Outreach in Health Affairs
November 4 , 2005
by Tom O'Keefe

Lab Overview
Stop 1: UNC Air Care
Stop 2: Area Health Education Centers
Stop 3: School of Pharmacy

UNC Air Care, in operation since 1986, is available 24 hours a day, 365 days a year to provide medical air lift service across the state and into parts of South Carolina and Virginia. The class met with Jeffrey Strickler, the Administrative Director of the Department of Emergency Medicine, Patrica Corbett, Director of UNC Air Care, and Shep Kaylor, a retired Navy pilot who now flies for Air Care. UNC Air Care offices are on the top floor of the Neurosciences Hospital and it operates two helicopters from the helipads atop this building (consequently, they also enjoy one of the best views in Chapel Hill). The services they provide can be viewed as the most immediate and direct type of medical outreach that UNC offers: an extension of EMS first response capabilities to communities across the state. With an average air speed of roughly 120 mph (depending on wind speed, atmospheric conditions, air temperature, etc), many communities and critical patients are within only two hours of helicopter pick up and delivery to the hospital. The average lifespan for a helicopter is 25 years, and at present prices a new one might cost anywhere from $3-$10 million. UNC Air Care is one of seven such programs in the state, and there is extensive collaboration between these programs.

North Carolina is one of 41 states with a fully operational Area Health Education Centers (AHEC) program. North Carolina AHEC has an annual operating budget of $160 million with lean administrative offices on the 5 th floor of the Health Affairs Bookstore on the UNC campus. Karen Stallings, AHEC Associate Director, was proud to inform us that the administrative offices are modest and often empty because the real work of the program is in the field where most of the AHEC staff spend their time. The state is divided into nine AHEC districts and each district is home to a central office. AHEC programs vary widely in their services: flying health professionals to underserved communities to provide training and care through its Medical Air Operations, publishing a Health Careers Manual that is provided to career counselors at every high school in the state, sponsoring initiatives to increase diversity in health professions, running training programs for students in schools across the health affairs spectrum, providing continuing education opportunities for health professionals across the state. Additionally, during the 2003-04 academic year, more than 10,000 student-months were logged at such AHEC-Based Student Rotations.

In a state that is currently suffering intense shortages of health professionals, where some counties are without a single dentist or a single doctor, the mission of NC AHEC is “to meet the state’s health care and health workforce needs”. AHEC can be viewed as the backbone of the medical outreach that Carolina provides, and yet because the work that it does is neither glamorous or high-profile, it often finds its budget on the legislature’s chopping block. Many policymakers realize the value of AHEC’s programs in North Carolina and have advocated successfully against significant cuts in the past.

Three pharmacy schools exist in the state of North Carolina: UNC, Campbell University, and Wingate University. The class met with Dr. Pamela Joyner, Associate Dean for Professional Education, and Dr. Tammie Davis, Assistant Professor of Professional Education in Beard Hall and Kerr Hall— a building dedicated in 2002 and named in honor of Carolina alumnus Banks Kerr who founded the Kerr Drug store chain. Drs. Joyner and Davis emphasized the severity of the shortage of pharmacists across the state; pharmacies are closing or being forced to reduce their hours due to a lack of pharmacists. This fact leaves many North Carolina citizens without desired access to the medications they need. The SOP offers graduate programs (the track often chosen by students interested in the pharmaceutical industry), a Doctor of Pharmacy program (called a PharmD), which is a four year professional degree, and residency programs. A minimum of two years college coursework is required before matriculation to a PharmD program, and the average incoming class size for the Doctor of Pharmacy program is 80.

Additionally, the SOP is in its first year of collaboration with Elizabeth City State University (ECSU) to offer the Doctor of Pharmacy Partnership Program. At present, this growing program allows an additional 14 students in eastern North Carolina to pursue their PharmDs. Admission and curriculum requirements are the same for students enrolled in the Doctor of Pharmacy Partnership Program, but they live in Elizabeth City and receive their instruction via “ synchronous and asynchronous video-teleconferencing, web-based instruction, and ECSU-based faculty instruction.” Like their peers on the Chapel Hill campus, these students complete the experiential component of their training through AHEC. This is a prime example of a pioneering program that is taking advantage of advances in information technology to address a pressing social need in the state.