Oklahoma State University Center for Health Sciences
Oklahoma State University Center for Health Sciences


Rural Health Option

Perspectives in Rural Health (Spring Elective)

Though we talk about medical issues in other class work, we do not always relate the care provided with emphasis on rural factors. Oklahoma ranks 50th in the nation for the number of both practicing and primary care physicians per 100,000 populations (new figures are due out in January). We also know from a review of the literature that providing primary care to any population improves their health care status. Since Oklahoma also ranks near the bottom in the nation regarding our health parameters, it seems clear that we need to improve in two
areas: increase the number of primary care providers and prepare physicians for a rural practice by providing knowledge and skills needed.

The differences in the rural culture and demographics make recruitment more difficult so the objective of the course is to provide the student a rural perspective and also give course work in areas of medicine that will provide students knowledge about issues that are unique to rural areas. Rural representation in future D.O. leadership is needed and this course will aid in that preparation.

This course will provide students with an overview of rural health with topics ranging from rural health lifestyles to practice management. Students will develop a framework for choosing employment options, including starting and cultivating a successful rural primary care practice. The course will include didactic presentations both on campus and off campus, journal reflection and discussions led by OSU faculty and topic experts from across the state.

Course Description:

Course Title: Perspective in Rural Health
Course Length: Spring semester
Course Format: Elective (required for Rural Health Option)
Student Level: 1st or 2nd Year Osteopathic Medical Students
Course Coordinator:
William Pettit, D.O.
Associate Dean for Rural Health
Course Contact:
Vicky Pace, Director of Rural Medical Education


Through Community Assessment Journal entries, students will:

  • Demonstrate awareness of the osteopathic rural family physician's role as the physician of first contact that
    delivers family-oriented medical care to rural patients
  • Describe how OSORH and AHEC contribute to improving rural health care in Oklahoma
  • Compare the rural physician’s lifestyles to urban physician lifestyles and how it relates to their practice
    decision making
  • Analyze the availability of health care resources in a rural setting including mental health
  • Identify limitations to care or health disparities in rural communities including agricultural injuries
  • Describe the cooperative nature of rural health care professionals
  • Discuss how Medicaid and Medicare policy impact rural physicians
  • Describe various leadership roles of physicians in rural settings
  • Explain differences in rural and urban hospital settings
  • Discuss the use of technology (i.e. telemedicine) to address needs in a rural community
  • Compare rural practice management issues with urban settings
  • Discuss how care of patients with disabilities and Workers Comp is managed in the rural setting
  • Discuss the role the rural physician plays in sports medicine for rural communities

Meeting Times:

  • Friday, January 21, 2011, 12:00 p.m. to 4;00 p.m., Room D101 or D105 (presentations and discussions)
  • Friday, February 18, 2011, 1:00 p.m. to 4;00 p.m., Room D101 (presentations and discussions)
  • Friday, March 4, 2011, 1:00 p.m. to 4;00 p.m., Room D101 (presentations and discussions)
  • Friday, April 1, 2011, 1:00 p.m. to 4;00 p.m., Room D101 (presentations and discussions)


Topics Covered:

  • StORM Club and Rural Health Option Program
  • Introduction to Associations: the NRHA
  • Overview of OSU-CHS Center for Rural Health and the Oklahoma State Office of Rural Health
  • Oklahoma Area Health Education Centers and Community Campus
  • Early Rural Experience and the Summer Rural Externship
  • Rural Clinic System and Non-Physician Clinicians
  • Rural Lifestyles Choices and Community Leadership Role in the Rural Setting
  • The Rural Hospital, Not a Small Urban Model
  • Oklahoma Residencies
  • Telemedicine’s role in Rural Health
  • Medical Examiner’s Role
  • Practice Set-Up/Management and Billing and Coding
  • Agricultural injuries, disabilities
  • Workers Comp



  • Four Friday presentation days with rural physicians/topic experts, discussions/panels/Q&A and case
  • Rural Health Journal (Send as email attachment, double spaced, 3-6 pages, due no later than April 8, 2011)
  • Recommended Reading Assignments
  • One Group Trip (off-campus) required (transportation available) (additional trips optional)
  • One Special Event required additional events optional (Lectures/CME Events/Conferences)


Course Outline:

January 21, 2011:

