This Rural Mission is a podcast that discusses pertinent topics related to rural community health and social issues around the state of Michigan. Each episode highlights rural providers, medical students, and community members who are making a difference in the lives of rural residents.
40 Years of Rural Medical Education
To tell you that we are experts in Rural Medical Education is a bit of an understatement! We have been training and retaining rural doctors in our state for more than 40 years! So, let's take it back to where it all began, the U.P., and learn how it all happened from the man that was there!
This Rural Mission is a podcast brought to you by Michigan State University College of Human Medicine. The podcast is produced with funds from the The Herbert H. and Grace A. Dow Foundation and The Michigan State University College of Human Medicine Family Medicine Department. Welcome to season two. I'm your host, Julia Terhune, and I hope you enjoy this episode.
I don't think there's been a week that has gone by since I started working for the college of human medicine that I haven't talked about how we have been recruiting, training and retaining rural doctors for over 40 years. For those that I work with, I'm pretty sure they were able to dub those words with almost my exact inflection. I talk about it all the time and not just because it's my job, but because I'm really proud of the outcomes of our program. I'm really proud of the work that everyone for decades has put into the success of our medical students and the success of the rural medical systems that take our medical students. Now in 2019, I get to change my script just a little bit because this year we are celebrating 45 years of rural medical education.
In these 45 years, we have been able to show the outstanding and significant outcomes related to developing the rural medical workforce, and we have expanded our rural medical education certificate programs to include two additional rural campuses where students can receive that certificate. Those campuses are now Traverse City and Midland. With that expansion in 2012, we have been able to cover the map of Michigan with rural medical education opportunities. Those opportunities provide students with an understanding of the unique needs found in many of our rural regions across the state.
For those medical students who want to get rural medical training, they can pick from two different programs, the rural physician program based out of Marquette or the rural community health program that's based in either Midland or Traverse City. Both programs are under one big umbrella called the Leadership in Rural Medicine program. But this umbrella wouldn't exist at all if it wasn't for the men and women who worked so hard to establish rural medical education opportunities in the upper peninsula starting back in 1974. To honor this legacy, we wanted to showcase the man who was there when it started and let him tell you the story about how it all began. Dr. Daniel Mazzuchi was an internal medicine doctor who came to the upper peninsula of Michigan in the late 1960s.
He was an integral part of establishing the program first in Escanaba and then in Marquette in later years. His influence on the college was so tremendous that much of what he's established during his medical education career is still in place today. Dr. Mazzuchi sat down with Dr. Andrea Wendling, the current director of our program, and told us the story of how it all began.
To talk about medicine in Marquette, you have to kind of... Medical education in Marquette, you have to kind of break it up because nothing happens in a vacuum. The political factors that went into allowing the UP experiment, which is what it was called, to be started, the people or cast of characters involved in it, and then how it eventually evolved as medicine evolved in the UP.
We owe a great deal of credit to the development of our Marquette campus and our rural medical education heritage to the late Donald Weston who served as Dean of the college of human medicine from 1970 to 1989.
He's the reason why we're here. I mean, that's a simple declarative sentence. He was a fly fisherman and he a
Beyond a One Room School House
We started off this season talking about how limited broadband access can impact student performance and the overall well-being of a community. Today we are going from worry to a celebration and talking about the people who make a positive impact on students in rural communities through the public health system.
This Rural Mission is a podcast brought to you by Michigan State University College of Human Medicine. The podcast is produced with funds from the Herbert H. and Grace A. Dow Foundation and the Michigan State University College of Human Medicine Family Medicine Department. Welcome to season two, I'm your host, Julia Terhune, and I hope you enjoy this episode.
Education levels in rural communities is something to talk about. While rural communities lead the nation in number of individuals who have a high school diploma, according to the USDA, the number of people living and working with any additional education drops right off. In 2016, only 19% of all rural adults had anything more than an associate's degree as compared to 33% of all urban adults. When we look at county data, rural America leads the way in number of counties where more than 20% of the working population does not have a high school diploma. The prospects for higher education in rural America is bleak and it's low educational attainment seems to perpetuate the issues of rural poverty and the vitality of these communities, but there are success stories.
