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 cchs.ua.edu/pickenscounty.

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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.

AAFP-student-officers-web

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.

The 41st Annual Graduation Ceremony honoring the 2016 graduates of The University of Alabama Family Medicine Residency and Fellowships

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.

Mini Med School series with OLLI continues

There are times patients might ask their doctors for medications and tests that might not be necessary and that could cause harm, according to Dr. Ray Brignac, a family medicine physician who practices at University Medical Center-Northport, which is operated by the College.

During a lecture that was part of the College’s Mini Medical School program with The University of Alabama’s OLLI program, Brignac said doctors and patients need to talk and to use evidence-based recommendations to make the best care decisions possible.

“You need to put as much research into your medical decisions as you do buying a car or a washing machine,” he said. “There’s a lot of information out there. Try to go where the evidence is.”

A national campaign called Choosing Wisely advocates just that. The campaign encourages doctors and patients to have conversations informed by evidence-based recommendations that facilitate good decisions about appropriate care based on a patient’s individual situation, and to avoid unnecessary medical tests, treatments and procedures.

“The Choosing Wisely campaign gives us good tools to be better informed and wiser,” said Brignac, who titled his lecture “Choosing Wisely in Geriatrics.”

OLLI, short for Osher Lifelong Learning Institute, is a member-led program educational program catering to those aged 50 years and older. The College’s Mini Medical School lecture series through OLLI provides an opportunity for OLLI members and community learners to explore trends in medicine and health and to receive important information about issues and advances in medicine and research.

Brignac presented on May 3, and Dr. Catherine Ikard, a physician at University Medical Center and UMC-Northport, presented on May 10.


Choosing Wisely in Geriatrics
Brignac said older people often have more medical conditions and, as a result, take more medications than younger people. While medications have benefits, they also carry risks. “Is it always wrong to take medications? No. But you need to exercise caution,” he said.

He noted that sleeping pills help with insomnia, which affects many people over the age of 60, but studies show increased falls by those taking sleeping pills. Antibiotics do not cure colds and have risks, including diarrhea and damage to nerves and tendons. Nutritional supplements have the potential to react with other medications. Narcotics are not always the best way to treat chronic pain and non-drug interventions like exercise and physical therapy are sometimes more  effective. Non-steroidal anti-inflammatory medications like Aleve and Ibuprofen are safe but can sometimes cause gastrointestinal bleeding and increased risk of heart attack or stroke, and while acetaminophen, found in Tylenol, is a good medication, if taken in excess can damage the liver. Medications for heartburn and acid reflux can carry higher risk of osteoporosis, but sometimes avoiding certain foods and sleeping with the head of the bed raised can help.

“It’s not that you shouldn’t ever take these drugs, but you need to be aware of the risks,” Brignac said. “It’s always good to questions medications – are there alternatives, lower doses?”

Many older patients have low back pain and often ask for X-rays or MRIs, Brignac said. He recommends patients wait a month before tests because most back pain clears up in that time. “If you jump right into testing, you can create needless anxiety, or you might wind up under the surgeon’s knife unnecessarily.”

Brignac joined University Medical Center-Northport last year after a 34-year practice at Selma Medical Associates in Selma, Ala. In addition to family medicine, Brignac also has an interest in geriatrics and nursing home patients and is working to build a “hands-on” nursing home practice in Northport and Tuscaloosa.

Recognizing, Treating and Preventing Strokes
If you suspect someone you know is having a stroke, the most important information that can be relayed to the EMT or physician treating that person is the last known well time, said Dr. Catherine Ikard.  This will determine the course of treatment.

Ikard, assistant professor in Psychiatry and Behavioral Medicine and Internal Medicine, spoke about the causes, symptoms and treatments of strokes at a lecture she presented as part of the College’s Mini Medical School with The University of Alabama’s OLLI program.

OLLI, short for Osher Lifelong Learning Institute, is a member-led educational program catering to those aged 50 years or older. The College’s Mini Medical School lecture series through OLLI provides an opportunity for adults and community learners to explore trends in medicine and health, and the lectures by CCHS faculty offer important information about issues and advances in medicine and research.

One of the best ways to identify if someone might be having a stroke is to ask the person to smile. If the smile is lopsided or there is drooping, the person might be having a stroke, Ikard said.

If a stroke is caused by a blood clot, a medication called a tissue plasminogen activator, or tPA, may be given within four and a half hours of the last-known well time, said Ikard.

After four and a half hours, or if the patient cannot receive a tPA for medical reasons, endovascular therapy can be used, which involves the use of a stent retriever that a doctor routes through a catheter to the blocked artery and removes the clot, Ikard said.

