Due to a lack of doctors, many rural areas in Alabama do not have convenient access to health care.

Eighteen counties stretch across the middle of Alabama in what is known as the Black Belt, an area with high rates of poverty.

“These areas have some of our poorest patients with the least access to medicine,” Dr. Shelley Waits, an obstetrics fellow at the College of Community Health Sciences, said in an emailed statement. “These are the front lines, where preventative medicine and counseling about diet and exercise might really make an impact on the quality of life for our patients.”

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Waits, originally from Texarkana, Texas, said she initially wanted to be a pediatric oncologist.

“But I learned that I loved family and obstetrics, and in order to do both, I need to be in a rural area,” she said.

Rural Alabama is important because the areas support bigger cities by supplying needs like timber, coal and gas, Dr. John Wheat, director of the Rural Scholars Program, said. He added that medical schools have become more elitist, making it hard for less privileged students to be accepted.

“If more kids from rural Alabama went to medical school,” he said. “We’d have more doctors there.”

Many doctors in rural Alabama grew up in a similar area and returned to those areas to continue their careers.

“Doctors who are in rural areas because they grew up there enjoy it just for that reason,” Wheat said. “‘This is my home. These are my kind of people. These are my values. This is my culture.’”

Wheat said family doctors are needed the most since they can see patients for a variety of health problems.

“If we had enough family physicians out there,” Wheat said. “The other health problems would take care of themselves.”

As an OB/GYN at Tuscaloosa’s University Medical Center, Dr. Dan Avery said he sees the need for obstetric care in rural Alabama. A few weeks ago, the hospital in Demopolis, Ala. lost its labor and delivery department.

“They have no obstetric care in that area,” Avery said. “That leaves an area 175 miles long and 100 miles wide where there’s no OB provider other than in Selma.”

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Avery said compensating rural practitioners is a key incentive to get medical students to choose that type of practice.

“It’s really easy when you’re in their shoes to feel forgotten,” Avery said. “If you look at all the things we want primary care providers to do, they don’t get paid well.”

Yet, rural health comes with benefits as well.

Avery said that in a rural setting a doctor is “treated like a king”.

“It’s a very interesting relationship,” he said. “When I go into the grocery store, I know most of the people there, and they know me.”

Wheat said the Affordable Care Act has potential to help rural Alabama. However, there can be a difference between theory and reality.

“Already we see some hospitals closing,” he said. “But theoretically it is going to put insurance in the hands of more people so that now they can pay their doctors for care instead of having to seek care for free at emergency rooms. Secondly, it proposes to increase the reimbursement for primary care physicians.”

The Rural Scholars Program at The University of Alabama works to interest rural high school students in medical school. Beginning the summer after the11th grade, the students come to the University to earn college credit as well as attend seminars and go on field trips. The program even leads up to a Master’s and medical degree option after undergraduate graduation.

Wheat said most participants do become primary care physicians in rural Alabama. More information about the Rural Scholars Program can be found at cchs.ua.edu.

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