Foundation offers help to bring more doctors to Virginia's coalfields

A Bristol foundation on Tuesday offered a million reasons for new doctors to practice in Virginia’s coalfields.

The United Company Foundation issued a $1 million challenge grant to Edward Via College of Osteopathic Medicine in Blacksburg to be used to help lower medical school debt for doctors who agree to practice in Southwest Virginia.

Two $40,000 scholarships will be awarded this spring to third-year medical students that will be payable toward their third and fourth years of study. After they complete their residencies, they will be required to work for three years in one of the 15 counties and three cities in Southwest Virginia.

The hope is that they will remain after their obligation.

“The foundation was motivated by what we saw as an enormous need for primary care physicians practicing in the region and inspired by VCOM’s mission to, and success in, solving the physician shortage in the Appalachian region, especially in rural and medically underserved communities,” said Lois Clarke, foundation president.

VCOM must solicit matching funds from donors over the next decade.

Dixie Tooke-Rawlins, president and provost of VCOM, said the partnership with the United Company Foundation will lead to more primary care in rural areas. The scholarships also are available to students pursuing specialties, but about two-thirds of VCOM’s graduates remain in primary care.

“As a college, we purposely recruit students from, and train them in, rural areas with the intent that once they complete their residencies, they will return to practice in the region. This challenge grant will greatly enrich VCOM’s scholarship program and enable many of our students to fulfill the college’s mission of improving the delivery of health care in medically underserved areas throughout Southwest Virginia,” Tooke-Rawlins said.

VCOM has graduated more than 2,200 physicians since 2007 from its Blacksburg campus, with nearly 40% of them practicing in rural or medically underserved areas of Virginia, as designated by the federal government.

VCOM did not know immediately how many are practicing in the coalfields, but said more than 100 alumni have returned to the school’s rural and underserved sites as clinical teaching faculty.

Wendy Welch, executive director of the Graduate Medical Education Consortium of Southwest Virginia, celebrated the news.

“Southwest Virginia is a beautiful, marvelous, misunderstood place. This generous funding from VCOM and the United Company Foundation will inspire people to get to know us and discover the overlooked awesomeness of practicing medicine in Southwest Virginia,” she said.

Medical school debt is one of the major hurdles in attracting doctors to the coalfields. VCOM’s cost of attendance is between $75,000 and $80,000 a year, including $45,500 for tuition.

Welch has championed debt-forgiveness programs as a way to help physicians return to their hometowns and to keep new doctors after they finish their residency programs. 

“People shell out massive money to go to medical school. Without debt forgiveness for these rural areas, it’s very hard. People who want to stay can’t afford it,” she said. “If you can walk into a job that’s going to pay you $350,000 in Richmond and down here that same job is going to pay you $150,000, even though the cost of living is a big, big factor in that, it looks like you want to be in Richmond.”

Relief from the debt changes the dynamic.

VCOM’s mission is to train students to practice medicine in rural areas. One of the challenges in Southwest Virginia is that much of the population relies on Medicaid or Medicare, which has lower reimbursement rates than commercial insurance.

Until Virginia expanded Medicaid in January, a large percentage of the population lacked coverage. Though more people have a way to pay for medical treatment, they don’t necessarily have better access to care as there remains a shortage of primary care physicians.

In Roanoke, for example, there is one primary care physician for every thousand people. In most of the coalfields, there is one doctor for every 3,000 people. Specialists are scarcer.

“Rural doctors see more, do more, act more. They are the psychiatrist, dentist, endocrinologist,” Welch said. “You get to practice really cool medicine, and in a really beautiful place.”

[This story was originally published by The Roanoke Times.]