Partnership joins UA and Pickens County in improving rural community’s health and educating students


The University of Alabama has teamed up with Pickens County to provide learning opportunities for students while improving the health and wellbeing of the rural county of nearly 20,000.

The University of Alabama-Pickens County Partnership seeks to provide sustainable health care for the county and “real world” training for UA students in medicine, nursing, social work, psychology, health education and other disciplines. Students will gain practice from internships and other learning opportunities, while Pickens County will gain additional and needed health resources.

When it was feared that Pickens County Medical Center, a 56-bed hospital that has provided inpatient, outpatient and emergency care for the rural county since it opened in 1979, would close, members of the community took action.

They met with UA leaders, including Dr. Richard Streiffer, dean of the UA College of Community Health Sciences, and former president Dr. Judy Bonner, and what began as a discussion about how to keep the medical center open evolved into a conversation about sustaining health care in the county.

CCHS hosted a meeting in December 2014 that included Pickens County leaders and citizens and UA vice presidents and deans. The conversation centered on envisioning a new model of health care for the county via an academic-community partnership. The idea was coined a Health Care Teaching County.

“A health care teaching county is novel in that in that it provides help for a community and learning opportunities and experiences for students,” says Streiffer. “It will train future physicians and other health care providers where most will practice, and sustain health care in communities that most need it.”

In 2015, $600,000 was obtained from the Alabama Legislature to initiate the Partnership, and with CCHS as the coordinator, the funds will be used to support the Partnership in the following ways:

1. A Partnership Coordinator was hired. Wilamena Hopkins joined the Partnership in May 2016 as coordinator. Originally from rural Archer, Florida, Hopkins, studied health care management at UA and has worked as an event and training coordinator for Maude Whatley Health Services in Tuscaloosa.

“My role is to make sure the community is aware of the Partnership and understands the Partnership, and I’ll be making sure that we are headed in the right direction and that at the end of this year, funding will continue,” Hopkins says. “I will be making sure that we are introducing innovative ideas into the community and providing needed resources.”

2. A portion of funding obtained will support eight projects that address Pickens County health issues. Each project includes a UA faculty, UA student and a Pickens County community organization or similar entity.

Disseminating the Power PATH mental health preventive intervention to Pickens County Community Action Head Start Program
Principal Investigator: Dr. Caroline Boxmeyer, associate professor of Psychiatry and Behavioral Medicine at CCHS
Co PIs: Dr. Ansley Gilpin, assistant professor of psychology at UA, and Dr. Jason DeCaro, associate professor of anthropology
Collaboration: Pickens County Community Action Head Start Program

TelePlay: Connecting physicians, families and autism professionals to increase early autism identification in Pickens County
PI: Lea Yerby, assistant professor of Community and Rural Medicine at CCHS
Co PIs: Dr. Angela Barber, assistant professor of Communicative Disorders and the clinical research director of Autism Spectrum Disorders Clinic at UA
Collaboration: Dr. Julia Boothe, family medicine physician in Pickens County

Improving Pickens County Residents’ Knowledge of Risk Factors for Cardiovascular Disease and Type 2 Diabetes
PI: Dr. Michele Montgomery, assistant professor at the Capstone College of Nursing
Co PI:  Dr. Paige Johnson, assistant professor at the Capstone College of Nursing
Collaboration: Pickens County Community Action Committee & CDC, Inc., Pickens County Board of Education, Pickens County Head Start, and the Diabetes Coalition

Development of a Rural Family Medicine Residency in Pickens County
PI: Dr. Richard Friend, director of the College’s Family Medicine Residency
Collaboration: Jim Marshall, CEO of Pickens County Medical Center; Deborah Tucker, CEO of Whatley Health Services

Pickens County Medical-Legal Partnership for the Elderly
PI: Gaines B. Brake, staff attorney with the Elder Law Clinic at The University of Alabama School of Law
Collaboration: Jim Marshall, CEO of Pickens County Medical Center

Improving Access to Cardiac Rehabilitation Services in Pickens County
PI: Dr. Avani Shah, assistant professor of Social Work at UA
Co PI: Dr. Jonathan Wingo, associate professor of Kinesiology at UA
Collaboration: Sharon Crawford Wester, RRT, Cardiopulmonary Rehab Pickens County Medical Center

Alabama Literacy Project
PI: Carol A. Donovan, professor of special education and multiple abilities at UA
Collaboration: Jamie Chapman, Superintendent of Pickens County Schools