  • StORM (Rachel Pattison, President and Chuck Janzen, Vice President, Charity Holder, Founding President
    and Amanda Reed, StORM member) and National Rural Health Association (NRHA Guest Speaker: Brock
    Slabach, Vice President of Member Services) Introduction to the NRHA Student Leadership and support for
    Rural Practice.
  • OSU-CHS Center of Rural Health Panel: Overview of Course, Research and Rural Oklahoma, Rural Health
    Option, SRE/ERE, Rural Rotations, Rural Core, Oklahoma State Area Health Education Centers and the
    Community Campus, and Oklahoma State Office of Rural Health and Community Engagement (William
    Pettit, D.O., Associate Dean for Rural Health and Course Coordinator, Denna Wheeler,Ph.D., Coordinator of
    Research and Evaluation, Vicky Pace, M.Ed., Director of Rural Medical Education, OSU Regional
    Coordinators: Kelby Owens (SE –Durant), Kelly Davie (NW-Enid), Richard Perry, M.A., Director of State
    Area Health Education Centers, and Val Schott, M.PH., Director for Oklahoma Office of Rural Health)

January Events (optional)

  • National Rural Health Policy Institute in Washington, D.C., January 24-26, 2011
  • StORM Club Spring Event, TBA
  • AOA Leadership Conference, January 13-15, 2011, Las Vegas, NV
  • NRHA Policy Institute, January 24-26, 2011, Washington, DC
  • OOA Winter CME Event, January 28-30, 2011, Hard Rock Hotel and Casino in Tulsa, OK.

January Group Trip (transportation available) (one required per course-other trips optional)

  • Saturday, January 22, 2011, 9:00 a.m. to 3:00 p.m., Trip to Tahlequah (group residency tour) Meet at
    OSU-CHS North Parking Lot

Recommended Readings:

  • “The Future of Primary Care – Perspective”; November 13, 2008: www.nejm.org, pp’s 2087 and 2091,
    Starfield. “The Medical Home: An Idea Whose Time Has Come…Again”; Family Practice Management, September
    2007, Vol. 14, No. 8, pp’s 38-41.
  • “A Snapshot of Current Conditions”, State of the States Rural Health, Center for Rural Health, 2007 Edition
  • “Reviving interest in primary care”, The DO, August 2009, Volume 50, Number 8, pp’s 16-25.


February 18, 2011:
  • Rural Physician Panel: The Role of the Rural Preceptor and the Rural Physician Lifestyle (Dr. Monty
    Grugan-Idabel, Dr. Darryl Jackson-Prague, Dr. Jennifer Scoufos-Sallisaw, Dr. Carl Smith-Bristow, Dr. Doug
    Brant, Drumright)
  • Rural Occupational Health Panel: Safety, Accidents, Disabilities and Workman’s Comp (Leroy Young,
    D.O., Oklahoma City Agribility: Linda Jaco, Stillwater)
  • The Medical Examiner’s Role in rural Oklahoma (C. Michael Ogle, D.O., Enid)

February Group Trip
(transportation available) (one required per course-other trips optional)

  • Saturday, February 19, 2011, , 8:00 a.m. to 5:00 p.m*, Trip to Durant(group residency tour)
    (Overnight stay at physician’s Lake House is available upon request)

Recommended Readings:

  • “Factors That Influence Physicians to Practice in Rural Locations: A Review and Commentary”, Balance,
    Darra, MLIS, AHIP; et al., NRHA The Journal of Rural Health, Volume 25, Issue 3, Summer 2009, pp’s
  • “Oklahoma State University Center for Rural Health Report to the Senate Interim Study on Comprehensive
    Assessment of Healthcare Workforce Issues”, Wheeler, Denna,PhD and Landgraf, Chad, MS, November 16,
  • “Medical Students and Rural Rotations: What’s in it for Me?”, Pace, Vicky, MS, Oklahoma DO, July/August
    2009, pp’s 20-23.
  • “The Primary Care Physician Shortage: The Bottleneck to Health Care Access for Rural Oklahomans”,
    Wheeler, Denna, PhD, Oklahoma DO, November 2009, pp’s 18-20.
  • “Rural Physician Survey”, Hanley, John A., Oklahoma State Medical association, Volume 83, August 1990,
    pp’s 408-409.
March 4, 2011:
  • Introduction to the Business Side: OHCA, PCMH, and Tiers (Dr. William Pettit)
  • Rural Hospitals and Centers for Medicare and Medicaid Services (Val Schott, M.P.H., Director for the
  • Oklahoma Office of Rural Health and Director of Rural Health Policy and Advocacy)
  • Practice Management and the Law (Ed Kelsey, J.D.)
  • Billing and Coding for a Profitable Practice (Dr. Dennis Carter, Family Practice Adjunct Faculty and Past
    2008-2010 Professor of Rural Medicine, Poteau)

