RICHMOND, Ky. — To fill a dire need for primary care physicians in rural Kentucky, Eastern Kentucky University is working to change the state’s low health metrics by adding a new osteopathic school of medicine.
Across the state, 26% of Kentuckians — one in four — do not have a personal primary care doctor, Kentucky Health News reported in 2021. While 40% of Kentuckians live in rural communities, only 17% of primary care physicians practice there.
“When we look at our communities across the state, we see that 94% of our Kentucky communities are underserved, or not served at all in primary care physicians,” EKU President David McFaddin said.
There also is a quick aging out in practicing primary care doctors. Currently there’s approximately 2,600 in the state of Kentucky, but an additional 2,400 will be needed in the coming years, which McFaddin said is an immense number of physicians to be replacing in an already underserved area.
There is currently one osteopathic school in the state of Kentucky, located at the University of Pikeville. There are two traditional medical schools in the state at the University of Kentucky and University of Louisville.
An osteopathic school of medicine graduates doctors of osteopathic (D.O.), rather than doctors of medicine (M.D.), which is what most other schools offer. Osteopathic medicine focuses on the musculoskeletal system, as well as looking at lifestyle and environmental factors, according to the American Osteopathic Association.
Other states that are considered to have healthcare desert areas, McFaddin said, such as Louisiana, Alabama and South Carolina, are home to four or five medical schools and more than one D.O. school.
EKU wants to lean into the primary care track with its medical training, because that is where the needs of the state lie.
He said obviously the need for specialists may arise with some of the main healthcare issues seen in Kentucky, such as cancer, diabetes and heart disease.
“We’ve got to be responsive to those things, but that first line of defense is making sure that we’ve got great primary care physicians,” he said.
A dire need in primary care
McFaddin himself has experienced issues trying to obtain a new primary care physician. His doctor retired, and when he was looking for a replacement, many providers were either not taking patients or the lead time to get in as a new patient was immense.
Additionally, as a native of far Eastern Kentucky, McFaddin goes into rural communities there and asks people what they think about the shortage of doctors. They tell him it is a dire need.
EKU’s current step in seeking to launch a new school of medicine is conducting a feasibility study, which McFaddin said the school wants to do within the next 60 days.
The expectation is that work will take place late spring into summer, and that the feasibility study will be in hand late summer or early fall, which will inform the next steps.
“I think there’s a lot of data that’s already out there about the demonstrative need for more physicians,” McFaddin said. “What we’ve got to look at is internally, our internal institutional structures and supports, and then we’ve got to look outward to the landscape of medical providers — they’re a big part of this process — to make sure that they, too, are ready in order for us to move out and start putting more doctors into rotations.”
A new medical school requires approval from the General Assembly. HB 407, which will allow EKU to offer D.O. medical degrees, passed the House unanimously this month. It must also receive approval in the Senate, where it has been referred to the education committee.
“We’ll be very hopeful to get that bill passed before the legislature adjourns on April the 15th,” McFaddin said. “We’re eager to move through that. That will create a pathway so we can move forward. We’ll do the feasibility study. Then once we get that back, in the fall, if everything looks we’ve got the information we need, we would then go into the applicant status.”
Getting all the pieces in place
McFaddin said the hope is that a new college of medicine would be graduating its first class in 2031.
He said the feasibility study will help inform them on what class sizes and enrollment numbers will look like, but that he imagines there would be somewhere between 100 and 150 students of each first-year cohort.
“We’ve had a lot of conversations with alumni, with others who are concerned about the health and well-being of the commonwealth of Kentucky, with a number of folk. In order to really move those conversations from concept to concrete we’ve got to get this legislative change done. It’s hard to start that conversation and say, ‘but we need a policy change that would even allow us to contemplate doing this.’ Once we get past that hurdle, we will get much deeper into those conversations,” McFaddin said.
EKU wants to focus on having a strong pipeline for Kentuckians, and McFaddin said it would be amazing if all students attending their school were Kentucky students.
EKU has already spoken to Murray State University about creating designated spaces for its students on the pre-med track that would have reserved spots for these students, he said. They will do the same for other schools throughout the state also.
“Once we get past this legislative hurdle,” McFaddin said, “we’ll get into some of those deep conversations about how we can be an addition to the options that are there for Kentucky students who are looking to go to medical school.”
Kristen Roberts is an editorial intern with The Lane Report.