Bringing Healthy Food options and ease of preparation home to our senior adults
PI: Jennifer Anderson, director of Osher Lifelong Learning Institute at UA
Co PI: Suzanne Henson, dietitian and assistant professor in Family Medicine at CCHS
Collaboration: Anne Jones, Pickens County Family Center and Mayor Joe Lancaster, City of Carrollton, Alabama


3. The Partnership also sought recent UA graduates for one-year paid fellowships that provide opportunities to serve in health-related capacities in Pickens County. Four fellows joined the Partnership: August Anderson, Laura Beth Hurst, Courtney Rentas and Judson Russell.

They will spend time in Pickens County in community engagement and leadership development activities, which include seminars on health and public policy as well as social determinants of health. They will also work on projects throughout the year.


Across the country, rural hospitals struggle to survive. Since 2011, Alabama rural hospitals have closed in Florala, Elba, Clanton, Hartselle, Thomasville and Roanoke. Others cut services, notably obstetrical care.

Pickens County Medical Center, which is county-owned and located in Carrollton, Alabama, had seen layoffs and furloughs and had cut programs and reduced services over the years.

What makes this worse is that rural areas are in more need of health care, as their citizens are typically older, sicker and poorer.

In Pickens County, 27 percent of the population lives below the poverty line and health outcome rankings show that the county is 41st among the state’s 67 counties.

Learn more about the Partnership at

College adds Emergency Medicine Fellowship

The College of Community Health Sciences is adding to its offering of graduate medical education an Emergency Medicine Fellowship.

The one-year program, which is provided in conjunction with Rush Foundation Hospital in Meridian, Mississippi, will accept two fellows who will start their rotations in July 2017.

The program will be based primarily at Rush Foundation Hospital, and will include rotations through radiology, anesthesia, orthopedics and trauma, and advanced courses in obstetrics, airway management and advanced life support.

Some of the rotations will take place at DCH Regional Medical Center in Tuscaloosa.

Funding for the program is provided by Rush Foundation Hospital, and Dr. Richard Friend, director of The University of Alabama Family Medicine Residency, which the College operates, says that more funding is being sought to grow the program over time.

Friend, who specializes in emergency medicine, says establishing this fellowship has been a goal since he arrived at the College in 2013.

“Fifty percent of all family physicians do some sort of urgent care or emergency medicine, and I think this will provide another venue for advanced education in areas where family medicine physicians might need some additional training,” he says.

Friend, along with Dr. Tamer Elsayed, assistant director of the College’s Family Medicine Residency and an alumnus of the Residency, and Dr. Walt Willis, the Emergency Room director at Rush Foundation Hospital, will work to develop the curriculum. Elsayed and Willis will direct the fellowship.

The College provides training in sub-specialties of family medicine to suit the needs of communities in Alabama and the region, including obstetrics, sports medicine, hospital medicine, behavioral health, rural public psychiatry and geriatric medicine.

For more information about the fellowships the College offers, visit

Faculty present at annual meeting of family physicians

Faculty at the College of Community Health Sciences presented about dementia, obesity in the media, pediatric limp and other topics at the annual meeting of the Alabama Academy of Family Physicians, which was held June 15-19 in Sandestin, Florida.

The meeting allows family medicine physicians throughout the state to connect, earn continuing medical education and learn more about representing family medicine in the legislative, regulatory and public arenas.

Pediatric Limp

Your child can’t sleep because his or her legs ache, something parents call growing pains. Doctors refer to this as non-specific limb pains of childhood and estimate that 20 percent of children aged 2 to 12 report mild to severe pain in their legs at night. There are no symptoms in the morning.

“The leg pain must be bilateral and it only occurs at night. The cause is unknown and there is no pain, limp or symptoms during the day,” said Dr. Richard Friend, an associate professor of family medicine for the College and director of its Family Medicine Residency. “We think it’s related to increased activity – moving around a lot during the day, and increased sports.”

Growing pains are often described as an ache or throb in the legs, often in the front of the thighs, the calves or behind the knee. Studies indicate the pains could be a sign of overused muscles.

In addition to growing pains, Friend also touched on other walking-related pain children might face in his presentation, “Pediatric Limp.” Juvenile rheumatoid arthritis can onset between the ages of 4 and 10, he said, and leg pain in children ages 11 to 16 often is a result of overuse.