If we drive North to beautiful Charlevoix County, we will get to a five square mile town called Boyne city. Boyne city is home to around 3,750 people, most of whom are over the age of 40. The average family in this area makes about $31,000 a year, which is more than $20,000 less than the mean income for the state, allowing for the average poverty rate in the county to sit around 12.5%. Like the rest of rural America, the majority of citizens have no more than a few college courses. Meaning that 60% of the population of Boyne City has nothing more than a high school diploma. For all those listening who are interested in medical access in rural Michigan, the health resource and service administration or HERSA has designated Charlevoix County as a health professional shortage area for primary care, dental care, and mental health care.
In 2018, Boyne City High School saw some amazing students graduate. In fact, around 115 stellar graduates came out of points city, if we're going to be straight about it. We are going to talk to three of these amazing students, but I want to quickly set the stage. Boyne City High School graduates are coming from a rural school in a county that has some big social factors to overcome. 38% of all the students at Boyne City High School receive free or reduced lunch, and around 18% of the population that lives on less than $35,000 per year are families with children.
Furthermore, I took the Liberty of plotting how far a student would have to travel to get to the nearest four year university from Boyne and I posted that map on our Facebook page, but I'll give the bag away. The closest four year institution to Boyne City is Lake Superior State University, which is over 90 miles away and across a five mile bridge. Therefore, options for a close to home education don't really exist for young adults looking to get something more than a high school diploma. But I told you there were success stories for this episode and there are. It's just that the students that have found their way to higher ed had more work to do than you would've expected.
So let's introduce our leading ladies, shall we? Katie is going to Northern Michigan University. Katie is the daughter of Joe McCue who you heard earlier this season and is the oldest of a big family. She's staying in the state, but remember NMU is over 150 miles from Boyne. Maddie is going to Brown. Yes, Brown, and is going to tell you a lo
The Real Victim
This week we are taking a part-two look at the opioid crisis and talking about who opioid addiction really hurts: children. The foster care system in this state is flooded with children who have had their lives impacted and uprooted by opioid addiction. In this episode we will hear from CPS workers, foster care parents, family service professionals and addiction councilors.
This Rural Mission is a podcast brought to you by Michigan State University College of Human Medicine. The podcast is produced with funds from the Herbert H. And Grace A. Dow Foundation and the Michigan State University College of Human Medicine family medicine department. Welcome to season two. I'm your host Julia Terhune and I hope you enjoy this episode.
This season I knew I had to address the opioid crisis that is affecting rural communities, but I really didn't want to do it in the traditional way. Truly because there is so much to unpack and in my opinion, I think that when we talk about the issue, we have a tendency to either focus on numbers or start blaming and pointing fingers as to why and who and when and who's not being considered and what the real root cause is. Really what I think is that isn't where any of the conversations should start because it doesn't matter. It doesn't matter how it all started. It's here and it's affecting real people and we have a problem.
We're going to talk about the real consequences and why we should care and why we all should care is because we're talking about children. When it all boils down, the people who are really affected the most and the longest in the midst of this crisis are kids. So in the efforts of impact and to contextualize this real issue, we are going to tell the story of the Brown family. The Browns adopted both of their children from foster care and the origin story for why they are together and a family today is because of opioids.
Back in 2010, Todd and I decided to go for foster care and in 2012 we were gifted with two wonderful children, their ages were nine months and four years at the time. They had been taken out of a home where they received trauma from abuse and neglect and they were placed in our home in a very short amount of time. From the call to the time they arrived in our driveway was about 45 minutes. They came to us, very malnourished. They were very dirty.
We believe they were under the influence of cannabis or second hand of cannabis because they were very dazed and confused. Our foster son at the time was very underdeveloped. We could tell that he had speech issues. He had gross motor skill issues and the little girl, our daughter now, which was nine months at the time, she weighed about 12 pounds and she wasn't able to crawl yet. She was just barely rolling over, so they were very much on the lower end of the scale of development.
Our children's mother had an opioid addiction and actually her mother overdosed on opioids in front of her and died when the mother was about 19 years old. With the opioids, we have all of our children's medical reports and our daughter, especially when she was born she was born at 31 and a half weeks, so she was very premature. She was less than three pounds. She was addicted to meth and cannabis and there was many things in her toxicology when they pulled it. So they had to put her on Suboxone and a bunch of different other medications to help her come off of that addiction along with trying to build her way up because she was so small and she was a premature.