“If you suspect a stroke, call 911,” Ikard said. “If it is a stroke, every 30 minute delay could lead to a 10 percent relative reduction in recovery.”

Wilamena_Hopkins

Coordinator of UA-Pickens County Partnership joins College

Wilamena Hopkins has joined the College of Community Health Sciences as the project coordinator for the UA-Pickens County Partnership, an effort that seeks to provide sustainable health care for the rural county and “real world” training for UA students.

The partnership of UA and Pickens County and its medical center will allow students in medicine, nursing, social work, psychology, health education and other UA disciplines to gain practice from internships and other learning opportunities in Pickens County, and the rural county will gain additional health resources.

Hopkins will be located primarily in Pickens County at its medical center and will direct and facilitate overall development, oversight implementation and administration for the project and serve as a liaison into the community and promote the partnership and its projects to the people of Pickens County and the UA community.

Approximately $600,000 was obtained from the Alabama Legislature in 2015 for the project, and the funds will be used for projects that address health needs in Pickens County, for fellows to serve in health-related capacities in Pickens County and for the project coordinator.

Four recent UA graduates have been selected for a one-year fellowship that will provide opportunities to serve in health-related capacities in Pickens County.

The projects that address an identifiable health issue or priority within the Pickens County community must involve UA faculty, students and a Pickens County community organization or similar entity.

The grant projects include:

1. 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

2. TelePlay: Connecting physicians, families and autism professionals to increase early autism identification in Pickens County
PI: Dr. 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

3. 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

4. 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

5. 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

6. 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

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

8. 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

 

Morales-Aleman_Headshot

Faculty joins Institute for Rural Health Research, Community and Rural Medicine

Dr. Mercedes Morales-Alemán has joined the College of Community Health Sciences as an assistant professor in the Department of Community and Rural Medicine and the Institute for Rural Health Research.

Morales-Alemán researches health disparities and health promotion among Latino populations in the southeastern United States through a community-based participatory lens.

She received her bachelor’s degree from the University of Puerto Rico, and her master’s and doctoral degrees in ecological-community psychology from Michigan State University.

Morales-Alemán was a research fellow for the Centers for Disease Control and Prevention in the Division of HIV/AIDS Prevention. At the CDC, she studied the multi-level predictors of intimate partner violence and access to HIV services in ethnic minority communities at risk for or living with HIV and AIDS.

She recently completed a training fellowship in Preventive Medicine at the University of Alabama at Birmingham, where she studied the social determinants of sexual health and health care access among adolescent Latinas in the South.

“I look forward to contributing to the University’s mission of excellence in research, teaching and service and to the Institute’s mission of bringing the highest attainable standard of health to rural citizens,” she says.

Medical students honored, presented awards at convocation

Thirty-one medical students were honored at the College of Community Health Sciences’ Senior Convocation on Friday, May 13, at the Tuscaloosa River Market. The students, now physicians, are beginning their residency training in programs across 11 states.

See the full coverage of Senior Convocation, including photos, a list of graduates and awards, here.

The students received their third and fourth years of clinical education at the College, which also functions as the Tuscaloosa Regional Campus for the University of Alabama School of Medicine. All students at the School of Medicine spend their first two years of medical education at the School of Medicine’s headquarter campus in Birmingham and then receive their clinical education at either Birmingham, Tuscaloosa, Huntsville or Montgomery.

In an opening address at convocation, Dr. Craig Hoesley, senior associate dean for medical education at the School of Medicine, said the students are leaving the College and the School of Medicine “even better than it was when they found it.”

The students received awards from faculty, clinical staff and their peers. One of the awards presented was the newly-named William Owings Award in Family Medicine, which was awarded to Dr. Elizabeth Junkin for demonstrating excellence in Family Medicine.

Owings, who recently retired from the College, was recognized at the ceremony by Dr. Drake Lave

nder for his 20 years of service.

“Dr. Owings embodies all that is good in family medicine,” he said. “He was practicing full spectrum family medicine before family medicine even existed.”

On Sunday, May 15, the students joined their 173 classmates for commencement.

At commencement, Dr. John Thomas Killian Jr. received the Hugh J. Dempsey Award, given to the student with the highest overall academic achievement over the four-year course of medical school. Dr. Amber Michelle Beg received the Medical Alumni Association Leadership and Community Service Award.