March Events
(one required for course-others optional)

  • StORM Evening Event, TBA
  • REQUIRED: OSU-CHS Hospital Day, Friday, March 25. 2011, Founders Hall, 9:00 am to 1:30
    pm. Rural Residency Programs (Gary Patzkowsky, D.O.-Enid, Douglas Nolan, D.O.-Tahlequah,
    Terry Lee, D.O.-Durant, and Guest Residents)
  • DO Day in OKC, March 2, 2011

March Group Trip (transportation available) (one required per course-other trips optional)

  • Saturday, March 5, 2011, 9:00 a.m. to 4:00 p.m., Trip to Enid (group residency tour)

Recommended Readings:

  • “Workforce Issues”, State of the States Rural Health, Center for Rural Health, 2008 Edition
  • “Expanding the Primary Care Workforce”, Whelan, Ellen-Marie, Center for American Progress, November
April 1, 2011:
  • Telemedicine and the Mobile Telemedicine Clinic (MTC) (Tatum Caldwell, Interim Director of
  • Introduction to Hospitals and Residencies (Dr. William Pettit and Val Schott, MPH)
  • Rural Hospital CEO Panel: Not a Small Urban Model and Recruiting Practices (Jerry Moeller-Stillwater,
    Teresa Jackson-Talihina, Sheryl Goodson-Ada, Dave Wallace-Woodward, Randy Segler-Lawton, Don
    Ikner-Elk City and Stacey Knapp, D.O., 20010-2012 Rural Health Professor-Clinton)

April Group Trip
(Set aside as a make-up date, should any of the above trips cancel due to hazardous weather.)

  • Saturday, April 2, 2011, 9:00 a.m. to 4:00 p.m., (group residency tour)

April Events (optional, let me know the last day of class if you plan on attending)

  • AACOM Annual Conference, April 13-16, 2011 Baltimore, MD
  • Rural Hospital Conference, April 11-13, 2011, Oklahoma City, Ok
  • D.O. Day on Capitol Hill in Washington, D.C., Thursday, April 7th 2011

Rural Site Assessment Journal Turn in today! (Must be in no later than April 15, 2011)

Recommended Readings:

  • “Starting a Practice: Critical Economic Decisions Associated with Locating and Operating a Rural Primary
    Care Practice”, National Center for Rural Health Works, Oklahoma State University: Center for Health
    Sciences, College of Osteopathic Medicine, Center for Rural Health, and Oklahoma Cooperative Extension
    Services, March 2009
  • “Telemedicine in a Rural Gero-Psychiatric Inpatient Unit: Comparison of Perception/Satisfaction to Onsite
    Psychiatric Care”, Holden, Dwight,M.D. and Dew, Elizabeth, M.Ed., CPHQ, Telemedicine and e-Health,
    Volume 14, No. 4, May 2008, pp’s 381-384.

Grading: This course is for 1 credit hour and is graded as Pass/Fail with 70 points required to pass.

  • Lecture Attendance: 60%
  • Journal Entries: 25% DUE APRIL 15, 2011.
    (Must be emailed to vicky.pace@okstate.edu)
  • Group trip off-campus to residency site: 15% (one bonus point for each additional trip)
  • Special Events Optional (one bonus point for each presentation, conference, or event attended) (must sign-in
    and stay for entire presentation and write a paragraph summary to receive credit)
  • A grade of "I" (Incomplete) may be assigned if the Course Coordinator recommends an extension and sets
    forth reasoning for the recommended extension.
  • Grievance of a course grade should start with the Course Contact (Vicky Pace).


Students are expected to exhibit professionalism and behave in an ethical manner which includes but is not limited

  • Demonstrating reliability and dependability by arriving prior to the start of class.
  • If you are unable to attend class you, must contact the Course Contact prior to class.
  • Make-up work is at the discretion of the Course Contact.
  • Preparing for and participating in course activities
  • Students are expected to participate in class discussions based on the reading assignments.
  • Communicating respectfully (Disruptive or disrespectful behavior will not be tolerated.)
  • Engaging in active learning through participation
  • Assignments must be turned in on time to receive full credit.
  • Students are expected to attend all lectures.
  • Accepting and applying constructive feedback.
  • Demonstrating a desire to exceed expectations.

University policies will be strictly enforced


Contact Information

Vicky Pace


PRHE Documents

PDF Syllabus
Enrollment Form

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