Alabama ranks among the lowest states in the nation for access to primary care, and a number of rural hospitals in the state have closed in the past decade. To help alleviate this problem, Mike and Gillian Goodrich gave $10 million to the UAB Marnix E. Heersink School of Medicine to establish the Goodrich Rural Innovation in Training for Alabama (GRIT).
This program will underwrite educational scholarships, support rural residency training programs, and invest in rural clinics. Pending approval from the University of Alabama System Board of Trustees, the gift will also establish the Goodrich Endowed Chair in Rural Health and Primary Care.
Witnessing rural Alabama lose ground for the better part of a generation motivated the Goodrichs to collaborate on potential solutions with Anupam Agarwal, MD, senior vice president for Medicine and dean of the UAB Heersink School of Medicine.
“Gillian and I have been concerned about access to quality healthcare in rural Alabama,” said Mike Goodrich. “We worked with Dr. Anupam Agarwal and his team to develop a program that will attract and retain primary care residents and physicians to rural communities.”
Agarwal said: “From the start, the Goodrich family shared our concern about gaps in access to care in rural Alabama. With their leadership, we have built GRIT into a comprehensive pathway that supports learners from training and into practice. GRIT will not be able to resolve a crisis singlehandedly, but the program has something that sets it up for success: sustainability.”
One of the central goals of GRIT is to cultivate and support doctors who settle into communities and stay. Where physicians train often determines where they end up practicing, with as many as 50 percent staying within 50 miles of where they graduated from residency. This fact informed the design of GRIT’s architecture, which extends outward from UAB into existing rural training tracks, already embedding residents in the communities that need them most while keeping UAB’s infrastructure as a central hub for academic and clinical resources.
Although GRIT will establish a new pipeline for rural primary care physicians, it builds on a foundation that already engages communities across Alabama. The pipeline begins long before medical school. For example, the Alabama Area Health Education Center Network, which is housed in the UAB Heersink School of Medicine and Department of Family and Community Medicine, supports pathway programs that introduce rural high school students to the possibility of careers in medicine and steers them toward training that will keep them in Alabama. From there, undergraduate and medical school programs work to carry that early interest forward into the field of primary care.
One of these programs enables supervised medical students to work with a panel of their own patients in the first year of their training. “Students get to work with their patients over the course of four years,” said Irfan Asif, MD, chair of the Department of Family and Community Medicine. “We give them 10 patients, and they serve as health coaches, helping them with screenings, vaccines and any other health needs they may have.”
By the time they graduate, these students spent four years with the same patients. Clinical skills are a given for dedicated medical students, but what stays with them is more difficult to teach: an intimate, accumulated sense of a person’s health over time and the responsibility of having been entrusted with it.
Medical school is the most expensive piece of the pipeline and the one into which GRIT pours the greatest share of its resources, down to the scholarships intended to ease the financial math of choosing rural primary care.
A portion of the Goodrichs’ gift answers immediate logistical needs. A rural practice cannot take on and train residents without first having the capacity to host them, and the physicians who agree to mentor these trainees require time and support that the current system rarely affords them.
In practice, this support can take the form of modest device upgrades, like handheld point-of-care ultrasound devices or digital tools to track chronic disease. It also means investing in practices that have stayed open against the odds, and in the people who have been doing this work largely unaided all along.
GRIT enters a healthcare landscape that remains under considerable strain. Hospitals have closed, preventive care is distributed unevenly, and in a number of communities, patients continue to drive long distances for care that was once available nearby.
It is early. The residency tracks are still taking shape, the partnerships are still being formed, and the outcomes will not become measurable for years. But if GRIT can embed enough physicians in rural Alabama with UAB as a homebase, the truest measure of the Goodrichs gift will have little to do with its size. It will be found, instead, in the towns that manage to keep their physicians, and in the people who no longer have to travel long distances to experience quality healthcare for which UAB.
The Mike and Gillian Goodrich Foundation has invested in 260 organizations through 850 grants, focused on education, the environment, the arts, neighborhood revitalization, and improving life in the black belt. To learn more, visit mggoodrichfoundation.org