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Home > Activities > Annual Symposium > 2006
Annual Symposium > 2006
9th Annual RoundTable Symposium Draws Highest Attendance Ever
With its focus on workforce issues, the two-day 2006 Symposium program "Addressing the Crisis in Rural Health Care: Creative Workforce Solutions," attracted some 170 attendees from the six states, clear evidence that workforce is a topic of highest priority for the health care professionals, legislators, health education leaders and other stakeholders who gathered at the Sheraton South Portland Hotel in Portland, Maine, October 18-19, 2006.


  • Nationally-recognized speakers, each with a compelling message
  • Record-breaking attendance
  • Strong focus on the two big Rs - Recruitment and Retention
  • Medicare updates on policy and reimbursement for rural providers, from CMS
  • Break-out sessions that offered participants a chance to share real-world experiences and come up with RoundTable action items

Keynote Address:

The Symposium was off to a rousing start with Dr. Tom Curtin's hard-driving keynote address. Dr. Curtin, Chief Medical Officer of the National Association of Community Health Centers, bluntly declared "we work in a dysfunctional health care system," despite the fact that the U.S. spends more money on health care than any other country and these costs are driving the economy. "For us to do something, everyone will have to give up something," he said, urging his audience to show leadership and to be politically active.

Dr. Curtin, co-author of the widely-read study "Shortages of Medical Personnel at Community Health Centers" that appeared in the March 1 issue of the Journal of the American Medical Association (available on the JAMA web site), presented some alarming statistics on "vacancy rates" in small and isolated rural areas:

  • Family doctors - 19 percent
  • Dentists - 30 percent
  • RNs - 50% (Currently there is a shortage of nursing faculty, due to low salaries.)

Remedies, as proposed by Dr. Curtin:

  • Increase pay for doctors, increase training in medical school, and provide more exposure to rural practice.
  • Increase the number of dental students, provide loan guarantees, and re-examine the scope of practice (hygienists can do more.)
  • Expose new graduates to rural life; provide mentoring to encourage medical and dental practitioners to settle outside large urban centers.
  • Encourage doctors to train at a health center - they will be more likely to work in a rural area.

In his hour-long talk, Dr. Curtin tossed out challenging and controversial ideas. Health care today is too fragmented, he said. "Turf" issues are a barrier: what's needed is a group to bring together all the parties - general practitioners, physician assistants, pediatricians, internists. On pay for performance, he said "there is no good research to show that it will work as we intend." On the trend to specialty practice, Dr. Curtin asserted there is no evidence that specialty care improves health.

Coming out of the National Health Service Corps himself - which matched him to a clinic in rural Michigan, where he continues to live today although his work is in Washington, it was no surprise that Dr. Curtin urged expansion of the NHSC.

Federal Health Initiatives:

Presenting the view from Washington was Dr. Marcia Brand, Director, Office of Rural Health Policy. (View Dr. Brand's Presentation) Always a favorite speaker at RoundTable events, Dr. Brand gave an overview of current Federal health initiatives, from a rural perspective. "Rural is a disparity," she declared, saying changes are needed in HPSA (Health Professional Shortage Areas) designations to more accurately reflect rural areas. Dr. Brand gave the audience helpful information on who to contact for getting or updating a shortage designation and urged her listeners to find out their HPSA designation.

Health information technology is a policy priority for the Office of Rural Health in 2007. Dr. Brand said, and it will be important to "get it right, from the beginning." Cost is a problem, as is lack of infrastructure support. Since there aren't any "geeks on demand" in rural areas, it's critical to solve the interoperability issue. Performance measurement is a second high priority of Dr. Brand's office, as we move into a new era of accountability.

Dr. Brand mentioned two valuable resources: North Dakota's Rural Assistance Center is "one-stop shopping" for information on rural health and human services. Check out the new State pages! (RAC is supported by Dr. Brand's Office of Rural Health Policy). She also pointed out the Rural Recruitment and Retention Network, which gives information about rural health positions and providers, by state. Maine, NH, VT and MA are members. The 3R Net is made up of not-for-profit state organizations that help health professionals locate practice sites in rural areas.

