AHEC Anchors Doctors

Area Health Education Centers are the outstretched limbs of Arkansas’ only medical school. With an annual budget of about $32 million, seven AHEC satellite offices use the resources of the University of Arkansas for Medical Sciences to benefit parts of the state that would be otherwise medically underserved.

UAMS Chancellor Dr. Dodd Wilson said AHEC Northwest is the strongest link between the Little Rock school and Northwest Arkansas.

AHEC Northwest uses about $7 million each year to maintain two clinics — one on Joyce Boulevard in Fayetteville and the other in Northwest Medical Center of Washington County in Springdale. El Dorado, Jonesboro, Texarkana, Pine Bluff, Helena and Fort Smith also host AHEC programs.

“AHEC is the vehicle to bring the programs that are needed to fortify the health care profession in Arkansas,” said AHEC Northwest Director Rick Guyton.

Guyton began directing AHEC Northwest five years ago. The region includes 11 counties and staffs 128 people, including 20 UAMS faculty members.

Guyton said AHEC’s biggest challenge is diminished support from the state.

About $1 million of the annual budget comes from UAMS, Guyton said, and AHEC Northwest lost about $35,000 during Gov. Mike Huckabee’s recent budget cuts. Of that $1 million from the school, Guyton said, 90 percent pays for personnel salaries.

Most of AHEC’s employees have not received a salary increase in three years, the director said, and pay for AHEC staff should be more competitive. For the last few years the program has been hamstrung by UAMS’ financial situation.

Serving a large number of indigent patients also stresses the program. Although AHEC Northwest doesn’t advertise itself as a free clinic, Guyton said 20-25 percent of the patients who visit AHEC Northwest clinics don’t pay.

However, with the national tobacco settlement and UAMS policy changes spurred by Chancellor Wilson, UAMS bookkeepers have begun to use black ink in the ledgers again.

Aside from state money, other AHEC Northwest revenue resources include professional fees from patient care; federal, state and local grants; community contracts such as the Children’s Safety Center in Springdale; and hospital support.

From Doctor to Resident

The AHEC residency programs bolster the health care system by strengthening it from within. Keeping doctors in Arkansas after they complete medical school is the primary goal of AHEC, Guyton said.

According to AHEC reports:

• 440 former AHEC family practice residents currently practice in 65 of 75 Arkansas counties,

• 73 percent of AHEC residency graduates have remained in Arkansas to practice, and

• 53 percent of those practice in towns populated by 15,000 or fewer people.

Those figures are a turnaround from 25 years ago, Guyton said, and the program’s main goal is to keep graduated medical students in Arkansas for their careers.

“A rural state like Arkansas cannot afford to prepare physicians for other states,” Guyton said, adding that 25 years ago, nearly 80 percent of the family practice physicians left the state. Now an average of 60-65 percent set up shop in the state.

AHEC administrators said the AHEC residency program makes the difference.

Dr. Teresa Loftin agrees. She is one of 44 AHEC residents who finished the AHEC Northwest program and began practicing medicine in Washington and Benton counties. Currently, 33 physicians and former AHEC Northwest residents serve in Washington County, and 11 operate offices in Benton County.

Loftin, a graduate from the University of Kansas at Kansas City, said the residency program bonded her to the professional community in Northwest Arkansas. During her two years with the program — most residents go for three, but Loftin completed her first year elsewhere — Loftin worked with family practitioners and neurology, gynecology and cardiology specialists.

Meeting and working with the network of doctors created a partnership opportunity for Loftin, who practices with First Care of Medical Services Northwest Arkansas.

“The blood and guts of AHEC is the residency program,” Guyton said.

The AHEC Northwest residency program hosts 27 residents at its two teaching hospitals, Washington Regional Medical Center and Northwest Medical Center of Washington County.

Last year, Guyton said, more than 75 candidates interviewed for the nine available positions. Using a national matching system, medical school grads rank their favorite residency programs. Coordinators also list preferred candidates, and the computer system directs residents to their locations.

When the computer received AHEC Northwest’s list of top candidates, it only scrolled through 11 students to fill the positions. Nine of those top 11 students named AHEC Northwest as their residency program of choice.

Nine residents work at Northwest Medical, and WRMC has 18.

Guyton said AHEC Northwest is fortunate to have two teaching hospitals from which to draw. WRMC helped pioneer the AHEC Northwest residency program, and Northwest Medical got involved about 10 years ago.

Established health care professionals also can use AHEC for continuing education and maintaining their required certification training.

Grassroots Opportunity

Arkansas AHEC Director Dr. Charles Cranford said Guyton stands at the center of the next big initiative for the program. Armed with a background in public health, Guyton developed a counseling system intended to change patients’ unhealthy behavior through education.

Heading up the self-care movement — officially called the Arkansas AHEC Model — Guyton said Arkansans rank among the lowest for quality of living because health problems such as high blood pressure, diabetes, asthma and obesity are so common.

The revolution, Guyton said, will come from educational prescriptions. Doctors refer their patients to an initial 45-minute counseling session to map out a behavioral-change plan, a negotiable contract signed by the patient.

“People can be taught to care for themselves,” Guyton said.

Since launching the program 18 months ago, doctors have issued more than 600 referrals.

Cranford said the program deserves to be implemented within the other AHEC locations. Representatives from the other locations attended a workshop about the model last year.

Eventually, Guyton said, patients might be able to get reimbursed for the counseling, but the program is too young yet.

AHEC Residency Graduates in NWA

Washington County doctors: Bryan Abernathy, Johnny Adkins, Bernadette Alberty, B. Eual Allen, Peter Ball, Becky Barrett, Charles Belt, Mark Bonner, Mark Corbell, Al Gordon, Susan Ferguson, Carol Fossey, Lee Gray, Robby Guinn, Karl Haws, William Kendrick, Ron Lee, Teresa Loftin, Tom Maddock, Kathy Mayhew, Sara McBee, William McGowan, Michael Meyer, Mark Miller, Randall Oates, Mark Olsen, Danny Proffitt, Susan Rogerson, Todd Simpson, Joanna Thomas, Sam Turner, Larry Tuttle, Steven Wilson

Benton County doctors: David Beeman, R. Dale Clemens, K. Lamar Howard, John Huskins, Brad Johnson, Nancy Jones, Robin McAlister, Gary Moffitt, Vance Stock, Rick Tutt, David Ureckis

Source: the University of Arkansas for Medical Sciences