Awards given at Convocation:

Department and College Awards:
Robert F. Gloor Award in Community Medicine
Drs. Jackson Averett Reynolds and Daniel Seale
Awarded for excellent performance in Community and Rural Medicine

William Owings Award in Family Medicine
Dr. Elizabeth Ann Junkin
Awarded for excellence in Family Medicine

Rural Medical Scholars
Drs. Nicholas Drew Darby, Justin Len Deavers, Andrew Lloyd Jones, Nicholas Allen Rockwell, Daniel Seale, Elijah J. Allen Stiefel

Family/Rural Medicine Preceptor’s Award
Dr. J.D. Shugrue
Awarded annually to a community preceptor in Family Medicine/Community and Rural Medicine who exemplifies excellent teaching and role modeling for students.

William Winternitz Award in Internal Medicine
Dr. Melissa Rae Jordan
Awarded for outstanding achievement in Internal Medicine during the third and fourth years. This student possesses an exceptional wealth of knowledge, is able to integrate the pathology of disease with the physiology of clinical skills, and practices with empathy, compassion, and a desire to improve the patients with whom he or she comes in contact.

Neurology Award
Dr. John Thomas Killian, Jr.
Awarded for outstanding academic and clinical performance during the Neurology Clerkship.

Pediatrics Recognition Award
Dr. Andrew Lloyd Jones
Awarded for outstanding interest, ability and the reflection of pleasure in helping parents and their children reach their full personal, social and educational potential.

Peter Bryce Award in Psychiatry
Dr. John Thomas Killian, Jr.
Awarded for excellence exhibited by a medical student both academically and clinically during his/her Psychiatry Clerkship. This award is presented in honor of Dr. Peter Bryce, who was appointed the first superintendent of Bryce Hospital in Tuscaloosa. He and his wife, Ellen Clarkson Bryce, were cornerstones for Tuscaloosa society and tenacious advocates for people who experience mental illness.

Finney/Akers Memorial Award in Obstetrics and Gynecology
Dr. Brittany Taylor Massengill
Awarded to a student achieving outstanding academic and clinical success in Obstetrics and Gynecology. This award is presented in honor of former medical students James H. Akers and Teresa K. Finney.

William R. Shamblin, MD, Surgery Award
Drs. Daniel Barton Booth, John Thomas Killian, Jr. and Paul Frederick Sauer, Jr.
Awarded to a student or students with the highest scholastic achievement during their third-year Surgery Clerkship. Dr. William R. Shamblin, a Tuscaloosa native and former Chair of the Department of Surgery, spent years educating medical students and Family Medicine residents. This award continues in his honor.

Interprofessional Excellence Award
Dr. Jonathan Russell Guin
This award recognizes the medical student who has best demonstrated excellence in communication skills, respect for staff and patients, and a commitment to working as an effective member of the health care team.

Larry Mayes Research Society Scholars
Drs. Daniel Barton Booth, Pia Marie Abano Cumagun, Katherine Rainey Dean, Wyman Oscar Gilmore III, Jonathan Russell Guin, Andrew Lloyd Jones, Brittany Taylor Massengill, Cyrus Massouleh, Jackson Averett Reynolds, Robert Rhett Rhyne, Nicholas Allen Rockwell, Daniel Seale, Elijah J. Allen Stiefel

Official Fellow Members:
Drs. Nicholas Drew Darby, Justin Len Deavers, Lauren Marie Gibson, Melissa Rae Jordan, Elizabeth Ann Junkin

Official Members: Drs. Emily Cleveland Ager, Cory Daniel Smith

Student Research Award
Dr. Wyman Oscar Gilmore III
Recognition of the pursuit of one or more research projects leading to presentation or publication during the clinical years of medical training.

Scholastic Achievement Award
Dr. John Thomas Killian, Jr.
Awarded for superior performance in the clinical curriculum.

William R. Willard Award
Dr. Elizabeth Ann Junkin
Established by the Bank of Moundville, this award is presented for outstanding contributions to the goals and mission of the College of Community Health Sciences as voted by the College faculty.

Faculty, Resident and Student Awards as determined by the graduating class
Faculty Recognition Award
Dr. Joseph Wallace
Awarded for outstanding contributions to undergraduate medical education during the students’ junior year.

Community Preceptor Recognition Award
Drs. Erica Day-Bevel and Charles Gross
Awarded to a community preceptor for outstanding contributions to undergraduate medical education.

Patrick McCue Award
Dr. A. Robert Sheppard
Awarded for outstanding contributions to undergraduate medical education during the students’ senior year.

Resident Recognition Award
Drs. Blake DeWitt and Brittney Anderson
Awarded for outstanding contributions to medical education.

