College Aims to Boost Numbers of Primary Care Physicians from Diverse Backgrounds

College Aims to Boost Numbers of Primary Care Physicians from Diverse Backgrounds

Oklahoma’s poor health outcomes are partly due to access to medical care: Of the state’s 77 counties, 76 have a shortage of primary care physicians. Seventy-three counties don’t have enough mental health professionals to care for the population.

Those statistics, from the Oklahoma State Department of Health, may paint a discouraging picture, but the OU College of Medicine is determined to change those numbers, year by year. And the college has received new resources for the work: a $4.7 million grant from the U.S. Department of Health and Human Services.

“We have a great need for primary care physicians in our state, particularly in rural areas, under-represented communities and tribes,” said Steven Crawford, M.D., Senior Associate Dean and Director of Healthcare Innovation and Policy. Crawford is leading the grant with James Herman, M.D., dean of the OU-TU School of Community Medicine on the Tulsa campus.

The aim of the grant is two-fold: to recruit, retain and admit students from rural, tribal and medically under-represented areas, and to enhance the primary care experience among current medical students. Data shows that students from those groups who attend medical school and residency in Oklahoma are more likely to return to their communities to practice medicine.

The ultimate goal is to reduce healthcare disparities among Oklahomans and raise the health of the state. The School of Community Medicine, the college’s branch campus in Tulsa, is a prime example of the need. The school was founded in 2008 in the wake of a city study that revealed a 14-year difference in life expectancy between people who live in north Tulsa and south Tulsa. When a person’s ZIP code largely dictates their health, change is needed.

“Clinicians need to understand the needs of the people they are serving, to understand the facilitators of their health, to manage chronic disease, but also to understand the barriers to that for their patients,” said Frances Wen, Ph.D., an associate professor of family medicine on the Tulsa campus and a primary faculty participant in the grant. “Having personal and lived experience more fully informs a clinician’s approach to working with the people they serve.”

The School of Community Medicine plans several experiences designed to help current students better understand the importance of primary care and perhaps choose it for their future careers. Two new courses, Lifestyle Medicine and Health Promotion I and II, have been added to the curriculum to further educate students about the roles of food and exercise in promoting better health for their patients. Two other courses, Health System Science in Practice I and II, teach

students skills needed to practice in the modern health system. They also take students on a deeper dive into the social determinants of health – understanding that their patients’ health is affected by what takes place in their families, neighborhoods, the community at large and healthcare systems.

Students will put that knowledge into practice during the ongoing longitudinal care they provide at Bedlam Clinics, where people without health insurance receive treatment. Wen said partnerships also are being developed with the Creek Nation and Hillcrest Health System so that students can gain experience in their rural networks.

“Despite everything a physician can do, if we can’t get patients access to healthcare, then we’re not going to be able to improve their quality of life,” Crawford said. “We need more primary care professionals so that we can focus on prevention – providing vaccines, mammograms, colonoscopies and other things that can prevent disease or discover it at its earliest stages.”

However, to significantly increase Oklahoma’s number of primary care health professionals, the college must move upstream by interacting with students who are in middle and high school, mentoring those with interest and helping them clear hurdles to becoming a doctor.

The new grant will expand several existing programs in the College of Medicine in which students come to campus to

interact with healthcare professionals and researchers. Programs like Club Scrubs and Mini Medical School have already seen success in sparking interest among young people. Robert Salinas, M.D., a family medicine physician and assistant dean for diversity, said the success of such programs hinges on supporting students for years along the pathway to medical school.

“We believe that we can address the inequities in healthcare by bringing in students from diverse backgrounds – women, people from rural Oklahoma, the Latino and Hispanic communities, Native Americans, African-Americans and others who have traditionally been under-represented,” Salinas said. “Data suggests that if you bring in a more diverse workforce, you have better health outcomes. Those better outcomes may happen for a number of reasons – understanding the patient, culturally and linguistically, understanding their belief systems – but the overall goal is to bring in more students from around the state who want to go back and serve their communities, specifically in primary care.”

Faculty from both campuses plan to reach out to primary care physicians in communities across the state to enlist them in mentoring young people who dream of becoming physicians or other healthcare providers. Doctors across Oklahoma are especially positioned to identify young people, perhaps their own patients, who are interested in medicine.

“This grant asks us to be innovative and to create strategies – how do we reduce health disparities by bringing in students from under-represented groups who want to go back and serve their communities?,” Salinas said. “In what ways can we expose our current medical students to the importance of primary care? I believe this type of work is an institutional responsibility. As an academic health system, we have an obligation to provide leadership for the state.”

This project is supported by the Health Resources and Services Administration of the U.S. Department of Health and Human Services as part of an award totaling $4,704,476 with 10% financed with nongovernmental sources. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.