at
least have our own doctors!’ It’s that
kind of mentality I like to find in
students I’m interviewing. If I can
detect that kind of attitude, I’ve got
me a live one!””The doctors we want are interested
in YOU,” he added. “They are interested in you personally,
in your family and your
community, interested in all
that. We want doctors to get
involved in the schools, on
the bank boards, as deacons.
They’re involved in the
community. They’re people
persons. That’s what we’re
looking for.”But even rural students
often lack knowledge of
farming — something all
would-be country doctors
must learn under RMSP.
“The first thing they
need to know about is the
nature and culture of farming,”
said Wheat. “They
need to know why it is that a farmer
will forego medical care because of
working out on a farm. They need to
know the farming mindset.”Enlisting the help of Sam Wiggins
and other agents with the Alabama
Cooperative Extension System,
Wheat began sending students
with agents to visit farms. “It’s
been a good relationship,” Wiggins
explained. “I told the farmers they
should view the students as future
leaders and therefore, influential in
speaking up for agriculture wherever
they are. And the more they know
more about agriculture, a better
advocate they could be.”Before long, Wheat said, he
noticed that the students were
learning valuable information
not taught in medical school. “I
thought, ‘I bet we can learn a lot
more from them,'” he said. “‘Let’s
have some sort of purposeful
research effort to try to learn from
the farmers what doctors ought to
know to take care of them better.’
So, we got some graduate students
and some funding, and we started
having focus groups with the Extension
agents and the farmers. That’s
been very rich information.
“None of these students would
have chosen to spend a year of graduate
work learning about rural public
health — which is what they’re
learning — if I didn’t force them
to,” he added. “That’s part of the
pipeline — they get to go to medical
school because they plan on doing
all this. We are finding that when
they get back here, in comparison
with their peers, they are much
more mature, more seasoned.”As an example, Wheat points to
Russ Allinder, a student from rural
Jefferson County who is researching
grain bin safety and health issues on
the Pickens County farm of
Mike and Annie Dee. “Look
at Russ — he’s not a green
behind-the-gills, first-year
medical student. He’s going
to be set and solid.””It’s broadened my
vision,” said Allinder. “I
never really thought how big
agriculture was to a small
town rural community, but I
just bought into Dr. Wheat’s
idea of agromedicine.”Wheat hopes others will,
too.Not long ago, he says,
small towns couldn’t count
on recruiting ANY doctors
for their communities.
Now, he says, “Give me two Rural
Medical Scholars and I’ll produce
one rural family physician out of
it — guaranteed. We know there
will be at least five a year. Now
there’s something to recruit from.
We should have at least 40 students
a year in a program like this. Then,
we’d have 20 a year that we could
tell for sure would be rural docs.
Then, you can start filling up the
state with rural doctors.”To reach that goal, Wheat is
hopeful of establishing a Center for
Agromedicine whose mission would
be to train physicians for rural practice,
including agricultural medicine,
as well as develop scientific
information for the farm.”We don’t just need a center —
we need a center that recognizes and
builds on the work that was done
before. And we need a center that
builds on what we’ve done with
agro-medicine, builds on Extension
and builds on the Alabama
Farmers Federation and all those
kinds of existing cultures,” said
Wheat. “They’ve got centers for
heart health, they’ve got centers
for diabetes, they’ve got centers for
toenail trouble, they’ve got centers
for everything… but what turns me
on is agriculture and agricultural
medicine!” For more information on the Rural
Medical Scholars Program, visit http://tinyurl.com/37gw4bz.