James H. Akers Memorial Award
Dr. Melanie Wooten
Awarded to a graduating senior for dedication to the art and science of medicine.

College Scholarships
Dr. Sandral Hullett Endowed Scholarship
Chaniece Wallace
The Dr. Sandral Hullett Endowed Scholarship was established in 1992 from gifts given by the Capstone Health Services Foundation and proceeds from the 1991 Fiesta Bowl to honor Dr. Hullett, one of the first African-American Family Medicine residents to graduate from The University of Alabama Family Medicine Residency.

Frank Fitts Jr. Endowed Scholarship
Dr. Daniel Seale
The Frank Fitts Jr. Endowed Scholarship was created by Cynthia Ford Fitts (now Thomas) to address the needs of medical students who bear a high debt load upon graduation from medical school. The scholarship was named in honor of her late husband, Frank Fitts Jr., great grandson of J.H. Fitts, who established The University of Alabama’s first endowed scholarship in 1903.

Robert E. Pieroni, MD, and Family Endowed Scholarship
Drs. Elizabeth Ann Junkin and Jonathan Russell Guin
The Robert E. Pieroni, MD, and Family Endowed Scholarship was established by Dr. and Mrs. Robert Pieroni to support medical students intending to enter primary care.

Reese Phifer, Jr., Memorial Foundation Scholarship in CCHS
Drs. Elizabeth Ann Junkin and Jonathan Russell Guin
The Reese Phifer Jr. Memorial Foundation Endowed Scholarship is awarded annually to promote the education of medical students at the College of Community Health Sciences/University of alabama School of Medicine Tuscaloosa Regional Campus. The Foundation was established by Mr. and Mrs. Reese Phifer in 1967 in memory of their son J. Reese Phifer, Jr., a student at The University of Alabama who died in 1964. The foundation established the scholarship fund in 2014. Priority is given to current fourth-year medical students who intend to complete their residency at The University of Alabama Family Medicine Residency, Which the college operates, and who have an interest in spending part of their residency training in Fayette, Alabama.

Larry Mayes Endowed Scholarship
Dr. Amber Michelle Beg
Larry Mayes was an outstanding member of the class of 1986 who died while on an elective rotation in Africa during his senior year. Larry’s family and friends have created a scholarship fund in his memory to promote a broader understanding of international health care and of the health needs of underserved areas of this country. The award is presented to a rising senior to complete an international elective or an elective in an underserved area of this country.

School of Medicine Commencement Ceremony Awards:
Medical Alumni Association Leadership & Community Service Award
Dr. Amber Michelle Beg

Hugh J. Dempsey Memorial Award
Dr. John Thomas Killian, Jr.

Formal Academic Honors
Drs. John Thomas Killian, Jr. and Margaret Pollard Marks – Summa cum laude
Drs. Joshua Thomas Gautney, Matthew Monte May, Paul Frederick Sauer, Jr. – Magna cum laude

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College co-hosts training for clinicians who prescribe opioid medications

As the use of prescription pain-killing opioids, and problems associated with their use, has increased, clinicians now have the difficult task of balancing patient pain relief with the need to prevent adverse outcomes.

That was the theme of an opioid prescribing training session for clinicians held May 12 at The University of Alabama. The session by the UA Substance Abuse and Health Services Administration, “Clinical Challenges in Opioid Management: Balancing Safety and Efficacy,” was conducted by two physicians selected by SAMSHA, Drs. Jacqueline Tulsky and Stephen Wyatt. The session was hosted by UA’s College of Community Health Sciences, Capstone College of Nursing and School of Social Work.

“The course will address the balance between providing pain relief and preventing inappropriate use of opioids,” Tulsky said as she welcomed the more than 100 physicians, nurses, social workers, medical students and resident physicians to the training session. “This is as much of an art as a science.”

Tulsky is emeritus professor of Medicine at the University of California, San Francisco, in the HIV/AIDS Division at San Francisco General Hospital. Wyatt is medical director of Addiction Medicine/Behavioral Health Service Line at Carolinas HealthCare System in Charlotte, North Carolina.

According to SAMSHA, chronic pain affects about 100 million Americans, approximately one-third of the population. The agency said pain is the most common reason for medical visits, and there are 40 million pain-related doctor visits each year. An estimated five million to eight million individuals are on opioids long term, and the number of opioid prescriptions written for pain treatment grew from 76 million in 1991 to 219 million in 2011, according to SAMSHA.

“The prevalence of chronic pain and the increasing use of opioids have created a silent epidemic of distress, disability and danger,” Tulsky said.

