UB Heads $22 Million Federal Effort to Bring Health-Care Providers to New York's Underserved Areas

BUFFALO, N.Y. -- New York State ranks sixth in the nation in the number of people living in areas with fewer than 150 residents per square mile.

Unfortunately, only about 1 in 3,000 of those persons is a physician, and the ratio is worse in the state's inner cities.

To help alleviate that shortage of health professionals in the state's underserved communities, the School of Medicine and Biomedical Sciences at the University at Buffalo is teaming with the State University of New York Health Science Center at Syracuse and other New York professional schools.

The effort is being aided by a three-year, $3 million grant from the U.S. Department of Health and Human Services that funds the first cycle of a 12-year program with a potential for $22 million in federal funding.

With the UB medical school as lead institution, the grant will fund start up of an Area Health Education Center (AHEC) program in New York State.

The New York program is part of a nationwide effort launched in 1972, based on the 1970 Carnegie Commission's "Report on Higher Education and the Nation's Health." AHEC programs now operate in 41 states. An earlier effort in New York State did not succeed due to lack of institutional support.

The goal of the initiative is to bring more health-care providers to underserved areas by establishing clinical teaching and practice sites in these outlying communities or urban settings. Each AHEC site will be managed by a locally appointed director and advisory board, and will be linked with a medical school.

Through these sites, students from medicine, pharmacy, nursing, allied health, dentistry and social work will get first-hand experience living with and caring for patients in underserved areas of the state. The centers also will provide a training ground for medical and dental residents, continuing-education courses for health professionals already serving these communities and assessment of the region's health-care needs.

"We urbanize most of our medical students during their training," said Thomas C. Rosenthal, M.D., professor and chair of the UB Department of Family Medicine, who will oversee the initiative. "The high-profile urban medical setting is what young physicians are comfortable with, so that is where they tend to practice.

"They cluster in prosperous areas of cities and suburbs also for personal reasons. Most want to raise families where they will have the greatest opportunities, so it is difficult to retain providers in underserved rural communities in particular. It requires a person who understands and values rural America. The only way they will see themselves in those communities," he continued, "is to be in those communities."

During the program's first three years, UB will set up a statewide administrative office in its Department of Family Medicine and help establish regional offices at the SUNY Health Sciences Center at Syracuse and Albany Medical College/State University at Albany School of Public Health.

During subsequent funding cycles, center staff will help establish AHEC regional centers at SUNY at Stony Brook Health Sciences Center and SUNY Health Sciences Center at Brooklyn. Each regional center will be responsible for setting up two community-based AHEC sites in underserved areas by the end of the 12-year federal funding cycle. New York State is required to begin funding the AHEC program in its sixth year and eventually to assume full financial responsibility.

Diane G. Schwartz, director of special projects for the UB medical school, will be deputy director of the statewide program office. During the first year, the UB office will establish a community-based AHEC site in the 14-county Western New York region.

Rosenthal said each community-based AHEC will function as an arm of a SUNY health sciences center, providing teleconferencing links back to the main campus, a setting for meetings with faculty members and support services to students and residents living in the rural communities during their rotations. Site directors and community clinicians who will act as preceptors will be trained on-site by UB faculty.

"The overall objective is to attract and keep more health-care workers in underserved areas, both by linking medical residents and third-and-fourth-year medical students to these communities and by helping local practitioners feel more connected to the SUNY medical schools," Schwartz said.