Friend said when physicians exam children with leg pain, they need to take a good health history of the patient and perform a physical exam. “Observe the patient crawling and walking. Get the child or caretaker to localize the pain. Is it morning or evening pain, or all-day pain? This is important because arthritic pain is a morning pain while leukemia is mostly a night pain.”

When performing a physical evaluation, Friend said “listen to the sound of the feet hitting the floor. Have them stand on their toes and heels and hop on one foot.”

If needed, take x-rays of the area in question, from the hips to the feet, he said, adding that ultrasounds and bone scans can also be useful.


Dementia: Differentiating the Types

Physical and mental activity are among the best ways to treat or slow dementia, which affects 25 million people in the developed world and is the sixth leading cause of death, said Dr. Tom Weida, a professor of family medicine for the College and associate dean for Clinical Affairs.

Alzheimer’s dementia is the most common form of dementia and is a clinical loss of memory. “It’s the inability to lay down new memory, and it can lead to paranoia, delusions and an inability to swallow,” Wedia said in his presentation, “Dementia: Differentiating the Types.” He said the clinical presentation of Alzheimer’s dementia is a loss of: memory, executive function, visual-spatial orientation and social graces.

While age is the most common risk factor for dementia, family history, head trauma, depression and obesity also contribute to the risk. Weida said a strong screening tool is a verbal fluency test that requires patients to name as many animals as they can in 60 seconds. If patients name fewer than 15 animals, “it is suggestive of dementia. This is a highly specific and highly sensitive test.”

There are medications that can be prescribed for dementia, but they have side effects and there is limited evidence that they are effective, although they might slow dementia a bit, Weida said. He said non-medication treatments like physical activity and cognitive activity “seem to work the best. Brain stimulation seems to quell dementia states – art, music, reading, crossword puzzles and number puzzles.”

Good health is also important, Weida said, particularly a diet low in saturated fat, and high in fruits, vegetables and folic acid.


Interviewing for Residency

The College’s Family Medicine Residency, a three-year program that provides specialty training for physicians, accepts 16 new residents each year but annually receives approximately 2,000 applications. Of those, 150 applicants are interviewed.

“You are competing against a lot of people,” residency Director Dr. Richard Friend told an audience of more than 50 medical students ready to enter residencies.

Across Alabama, family medicine residencies accept only 55 medical school graduates per year. There are just 470 family medicine residencies in the United States. Funding for residency training slots is provided by Medicare, the US health program for the elderly. “There won’t be any new slots any time soon,” Friend said, which makes residency interviews vitally important.

When medical school graduates apply for residency positions, they use the Electronic Residency Application System, or ERAS, which is a system that collects common information from all graduates. “Interviews provide what can’t be seen in ERAS,” Friend said. “Applicants can explain their strengths and weaknesses … and showcase themselves.”

He said the interview process starts when the application is submitted to ERAS. “Don’t do your application the night before. Work hard on it and don’t take it lightly. Proofread it and make sure it’s complete. Spend time on your personal statement. Remember, you’re competing against a lot of people.

Friend said the College’s program, The University of Alabama Family Medicine Residency, ranks the applicants it brings in prior to their interviews. “Some candidates have moved up in rank after the interview,” he said.

Other advice? “Have a professional email address and voice mail message. And find out how you appear online. Social media is a good resource for us,” Friend said.


Updates in Adult Primary Care

Dr. Scott Arnold, chair of Internal Medicine for the College, provided a review in literature of the previous year in primary care and shared his recommended changes in practice.

One study he shared looked at the relationship between the use of lipid-lowering statins and a heightened risk for diabetes. More than 3,000 non-diabetic statin users and more than 3,000 non-diabetic statin non-users were studied retroactively, and diabetes developed in 31 percent of the statin users versus 19.4 percent of the statin non-users.

This is consistent with other prior studies, Arnold said.

“This appears to be a real entity,” he said. “It should give us pause only with those with primary prevention patients with borderline benefits. When do the benefits outweigh the risks?”

Another study he shared looked at identifying the community acquired pneumonia (CAP) pathogen and whether or not antibiotics should be used to treat this pathogen.

The study examined 2,200 adults in five hospitals in Chicago and Nashville who demonstrated CAP. Only 38 percent of the cases had an identifiable pathogen, and of those, 23 percent were viruses, 11 percent bacterium, 3 percent were both and 1 percent fungus or mycobacterium.

