Health Care Where It's Needed

It was no ordinary summer school tainted by sultry days spent in a stuffy classroom. For Michelle Collins, summer school meant living in a hospital and being on call 24/7. Collins was one of 13 Tulane students who volunteered this summer to spend a month learning about primary health care in placements across rural Louisiana.

For Collins, who was raised on a corn and cotton farm in Pineville, La., and attended nearby Louisiana College for her undergraduate education, it was a natural choice. She is entering her second year of medical school and she has always wanted to be a doctor in rural Louisiana.

“I grew up in 4-H, raising cattle, and I felt called to become a medical doctor,” Collins says. “I think I can balance pursuing a higher education and taking care of people. I have a real desire to give back to my community.”

Collins lived for a month this summer in a patient room at Bunkie General Hospital, 50 miles south of her hometown. The hospital has 25 medical beds and eight psychiatric beds to serve approximately 7,000 residents in the area. She shadowed Dr. Blaine Lavergne, a family physician who has an office across the street from the hospital.

The program is sponsored by the Louisiana Area Health Education Centers as part of a program designed to give medical students the opportunity to observe medicine as it is practiced in rural areas that are underserved by physicians. Funding also was provided by the dean's office at the School of Medicine.

“Students find that they gain valuable clinical skills earlier than classmates who do not have this experience between their first and second years of medical school,” says Rick Streiffer, professor and chair of the Department of Family and Community Medicine at Tulane.

Collins says she watched a number of emergency cases and minor surgery. She talked with patients to obtain their medical histories and assisted the doctor in treating infected wounds. She experienced first-hand the many challenges of practicing medicine in a rural area without enough doctors, including patients' poverty, illiteracy and lack of access to specialists and resources.

“I think she learned a lot,” says Linda Deville, chief executive officer of the hospital. “It was a busy time, when we were implementing computerized order entry so our doctors can look at medical records online.”

Streiffer says studies have shown that early exposure to family medicine predisposes medical students to choose primary care medicine as a career, helping to boost the ranks of needed doctors, especially in rural areas.

“Today, about 10 percent of physicians practice in rural areas, while nearly a fourth of the population lives in these areas,” Streiffer says. “And these are places where people tend to be older and sicker, so they are more in need of access to health care.”

In support of the Tulane Rural Outreach Initiative, medical school dean Dr. Ben Sachs has established two full-tuition medical school scholarships, beginning this academic year, for students who are from rural Louisiana and make a commitment to return to rural Louisiana to practice primary care medicine after their training.