In my third year of residency, I received a program award from an Area Health Education Center (AHEC) to take a rural medicine rotation in Miles City, Montana. This is a rotation I would NEVER have done without the program. They funded my travel and gave me a stipend to afford this trip. In addition, the provider I worked with made every effort to show me what it was like for physicians AND patients in rural cities in the U.S. I remember fondly admitting a woman with cancer early on in the month and doing her history and physical (H&P) followed by seeing her with my attending in the outpatient clinic and going to her home with the hospice company that cared for her after her hospitalization. It took us 1.5 hours to get to her ranch and house on that ranch. I had a new respect for the type of coordination that was required in rural areas. Today, I use that type of information when I teach residents/students about issues of access and how this looks different depending on where you live.
I have a background in sociology (emphasis in health policy), so you could say that I have always looked for programs that would teach me about access, healthcare utilization and special populations and their needs. I have worked with several clinics and hospitals in medical school and residency that were federally qualified health centers (FQHCs) and spoke to several people who were NHSC scholars over the years. After residency, I sought out a job working in an FQHC and applied for and completed NHSC Loan repayment programs at 2 different institutions.
When I completed medical school I was over $200,000 in debt, and this was way back in the early 2000’s. I was a loan repayor for eight years before I paid off all my student loans. This is something that would have taken me many more years, even with the new federal loan forgiveness program. In addition to paying off my loans, however, I have continued to work at FQHCs as a provider, preceptor, and volunteer throughout my 20+ year career and now work in a Teaching Health Center creating programs to make the next generation of internal medicine residents sensitive to and aware of the challenges faced by both the organizations trying to care for these patients and the patients who face so many barriers to quality care.
Without the funds and programs that the NHSC program and its sister programs provide, people like me who were in debt after medical school and wanting to catch up to our peers in terms of quality of life after completing our training, choose to go into private practice or to organizations promising higher salaries and sign-on bonuses. Even with the lure of loan repayment that my organization works with, we have challenges getting internists to come to our program and our residents to continue in an FQHC. This is despite the recent increases in physician salaries, the improvements in our benefits packages, and the flexibility that is offered with our organization. It is challenging work, rewarding, and serves such an important function in society for all the patients who don’t find the services, office hours, compassion, and cultural competence with other organizations. I wouldn’t dream of doing anything else with my career.
Jennifer Poast, DO, MA, FACP
Core Clinical Faculty,
Director of Research and Quality Improvement,
Site Director, SYHC
San Ysidro Health IM Residency Program
2019-20 AACOM Health Policy Fellow
Tell Us Your Health Center’s NHSC Impact Story
Help us emphasize to Congress the impact of the NHSC on the lives of individuals and families living in medically underserved communities. Please share with us how important the NHSC is to your health center and the implications of funding cuts from a full-year CR by emailing ACU’s Deputy Director of Policy and Advocacy Jordan Marshall. We need your help informing Congress how vital the NHSC is for providing healthcare access to their constituents! Congress must stay focused on passing a bipartisan spending agreement by Jan. 19.
Stay tuned for further updates, become an ACU Advocate, and encourage all of your colleagues to do so as well.
Jordan Marshall, Your ACU Advocacy Contact
Jordan Marshall is leading ACU’s grassroots advocacy to secure long-term funding for the National Health Service Corps (NHSC). Contact Jordan with any questions regarding policy analysis or if ACU can be of assistance with your own organizational or individual advocacy.