Because of that, now she is a fully developed child. If you saw her, she's very small but she is fully developed mentally and physically and all that, but she does suffer from deteriorated vision in her left eye because of the opioids. So unfortunately she has a patch that's over her right eye right now trying to strengthen her left eye.
That's one thing. People will always say
People are People No Matter...
In our effort to cover the issue of opioid use in rural Michigan, we took to the hospitals, providers, and persons who are trying to have an impact on opioid use and overuse in our state.
A Rural Connection
We spoke with experts on bringing fiber internet to rural Michigan. Bringing fiber internet to rural Michigan can reduce major barriers to educational, healthcare, and economic opportunities and benefit whole communities and families. We also speak to Dr. Edward Smith on why advocating for remote areas as a physician is so important when decisions are being made based off of what can be done in urban areas.
This Rural Mission: Bravery
Young professionals today are super brave. We move across cities, states, and even oceans
- [Julia] This rural mission is brought to you by Michigan State University College of Human Medicine Leadership and Rural Medicine programs. The podcast is funded in part by a generous grant provided by the Herbert H. and Grace A. Dow Foundation. To learn more about the Leadership in Rural Medicine programs, please visit www.msururalhealth.chm.msu.edu. I'm your host, Julia Terhune, and stay tuned for more from this Rural Mission.
-[Julia] Hello, and welcome back to another episode of this Rural Mission, brought to you by Michigan State University College of Human Medicine. Today we're going to take a little bit of a different route. Today we're going to talk about what it means to be brave. That might seem like a really different topic. Typically we talk about rural health disparities or we talk about social issues in rural America and now we're going to talk about bravery? Well, hear me out for a second We do a lot of brave things in our lives. Some of us move overseas, some of us go out of state to a brand new place to get an education or change jobs and all of those things, every single one of them is extremely brave and courageous, but there's something else that's just as brave and that's going back. Going back to that small town that you grew up in, going back to the place you said you would never return to.
(electric guitar music)
We're going to talk to a number of people today. Some of the people that we talk to are planning to return to their small town after they graduate. Some are already returning to their small town to get an education, and some swore they would never, ever return but have made a career out of their small town. I encourage you to stay tuned and hear more from this Rural Mission. We've got an interesting road ahead and I'm excited for you to see how brave you really have to be to go back. Daniel Drake, soon to be Dr. Daniel Drake, is a Rural Community Health Program student at the Midland Regional campus.
- [Daniel] I mean, I grew up in Caro and Caro is a relatively small town. And so I went up to the UP and I was at Michigan Tech. No one in my family is a physician, no one had gone to a four-year university at all. So I was kind of figuring it all out on my own and when I was at Tech, I heard about an early assurance program that Michigan state did and you took your MCAT early and applied early and so I think I found out it was 2012 when I found out that I was going to go to Michigan State for my medical school.
- [Paula] So I'm Paula Klose and I am a family physician, I'm a graduate of Michigan State College of Human Medicine and I trained in the Upper Peninsula campus for my clinical years.
- [Daniel] I have always kind of known that I wanted to do rural health, that was always my big thing. Being from a small town, going to undergrad in a small town where I knew I wanted to practice rurally.
- [Paula] I wanted to work in a rural community, I wanted to live in a log cabin that I built by hand (laughs). And so when I was applying to medical schools, I chose Michigan State College of Medicine because of the Upper Peninsula medical education program.
- [Daniel] With R-CHP, the rural community health program, Midland has a site for that in Pigeon.
- [Paula] For the past, let's see, six years, I have been involved with Michigan State again and was asked to be the community assistant dean for the Midland Regional campus.
- [Daniel] In Pigeon, it is near the tip of the thumb and Huron County, not far from my hometown at all and it was a place that I was familiar with. I was like, it would be really exiting to go back and just be able to actually practice clinical medicine up there.
- [Julia] You grew up here too, didn't you?
- [Paula] Yes, yeah. I wasn't born here, but my dad work