Dinner Address:

Hilda Heady's dinner address wove colorful family images with an inspiring message. Ms. Heady, who is Associate Vice President for Rural Health, Robert C. Bird Health Sciences Center at West Virginia University, delighted the audience with her "rural beatitudes," an enumeration of rural values. She urged her listeners to stay connected with those values and use them as a resource to move beyond what she called "deficit-based advocacy" to values-based advocacy. Workforce solutions should take place in the context of values and culture. View Dr. Heady's Presentation for details on her development of the healthcare educational pipeline as a way of addressing the workforce crisis in rural West Virginia.

2006 Data Project:

Day 2 of the Symposium opened with a brief Annual Meeting, conducted by Board President Ed Perlak, followed by a review of preliminary findings from the RoundTable's 2006 data project.

Eric Turer, Community Health Institute/JSI-Senior Health Consultant and NERHRT Policy Committee Chair presented initial findings. The purpose of the project is:

  • to explore the nature of rural communities in the New England area,
  • identify and quantify differences in health and health related statistics between more and less rural areas of the region.
  • Guide NERHRT activities and initiatives to address areas of identified need.

Defining "rural" was a major task of the report. (View Dr. Turer's Presentation) The next step for this project is to refine the analysis of the data, produce a final report, and develop plans for addressing key areas of identified need. The RoundTable will look at the final report to see what initiatives and action could come from it.

Presentations and Sessions: (Viewable in PowerPoint format)

Interspersed with the formal presentations were break-out sessions covering a wide range of workforce topics, which are covered in separate articles.

  • Rural Health and Workforce Programs and Resources: A New England Perspective (PPT/519KB) Marcia Brand, PhD, Director, Federal Office of Rural Health Policy
  • Telehealth Contribution to Health Care Access in Maine (PPT/4MB) Ron Emerson, Director, Maine Telemedicine Services HealthWays
  • Rural EMS Personnel - Building a Stronger Workforce (PPT/5MB) Rural EMS Panel
  • The Healthcare Educational Pipeline: Meeting the Workforce Crisis for Rural West Virginia (PPT/3MB) Hilda R. Heady, 2005 NRHA President and Associate Vice President for Rural Health, and Ann Chester, Ph.D, Assistant Vice President for Health Sciences for Social Justice, West Virginia University
  • The Power of Rural Values and Culture in Creative Workforce Solutions (PPT/11MB) Hilda R. Heady, 2005 NRHA President and Associate Vice President for Rural Health, West Virginia University
  • Medicare Updates (PPT/355KB) Richard Hoover, Provider Relations Specialist New England, Region I, Centers for Medicare & Medicaid Services
  • Provider Recruitment & Retention In Rural New England (PPT/160KB) Jane Ham, Director, Maine Recruitment Center and Stephanie Pagliuca, Director, NH/VT Recruitment Center
  • Medicaid (PPT/408KB) Richard G. Pecorella, Centers for Medicare & Medicaid Services
  • When to Say "When": EMS Staffing Options (PPT/8.16MB) Sue Prentiss, BA, NREMT-P, Chief, Bureau of EMS Department of Safety
  • Medicare Reimbursement Policy for Rural Providers (PPT/589KB) Craig D. Schneider, PhD, Centers for Medicare & Medicaid Services, Boston Regional Office
  • Rural Primary Care Physician Workforce in Massachusetts (PPT/130KB) Joseph Stenger, MD, Suzanne B Cashman, ScD, and Judith A Savageau, MPH
  • The Art of Using Interpreters and Cultural Health Outreach Workers (PPT/972KB) Meryl C. S. Troop, CI & CT, Language Access and Deaf Services Coordinator, Maine Office of Multicultural Affairs, DHHS
  • New England.Rural Health Study (PPT/2.16MB) Eric Turer, Community Health Institute/JSI-Senior Health Consultant and NERHRT Policy Committee Chair
  • Current issues in Rural Emergency Medical Services (PPT/581KB) Gary Wiemokly

Along with challenging speakers and stimulating small group sessions, attendees at the Symposium had an opportunity to make new friends and renew acquaintances at the festive lunch and dinner sessions. All agreed the food was excellent and the accommodations very comfortable. And there were no freak October snow storms!
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