CHAMPAIGN, Ill. - Dr. Hugo C. Avalos, a small-town physician who has been retired for nearly four years, is helping the University of Illinois College of Medicine at Urbana-Champaign tackle a series of challenges facing the medical profession.
The numbers of doctors willing to serve in rural counties and in many vital specialties, including obstetrics, neurosurgery and emergency care, are dropping. The medical profession is struggling to keep pace with a growing population. Many aging doctors are retiring. And physicians have been hit hard by rising insurance costs and the declining availability of malpractice coverage.
Avalos, of Morris, Ill., was named in May as the College of Medicine's first ambassador in a new program of public engagement. An ambassador is to be a bridge connecting the college's faculty and students with people in a community to talk about issues facing medicine and the need to lure more young people into the field.
Although the ambassador program is in its infancy, Avalos plans to get it up on its feet in the fall. His efforts will be a template for other Illinois communities, said Diana Avalos Dummitt, associate director of development for the Urbana campus of the university's four-city College of Medicine system. She is Avalos' daughter.
The college gradually will appoint about 14 more ambassadors to rural communities that show an interest and desire to learn more about the medical field.
"The key is to identify an ambassador in the each community who will be able to point to how the college could connect with the community," said Madeleine A. Jaehne, director of advancement. The college and its ambassadors will tailor programs to the particular needs of each community, she said.
"We have a special responsibility to offer our research and resources to citizens across Illinois," Jaehne said, referring to a mission shared by all U. of I. campuses and set in place by the state and the federal Land Grant Act of 1862.
"We wondered what we could do to make a difference in Illinois communities. We talked to people from both the community and the College of Medicine and decided that an ambassador program would be a good fit."
In the fall, Avalos will host a community reception in Morris for Regional Dean Bradford S. Schwartz. "It will be a chance for the dean to tell Morris residents the vision of the college and to work with them to investigate what they would like to see happen to promote health careers in their community," Dummitt said.
Through the ambassador program, the College of Medicine wants to encourage students to pursue medical, biological and scientific careers. These days, Jaehne said, "people really have to want to be a physician."
It is hoped, Schwartz said, that Avalos and future ambassadors can deliver a message that fits today's medical climate and "acquaints people with a realistic idea of what medicine can realistically achieve."
"It's important for people to understand how people learn to become doctors, including the critical importance of a university education before medical school," he said. "Understanding how the university combines research and education into overlapping activities is essential."
In addition, after completing their science courses, students go through an apprenticeship period in which they work closely in a series of settings with experienced doctors.
"This tends to slow down the mentors, because they take time to teach," Schwartz said. "However, Medicare and the insurance companies push the physicians to see more patients per day, something that is at odds with having time to teach."
Meanwhile, universities and medical schools do not get sufficient funding to allow them to pay experienced doctors to teach, Schwartz said, so arranging for adequate clinical experience for doctors in training is getting increasingly difficult.
"The college wants to attract people who want to be doctors for the right reason," Schwartz said. "These are people we would want as our doctors. They are people with both scientific and humanistic perspectives."
A major challenge is filling medical positions in rural areas, even though the desire by young people to enter the field is so strong that admission to medical schools remains extremely competitive.
"Data show that doctors are likely to go into practice near where they train, which often leaves rural communities without sufficient health care," Schwartz said.
In rural Illinois, about 40 positions for physicians remain unfilled, according to a November 2004 newsletter from the American Association of Medical Colleges. Nationally, the American Medical Association's Council on Graduate Medical Education projected in June, a shortage of 90,000 doctors is likely by 2020.
The College of Medicine wants to address the problems through public engagement at the local level throughout Illinois. "The ambassadors will share information with their communities on a full-time basis," Schwartz said.
Such an approach is a perfect fit, Avalos said. "I like to be with people, and I like to communicate."
Avalos easily met the college's need, Schwartz said, because he can speak passionately with the public about societal trends and medical breakthroughs, and how these trends and breakthroughs can benefit Illinois residents.
In 1960, the Mexican-born Avalos, his wife Mary, and their young children moved to Morris, located an hour southwest of Chicago along the Illinois River. Prior to his move, Avalos received a degree in medicine in 1947 from the University of Mexico in Mexico City. He trained in surgery at Little Company of Mary Hospital in Oak Lawn, Ill., and at Cook County Hospital in Chicago in the 1950s.
"I love Morris!" Avalos said. "There are about 10,000 people who live here and a magnificent hospital." (The official 2000 census was 11,298 residents.)
When Avalos moved to Morris, six doctors practiced at its hospital. "With so few doctors, we all had to do everything," he said. "Even though my specialty was surgery, I found myself doing pediatrics. I delivered about 2,000 babies in 25 years."
Now the Morris Hospital & Health Care Centers employ multiple obstetricians, along with specialists in other fields such as cardiology, oncology and plastic surgery.
Avalos also served for 35 years as the team doctor for the Morris High School football team, for which he won the Illinois State Medical Society Team Physician of the Year Award in 1981. His retirement on Dec. 31, 2001, after a 42-year career, was recognized by a special House resolution during the state's 92nd General Assembly.
The college is asking alumni to help identify potential ambassadors. U. of I. Extension, with offices across the state, also will help identify candidates. Individuals also may nominate themselves or others.
"Ambassadors don't need to be doctors," Schwartz said. "But they should understand medical training and appreciate that truly good education needs an environment of curiosity and discovery."