“We are overusing antibiotics for CAP,” he said. “We need to figure out in the future who needs antibiotics and who doesn’t.”


Obesity in the Media

When doctors have conversations with their patients about weight loss, realistic goals must be set, said Dr. Alan Blum, the Gerald Leon Wallace Endowed Chair of Family Medicine for the College.

One-third of the United States is obese and Alabama has led the nation in obesity trends, Blum said in his presentation. But with the media littered with advertisements for sugary drinks and supersized fast food portions, coupled with magazines and TV advertising touting extreme weight loss goals, like losing 30 pounds in 30 days, reality gets skewed, he said.

As a result, many patients arrive into the exam room with unrealistic expectations.

“Many people might suggest that a pound a week is normal weight loss,” Blum said. “But we’re really not ever giving good advice if we’re going to suggest that to our patients. I ask instead, ‘What would you like to weigh?’ People usually have a number. Then I ask, ‘When was the last time you weighed that much?’”

The reality test, he said, is when he asks the patient how long they think it will take to lose the weight.

“If it took 10 years to get there, why would they think it should take three months to get it off?” he says.

Blum thinks more action must be taken to prevent obesity in the first place. He says physicians should make the following suggestions to patients:  support breastfeeding, limit sugary beverages, encourage family meals with less fast foods and more fruits and vegetables, get exercise and spend two hours a day or less on a phone or at a TV.

Medical students elected as student officers for Alabama Academy of Family Physicians

Two medical students at the College of Community Health Sciences were elected to yearlong student leadership positions with the Alabama Academy of Family Physicians.

The University of Alabama School of Medicine students, who are receiving their third and fourth years of clinical education at the College, were named to the positions after an election that took place at the Academy’s annual meeting, which was held June 16-19 in Sandestin, Florida.

D. Paul Strickland, a third-year medical student and a Rural Medical Scholar, was elected the communications chair for the student leaders.

Jessica Powell, a fourth-year medical student and also a Rural Medical Scholar, was elected as the communications liaison to Tuscaloosa.

One of the College’s functions is to serve as the Tuscaloosa Regional Campus for the University of Alabama School of Medicine, providing clinical education for a cohort of third- and fourth-year medical students. All students receive their first two years of medical education at the School of Medicine’s main campus in Birmingham.

Four additional medical students from other School of Medicine campuses were also elected to positions.

More than 900 family physicians and more than 430 students and family medicine residents across the state make up the Alabama Academy of Family Physicians. The annual meeting allows members to connect, earn continuing medical education and learn more about representing family medicine in the legislative, regulatory and public arenas.

Residents, fellows honored at graduation

Twenty-one physicians were honored at the 41st annual graduation ceremony of The University of Alabama Family Medicine Residency and Fellowships.

The 14 resident physicians and seven fellows who were honored at the ceremony, held Saturday, June 25, at the Zone-South at Bryant Denny Stadium on the UA campus, will soon begin their own practices in Alabama and other states. Some resident physicians will go on to complete fellowship programs.

The UA College of Community Health Sciences provides graduate medical education through both the three-year Family Medicine Residency and year-long fellowships for family medicine physicians seeking additional training in behavioral health, hospitalist medicine, obstetrics, rural public psychiatry, sports medicine or geriatric medicine.

“We’re very proud of the work this group has done in continuing the mission of the College,” said Dr. Richard Streiffer, dean of CCHS, as he welcomed graduates and attendees.

Dr. A Robert Sheppard, associate professor of Internal Medicine and the director of the College’s Hospitalist Fellowship, was the guest speaker of the ceremony.

He shared with the graduates that he grew up poor on a farm in south Alabama, and that he initially struggled when he came to UA as a pre-med student. His academic advisers discouraged him from pursuing medicine because of his low grades, he said, and he had trouble with reading comprehension and vocabulary.

But he worked diligently, improved and was eventually accepted to the University of Alabama School of Medicine.

“Don’t ever give up,” he said to the graduates. “And don’t ever let someone tell you that you can’t do something.”

Awards were given to many of the graduating residents, including the inaugural William W. Winternitz Award in Geriatrics, which was given to Dr. Michael Gabriel in recognition of his interest in geriatrics and exceptional care of the geriatric population.

