By Marti Webb Slay
As president of the Medical Association of the State of Alabama, Julia L. Boothe, MD, MPH, FAAFP, wants to continue building an organization that represents physicians of all kinds, that collaborates with advanced practitioners and provides information that is critical to quality healthcare for Alabama.
Founder of Pickens County Primary Care, Boothe has a particular commitment to rural health care. The Medical Association has a task force addressing that issue, especially in the Black Belt. “We still have a swath through the middle of our state where patients are significantly underserved. We have some different state scholarships which have been out there for years to encourage people to choose primary care in a rural setting,” she said.
Boothe said the closing of rural hospitals had made it even more difficult for beginning physicians to establish a rural practice. “When I first got out, I didn’t really know how to run a business. In the old days you just hung out a shingle, but with the way insurers are now, it’s more cumbersome. So, I was employed by our local hospital. Well, our local hospital closed two years ago, so we don’t have that infrastructure.”
For a list of the scholarships available for pre-med students, medical students and resident physicians to help attract them to underserved parts of the state, visit alabamamedicine.org.
Expanding Medicaid has been an effort by the Medical Association in recent years. The website says, “Right now, more than 220,000 residents are caught in the state’s health ‘coverage gap.’ They earn too much to qualify for Medicaid and too little to afford private insurance.”
“We were able to get the postpartum expansion approved and that went into effect earlier this year,” Boothe said. “New mothers now have postpartum coverage for a full year, where in the past they just had a few weeks of care. Our infant mortality and maternal mortality have escalated in recent years, and lot of that is due to not having health care for long after delivery. That was our first step: to get the legislature to expand to that group. We are hopeful we can use that data and information to push forward so we can expand Medicaid.”
The Medical Association is also addressing the state’s opioid crisis. “It’s been going on for years, but now it’s in every community,” Boothe said. “We are trying to educate not only physicians, but also the public on what’s available, what to look out for and how to screen. Like every area of medicine, we are constantly learning and evolving, so we’ve got to get that information out.”
“And we’re working on having more cohesiveness between advanced practice providers such as physician assistants, nurse practitioners and nurse midwives. We know it takes all of us to make the team of health care succeed. The physicians in this state can’t see everybody, and we want to make sure it’s a true collaboration.”
The association also advocates and represents physician’s interests with the legislature. “We are one of the top groups legislators respect, and we are trying to build on that,” she said.
Boothe expects to see increased efforts concerning emergency services around the state, to address gaps as a result of so many hospital closures. “A lot of us are dependent on an urban group to cover our areas, and they are getting pulled too,” she said. “In our county, an ambulance used to be gone about an hour to get to the patient, treat them and get them to the hospital. Now it’s pretty much a three-hour minimum to drive out of the county for every transport. And the hospital ERs are having such slow times due to the volume, so they can’t get patients off to release the EMS to take other calls. There are times in our county when there is nobody available.”
Boothe estimates that only one-third to half of physicians in the state are members of the Medical Association, and she urges everyone to join, in order to make the association more effective. “We represent all physicians in the state, whether they are a member or not,” she said. “We are working to help people understand why the Medical Association is here and what we do. I don’t think some know what we are doing for them. We meet face to face with various insurers each month, where we ask about issues our members have sent to us, including reimbursement issues or an authorization problem and work through those.”
“We want people to be a part of our organization so that all our voices are heard. The best way to do that is to join, talk with us, let us know about your issues. We do our best to represent all the different specialties and bridge the gaps, because we are all in this together. We don’t want the ‘versus’ like urban vs. rural or super specialties vs. primary care. It’s going to take all of us to make health care work, and we know we’ve got things we want to work on for our state, but it takes having all of us at the table.”
For more information about the Medical Association and its programs, or to join, visit alabamamedicine.org.