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'Chicken and egg situation' There are many organizations and authorities studying how to aid economic development in rural Alabama. "There is an intimate relationship between healthcare and economic opportunity," said Dale Quinney, executive director of the Alabama Rural Health Association. "It's a chicken and egg situation. To attract economic development…you need to have good, adequate, quality healthcare. To be able to afford…quality healthcare, you have to have economic opportunity." Quinney spoke Nov. 15 to the current class of Leadership Clarke County at Alabama Southern Community College in Thomasville. "Information is power," he said. "You can tell somebody that you think something is a problem, but if you have the information to back that up and show that it is, you're in a whole different position." Quinney has reviewed data concerning the healthcare situation in rural Alabama for over 33 years. He previously worked for the state Department of Public Health. He has gathered data from 27 different state offices as well as traveling to every doctor's office, dentist's office, mental health clinic, public health department, dialysis clinic, nursing home, pharmacy, assisted living facility and ambulance company. "I can do my job better if I know what is going on in rural Alabama," he said. The trend in the next few decades is for people in Alabama to move from urban to rural areas. In addition, there will be more Hispanic people moving into the rural areas. "We have some rather serious issues….One overriding issue is the shortage of the healthcare workforce (including primary care physicians). "…I am also seeing some very innovative things that are going on - some best practices that need to be shared with other counties." Quinney said. An example was an American Indian student from Washington County was approved for a program producing family doctors who also are trained as dentists. (Alabama will be able to admit 10 students a year to this dual program, he said.) Alabama needs younger physicians to take care of the aging population. Young doctors are staying in urban areas or going into specialized medicine, he said. "America is aging - so is the physician workforce." In 22 counties studied, "21 percent of all actively practicing primary care physicians will be 65 or older within five years. More than half will be age 55 or over in five years. "It takes seven years to train a primary care physician." Foreign doctors are having to fill the void. No matter, "we have many communities that do not have adequate physician care," Quinney said. "…We need 190 more primary care physicians in Alabama to eliminate all shortages for providing minimal service." Rural Alabama needs at least 250 more dentists to provide adequate care. In addition, "psychiatrists are as rare as hen's teeth in our rural counties." Community mental health centers will have psychiatrists who maybe work four hours a week, he said, but few live and work in rural counties. The Rural Medical Scholars Program at the University of Alabama and the Rural Medicine Program at Auburn University selects students who pledge to work in rural areas. However, those programs are only producing five doctors a year for rural areas. A new Alabama Medical Consortium also allows up to 120 medical students to train at 20 state colleges and universities and eight out-of-state osteopathic medical schools. Osteopathic doctors have a more holistic or preventive approach to medicine, and Quinney said they often are "better designed and trained for rural areas. You get twice the impact - potentially. You have somebody who can not only treat patients but prevent problems in the first place."
The Tombigbee Healthcare Authority in Demopolis, as an agent for the Delta Regional Authority, will soon be sponsoring medical screenings through churches in Clarke County.
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