\n<\/p>\n
At a rural clinic on a Native American reservation, Nina Sanfilippo encountered a model of care designed to keep patients\u2014and aspiring health-care providers\u2014rooted in their community.<\/p>\n
Sanfilippo, a third-year physician assistant student at Touro University, spent 12 weeks in a clinical rotation in Covelo, a quiet, rural town in Northern California where the closest hospital and medical specialists are nearly two hours away. The clinic, one of several where Touro students complete their rotations, serves a close-knit community shaped by systemic inequities and long-standing barriers that shape how residents seek and receive care.<\/p>\n
\u201cWatching all of these amazing providers work tirelessly\u2014not only to care for their patients, but to make sure they feel heard and taken seriously\u2014really blew me away,\u201d Sanfilippo said. \u201cEveryone was so collaborative and motivated to take care of their own community.\u201d<\/p>\n
Across the country, rural communities face persistent shortages of physicians and dentists, despite decades of policy attention. Sanfilippo is one of many medical students at Touro University who are part of the institution\u2019s effort to address those gaps through locally centered training models designed to keep providers where they\u2019re most needed.<\/p>\n
Touro has taken a place-based approach in two states\u2014California and New Mexico\u2014using its medical and dental schools to build clinics and workforce pipelines focused not just on training but on rural retention.<\/p>\n
Alan Kadish, Touro\u2019s president and a physician himself, has been a driving force behind the institution\u2019s investment in rural health care, choosing to open satellite colleges in rural communities and train providers to help fill long-standing gaps.<\/p>\n
\u201cThe main thing that convinced us was the magnitude of the problem,\u201d Kadish said. \u201cIn many of the places where we\u2019ve opened schools, we\u2019ve found that rural health indicators are poor.\u201d<\/p>\n
\u201cWe are not a major provider directly in rural health care, but we are collaborating in a number of ways with many of the people who deliver health care rurally,\u201d he added, noting that the institution has worked on telemedicine and teledentistry initiatives to reach residents who live far from a hospital or clinic.<\/p>\n
Kadish said those partnerships are central to Touro\u2019s strategy, allowing the institution to support care delivery in the communities it serves.<\/p>\n
\u201cWe partner with the local communities where we are and try to understand local culture\u2014the way local health-care systems and government work\u2014and try to interact with them positively,\u201d Kadish said. \u201cIt has been a conscious effort, and one that\u2019s needed to make a difference.\u201d<\/p>\n
California\u2019s rural care:<\/strong> Tami Hendriksz, dean and chief academic officer of Touro University California College of Osteopathic Medicine, has led the institution\u2019s investment in rural communities in California through expanded outreach and partnerships with underresourced local clinics. The initiative increases health-care access while giving students hands-on, community-based training, aligning with the university\u2019s commitment to reducing health inequities.<\/p>\n As a result, 21\u00a0percent of its graduates now practice in underserved areas and 8\u00a0percent in rural communities\u2014the highest proportion of any medical school in the state, according to the National Center for the Analysis of Healthcare Data.<\/p>\n \u201cWe\u2019re here to address the workforce shortages, and in order to do so, you really have to partner with rural communities,\u201d Hendriksz said.<\/p>\n Just as importantly, the model emphasizes residency placement and long-term retention in rural regions, with many graduates choosing to stay and practice in the same communities where they trained.<\/p>\n \u201cWe\u2019re the only medical school in the country that has a program learning outcome of structural competency,\u201d Hendriksz said. \u201cThe way I describe structural competency is we\u2019re not just teaching our students about the social determinants of health, but we\u2019re taking it a step further to talk about why those social determinants of health exist.\u201d<\/p>\n A Touro University physician assistant trainee practices clinical skills.<\/span><\/p>\n New Mexico\u2019s oral health: <\/strong>Ronnie Myers, dean of Touro\u2019s College of Dental Medicine, said New Mexico had never had a dental school before the institution opened its doors.<\/p>\n \u201cThat brings up a whole set of issues\u00a0\u2026 because it\u2019s clearly known that people who go to school or are educated in an area are more likely to stay in that area when they\u2019re done,\u201d Myers said. \u201cThat\u2019s truly written in the literature as far as residencies are concerned.\u201d<\/p>\n Touro launched the state\u2019s first dental school and clinic in Albuquerque to address one of the nation\u2019s lowest dentist-to-resident ratios. Myers said the national average is about 61 dentists per 100,000 residents; in New Mexico, it\u2019s about 42 per 100,000\u2014and the state has seen a roughly 10\u00a0percent drop in dentists over the past decade.<\/p>\n \u201cNew Mexico is one of the highest Medicaid-population states in the U.S., so the number of underserved and underinsured is high,\u201d Myers said. \u201cThe potential for people leaving because of reimbursement is high, especially given the debt of dental students.\u201d<\/p>\n The program focuses on recruiting students with ties to New Mexico and training them locally, while building a long-term dental workforce for rural and underserved areas in the state.<\/p>\n \u201cThey enjoy the area, and many of them have expressed the idea that this might not be a bad place to live and practice,\u201d Myers said.<\/p>\n Keeping care local:<\/strong> Hendriksz said Touro\u2019s training model is already showing results in retaining clinicians in rural communities.<\/p>\n \u201cThe most successful way to keep clinicians in rural, underserved areas is to recruit them from those areas,\u201d Hendriksz said. \u201cWe\u2019re seeing what the local workforce shortages are, and we\u2019re reaching out to the high schools, middle schools and community colleges to help set up some of those pathways.\u201d<\/p>\n She added that attacks on diversity, equity and inclusion have made it even more important to find ways to produce clinicians who look like the communities they\u2019re serving.<\/p>\n \u201cOne of the best ways to do that is to bring people from those communities that are committed and invested in those communities, because it\u2019s their family, it\u2019s where they\u2019re from,\u201d Hendriksz said.<\/p>\n Myers agreed, adding that universities need to be willing to take those types of risks to improve their programs.<\/p>\n \u201cYou see a need, and you see something that you believe will increase health-care access and get students to understand what it means to be community players and so on\u2014but if you don\u2019t have the university to say, \u2018This is something we want to do,\u2019 well, you may not get to,\u201d Myers said.<\/p>\n Ultimately, Myers said the early outcomes suggest that place-based recruitment and training can make a measurable difference in addressing provider shortages and improving local health care access.<\/p>\n \u201cWhether it\u2019s dentistry, whether it\u2019s primary health care, whether it\u2019s emergency care, I think it\u2019s important to\u00a0\u2026 expand what your footprint can be,\u201d Myers said.<\/p>\n (This story has been updated to correct Tami Hendriksz’s title. She’s the dean and chief academic officer of Touro University California College of Osteopathic Medicine.)<\/em><\/p>\n Get more content like this directly to your inbox. <\/em>Subscribe here.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" At a rural clinic on a Native American reservation, Nina Sanfilippo encountered a model of care designed to keep patients\u2014and aspiring health-care providers\u2014rooted in their community. 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