Efforts are underway nationwide to stem opioid abuse. Unintentional overdose deaths from prescription painkillers nearly quadrupled from 1999 to 2013, according to the US Department of Health and Human Services.

During the training course, information was provided about preventing adverse patient outcomes by teaching clinicians how to identify candidates for opioid therapy, how to monitor patient responses and how to better recognize problematic behaviors.

Opioids are effective in providing relief from pain, but there are side effects – nausea and vomiting, constipation, insomnia, respiratory depression, cognitive impairment and psychomotor dysfunction, and in rare cases organ toxicity. There’s also misuse, overuse and abuse of opioids, and even overdose deaths when opioids are combined with other medications or sedatives, Tulsky said.

A relatively new, unintended consequence has emerged – the shift from opioids to heroin. As access to opioids has tightened, more people are turning to heroin for pain relief and death rates from heroin use are increasing, Tulsky said. “There has been a rise in heroin use since 1999. Heroin is cheap and easy to get. No one will take care of you like your dealer will.”

Tulsky and Wyatt said the goal for clinicians is to “have a reasonable balance” and to “give opioids with some counseling to make it safer.”

“Pain is a complex problem, it’s not a single item,” Wyatt said. “As health care providers, we need to listen to patient experiences. Pay attention to depression, anxiety and other things they are experiencing. If we listen to patents we can start to care for them more effectively.”

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Twentieth class of Rural Medical Scholars graduates

The Rural Medical Scholars Program at The University of Alabama College of Community Health Sciences celebrated a milestone at its convocation in May – the 20th anniversary of the program, which is designed for rural Alabama students who want to become physicians and practice in rural communities.

“We are celebrating our 20 years, and recognizing students who are finishing the program this year and heading to medical school,” Dr. Jim Leeper, a professor of Community and Rural Medicine who works closely with the program, said as he welcomed graduates, their families and guests May 1 at the Hotel Capstone on the UA campus.

Eight Rural Medical Scholars graduated this year. Alumni of the two-decades-old program were also honored with a reception that preceded the convocation.

The Rural Medical Scholars program is exclusively for rural Alabama students and includes a year of study, after students receive their undergraduate degree, that leads to a master’s degree in Rural Community Health and early admission to the University of Alabama School of Medicine. Rural Medical Scholars spend the first two years of medical school at the School of Medicine’s main campus in Birmingham and then return to the College for their final two years of clinical education.

Dr. Kevin Leon, associate dean for Undergraduate Medical Education at the School of Medicine, provided the convocation address. He spoke to students about the importance of primary care, the area of medicine that many Rural Medical Scholars choose to practice, and the privilege of serving patients, sharing some of his own experiences.

“What sets a primary care physician apart from other physicians are the relationships that are built,” Leon said. “Being present at the beginning of a new life, caring for a person throughout their life, rejoicing with patients, crying with patients and being there at the end of their lives to help them with that transition. What a privilege that is.”

He said primary care physicians also need to be active proponents for health. “Our responsibility to our patients, their families and our society is to go further – as advocates for health care in our communities and the nation.”

Dr. Drake Lavender, an assistant professor in the College’s Department of Family Medicine and the first graduate of the Rural Medical Scholars Program, also spoke at the convocation. He noted that many Rural Medical Scholar graduates hold leadership positions in state and national medical and teaching organizations. Lavender currently serves as president of the Alabama Academy of Family Physicians. “I didn’t anticipate that leadership would be part of my responsibilities, but you need to. We need people to come behind us with leadership abilities.”

Also during the convocation, the Rural Medical Scholars Program Distinguished Service Award was presented to Dr. Jim Coleman, director of the Office of Family Health, Education, and Research at the UAB Huntsville regional campus of the School of Medicine. Coleman was founding director of the Rural Medicine Program, a sister program to the Rural Medical Scholars Program that was established at Auburn University and the Huntsville regional campus.

“There is no greater honor than to be recognized by students and your peers and by the program that started it all,” Coleman said in reference to the Rural Medical Scholars Program.

The Rural Medical Scholars Alumni Award for Outstanding Rural Medical Educator, presented for the first time, was awarded to Dr. John Brandon, a long-time family physician in Gordo, Ala., who has served as a preceptor to medical students and family medicine residents.

Graduating members of the 20th class of Rural Medical Scholars:

Anooshah Ata of Scottsboro
Helen Cunningham of Fairhope
Tanner Hallman of Arab
Gloria McWhorter of Pike Road
Carson Perrella of Salem
John Pounders of Leighton
Jayla Robinson of Addison
Harriet Washington of Carrollton