Strike up a conversation with a high school student, and it likely will not lead to a discussion about Oklahoma's growing shortage of primary care physicians.
Unless you're talking to Skylar Vogle, a junior at Perkins-Tryon High School.
Vogle wants to be a doctor in rural Oklahoma, and she's just the kind of student the Oklahoma State University Center for Health Sciences is seeking.
This past week, the medical school had a booth for the first time at the Oklahoma Future Farmers of American convention in Oklahoma City.
Four things predict where physicians will practice mid-career — where they grow up, where they go to college, whether their medical school has a curriculum with an emphasis on primary care or rural and underserved populations and where they do their residency, said Dr. Kayse Shrum, the OSU Center for Health Sciences provost.
“The FFA is the first piece of that to me, finding students who are interested in medicine, are already from rural Oklahoma and are more likely to return,” Shrum said.
In 2011, the New England Journal of Medicine ranked Oklahoma as the most access challenged state in regards to health care. Oklahoma was among seven other states that are expected to have large Medicaid expansions but have weak primary care capacity, according to the report.
One of the reasons Oklahoma has so few primary care physicians might be because of high rates of uninsured residents and poverty, which make it hard to attract and keep doctors in the state, according to the medicine journal report.
At the rate Oklahoma is going, it will hard to even attain an “average” health care ranking, Shrum said.
There's an immediate need to expand medical school class sizes, expand residency programs and retain physicians to supplement the aging physician population, Shrum said.
“We're already at the bottom, and if we don't do something different, and if we don't address it, it will be devastating to the state,” Shrum said.
Vogle, the president of her high school FFA chapter, already has a plan — go to OSU, major in biology and get accepted into OSU's Rural and Underserved Primary Care Early Admissions Program through its College of Osteopathic Medicine.
Students in the program must plan to practice primary care in rural or underserved Oklahoma. Through the program, students can complete pre-doctoral medical training in seven years.
Vogle doesn't want to leave Oklahoma, hoping to someday practice medicine somewhere near her hometown of Glencoe.
“The fact that you can take someone who is in pain and is hurting and is coming to you to help them and know what to do in that situation would be an amazing feeling,” Vogle said.
Glencoe, a town of 600 people, is about 15 miles northeast of Stillwater in Payne County. There are 81 medical doctors in Payne County, serving 68,190 people. This factors out to 841 patients per doctor, according to the state medical board.
But several counties in Oklahoma face significant physician shortages. In eight of Oklahoma's counties, there's only one medical doctor — Atoka County, Choctaw County, Dewey County, Harper County, Jefferson County, Pawnee County, Pushmataha County and Roger Mills County, according to the state medical board.
Less than one-fourth of the counties in Oklahoma, about 18 counties, have at least one doctor per 2,000 people, according to a draft from the state Health Department about provider population ratios. Almost half of the counties in Oklahoma, about 36 counties, have between 0.57 and 0.99 doctors per 2,000 people. About 23 counties have fewer than 0.57 doctors per 2,000 people.
That's why medical students like Rachael Pattison are important to keep in Oklahoma.
Growing up on a ranch in Holdenville, Pattison didn't initially want to go to medical school. Pattison, a third-year medical student at OSU, wanted to be a veterinarian.
Once she was at East Central University in Ada, a mentor asked her — have you considered medical school?
After shadowing a few doctors, Pattison decided her mentor was right and that she wanted to practice medicine in rural Oklahoma.
“It's where I'm from, it's what I know, and I see the desperate need for it,” she said.
Pattison, past president of the Student Osteopathic Rural Medical Association at OSU's medical school, hopes to practice medicine at a small hospital and have her own practice in Holdenville or at least close by.
Holdenville is about 80 miles southeast of Oklahoma City, population 5,771. The small town is in Hughes County, which has three medical doctors serving about 4,718 people each, according to state medical board data.
Pattison recently finished a shift on OSU's telemedicine bus when it traveled to Porter, a town of about 570 people in northeastern Oklahoma.
These patients are some of the most grateful people Pattison has found. Many of the patients treated through telemedicine don't have access to a doctor either because there isn't one in the area or they don't have a car or maybe they can't take a full day off from work.
“Or they need a specialist,” Pattison said. “That's the only way we can get a specialist to Porter, Oklahoma, is via telemedicine.”