Dr. Anne Halli-Tierney, a geriatrician and assistant professor in Family Medicine at the College, presented the award, which is named in honor of Dr. William W. Winternitz, a founding faculty member of the College who passed away in October 2015.

“[Dr. Winternitz] had a passion for the field of medicine and especially for academic medicine and the betterment of medical students and residents.” Halli-Tierney said.

Winternitz joined the College in 1977, serving as professor and chair of Internal Medicine and Director of Medical Student Affairs. He remained active at the College after his retirement.

He and his wife, Madeleine Hill, established the William W. Winternitz Geriatric Gift Fund to support the College’s Geriatric Initiative to provide enhanced educational opportunities for medical students and residents, new service-based learning opportunities and increased patient interaction.

“This award is supported by and named for a man truly dedicated to teaching both patients and medical learners,” said Halli-Tierney. “And it is given to the resident who has shown a solid interest in geriatric medicine and has provided exceptional, compassionate care of the geriatric population during his time at CCHS.”


2016 Graduating Fellows:

Dr. Nicole Denise Arthur, Obstetrics Fellow
Dr. Alexis Tanishia Mason, Behavioral Health Fellow
Dr. Byron Oswaldo Mata Gonzalez, Hospitalist Fellow
Dr. Bogdan Strambu, Hospitalist Fellow
Dr. Antoanela Zaharia, Hospitalist Fellow
Dr. Matthew David Andres, Sports Medicine Fellow
Dr. Carl Hunter Russell, Sports Medicine Fellow


2016 Graduating Residents:

Dr. Chandra Rekha Americhetty
Dr. Sirisha Chada
Dr. Mary Margaret Clapp
Dr. Jason Lee Clemons
Dr. Eric James Curley
Dr. Timothy Scott Eckford (chief resident)
Dr. Michael Daniel Gabriel
Dr. Katie Marie Gates (chief resident)
Dr. Maysoon Hamed
Dr. Ambreen Mardhani
Dr. Bhavika Rajanikant Patel (chief resident)
Dr. Jerry Yue Shen
Dr. Ross Alexander Summerford


Residency Award Winners

William R. Willard Award – Dr. Jacquelynn Luker (first-year resident)
Internal Medicine-Intern Award – Dr. Jacquelynn Luker
Internal Medicine-Best Resident – Dr. Katie Gates and Dr. Ross Summerford
Pediatrics Award – Dr. Eric Curley
Psychiatry Award – Dr. Bhavika Patel
Psychiatry/R3 Award – Dr. Jason Clemons
Obstetrics and Gynecology Award – Dr. Michael Gabriel
Research/Scholarship Award – Dr. Mary Margaret Clapp, Dr. Katie Gates, and Dr. Ambreen Mardhani
William W. Winternitz Award in Geriatrics – Dr. Michael Gabriel
Society of Teachers in Family Medicine Teaching Award – Dr. Jason Clemons
Clinical Competency Committee Awards –  Dr. Jason Clemons (third year), Dr. Keri Merschman (second year), Dr. Cheree Melton (first year), and Dr. Ashley Wambolt (first year)
William F. deShazo III Award – Dr. Ross Summerford
360 Award – Dr. Katie Gates


Rural Medical Scholar Graduates Recognized
Dr. Jason Clemons
Dr. Katie Gates
Dr. Ross Summerford
The College’s Rural Medical Scholars Program is designed to recruit students from rural Alabama who want to become physicians and practice in rural communities in the state.

For more coverage of the event, including photo galleries, click here.

WVUA Report: Heat Safety Tips for Summer

Dr. James Robinson, Endowed Chair of Sports Medicine at the College of Community Health Sciences, discusses some heat safety tips for summer.

UA Matters: Using Mindfulness to Lower Stress

Many chronic conditions, like high blood pressure, insomnia or heartburn, can be traced to a single common problem: stress.

Common advice for fighting stress is to eliminate the stressors, which could mean going to bed early or just saying “no” more often. But that doesn’t address how our brains handle stress hour-to-hour or moment-to-moment, says The University of Alabama’s Dr. Harriet Myers.

UA Matters: What is Mindfulness, and How Can I Cultivate it?

Mindfulness has become a popular buzz word, but it can be difficult to understand until you have tried it yourself. Mindfulness and contemplative practices have been in existence for thousands of years.

The University of Alabama’s Dr. Caroline Boxmeyer explains how mindfulness and contemplative practices can improve overall health and well-being.