By Marti Webb Slay
Issues for rural hospitals and gaps in healthcare for the underserved are well documented, but one local organization is making a difference, fueled in large part by vision and dedication to a common mission.
In 2004, when John Waits, MD, FAAFP, was practicing in Bibb County to pay off his student loans, he realized he loved living in a rural area, and these patients were who he went to medical school to take care of.
“There is a need for primary care doctors in this country, but there’s an unequal distribution of where doctors go when they finish training. I went to a rural area and realized it would take a generation to make this not an underserved area. So I hung my shingle and opened Cahaba Medical Care,” said Waits, CEO and co-founder.
Lacy Smith, MD, FAAFP, joined him a few years later. As a private practice, they saw all the problems that come with rural medicine: lack of transportation, low income, high deductibles, limited access to specialists and more. Waits and Smith committed to take care of anybody, regardless of their ability to pay, but it was a struggle.
They converted to a community health center to be eligible for grants, and as a result they were able to hire an RN, a case manager, and a counselor, better serving the needs of their community. Over time, word spread about their practice, and other physicians began to contact them, wanting something similar in their communities.
Along with the success of their clinic model, they were learning that the longer a doctor trains in rural medicine, the more likely they are to stay there. “Likewise, the longer you train in an underserved area of the city, the more likely you are to stay because you develop a familiarity with the difficulties there. So we got accredited and received grant money for a teaching program in the community,” Waits said. “That was the start of Cahaba Medical Care + UAB Family Medicine Residency.
“Unlike most graduate programs at university hospitals, our residency training program is in community health centers. We are spread out in rural tracks, located in Centreville and Marion, and urban tracks in Tuscaloosa and Birmingham.
“The residents we’ve trained are three times more likely to work in an underserved area. If you just zero in on our rural training programs, it’s an eightfold increase.”
This proved true for Carrie Brackett, MD, who trained at Cahaba as part of the rural residency, completed the Obstetrics fellowship program, and is now a faculty physician at the Centreville Health Center. “I wanted the broadest training I could get,” she said, “and that lead me to Cahaba. I fell in love with their mission, and once you do that, it’s hard to walk away.
“I chose the Obstetrics fellowship because I wanted to deliver babies and care for my patients from cradle to grave. Patients in rural areas don’t have easy access to specialists, so I have to be prepared to offer the full gamut of services.
“I love building relationships with my patients. Whether I’m putting in an IUD, doing a biopsy, prescribing a new heart failure medicine, or delivering their baby, rural patients trust me to do that. It’s the best part of my job.”
“I went into medical school pretty naïve,” said Colbe Earles, MD, faculty physician at Cahaba’s Fairfield Health Center. “After my first year in medical school I was pretty disillusioned with the healthcare system. I did an internship at Cahaba and found it to be very refreshing. It seemed to be people who cared less about prestige or money. I always saw medicine as a little bit of a calling. When it came time for residency, Cahaba was the one to beat, and that’s what pushed me into family medicine.”
The people who work at Cahaba were a large part of his decision to stay and practice in Fairfield. “I got to meet the people in charge and see the inner workings, and I know that everyone here is in the right place. They want to genuinely care for patients and love them well, and I’ll take the frustrations that come with any workplace for the trade-off of knowing that the people in charge care and that the mission is good,” he said.
Brackett agreed. “I find it hard to talk about the mission of Cahaba Medical and not get emotional,” she said. “It’s transformative for patients and staff. It’s not if you’ll make a dent in the universe, but how big.”
The Cahaba Medical Care Mission
Cahaba Medical Care is a community-based healthcare organization that aims to follow Christ in becoming an incarnation of love, peace, and justice for our patients on their journey towards physical, mental, social and spiritual well-being, as well as being a center for transformational primary care training in underserved areas by modeling and exhorting the next generation of medical professionals in a career of excellence, conscientiousness, and compassion.
19 Residents graduated in June.
33 residents and 20 alumni are currently based in Birmingham.
65 out of 91 (71 percent) of Cahaba Medical Care alumni are now working in underserved areas. The national average is 26 percent.
47 out of 91 (52 percent) of Cahaba alumni stayed to work in Alabama.