NAU paused plans for college of medicine. This expert says this could create health coverage gap

Northern Arizona University has paused their plan to build a college of medicine. Originally announced to great fanfare in 2023, NAU now says economic uncertainty and the tense climate around higher education policies necessitate putting the college on hold.

While the school still offers a nursing program, which graduated nearly 800 students last year, this guest says the pause creates a potential gap in vital health coverage around the state.

Will Humble is the Executive Director of the Arizona Public Health Association. The Show spoke to him back in 2023, when NAU announced their plans for a college of medicine, and at the time, he called it “exactly what the state needs.” He joined The Show again to react to this news.

Will Humble

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Full conversation

SAM DINGMAN: Will, good morning.

WILL HUMBLE: Morning. How are you doing?

DINGMAN: Doing well. Thanks for being here. So remind us why you felt this program was such a promising step. A major factor was that it would have focused on primary care, right?

HUMBLE: Yeah, that's exactly right. So all three universities put out a plan. It was called Healthy Arizona Tomorrow. So U of A had their plan for what they wanted to do, which is just basically double the number of medical students running through there. ASU has their plan, which is focused on sort of high tech integration of engineering and medicine, still, it's specialty focus.

DINGMAN: Right

HUMBLE: But if you look at what are the key health care needs in Arizona, it's really primary care. And that's what NAU’s plan focused on. It focused on building the inventory of primary care medical students and importantly, clinical rotations and residency slots in the rural parts of the state. Not just the rurals, tribal as well.

And so the NAU plan hit the nail right on the head. And it provided all the incentives that you need to get folks to choose primary care as their specialty because it provided debt relief …

DINGMAN: Debt relief. Let's also talk about a couple of the other ones. One of the other things is it would have moved students through medical school in about three years, right?

HUMBLE: Right. It moves them through medical school in three years with less cost and had rotations and residency slots when they graduate to help them get that clinical experience in the rural parts of the state that need primary care so much. So that's why it's so sad to see of all the three plans, and NAU's was the best by far. And it's the one that's gonna go down the drain, it sounds like.

DINGMAN: Well, talk a little bit about that focus on rural areas. There was also an emphasis on cultural competency, things like behavioral health. These also were very distinct in terms of what this program would have focused on, right?

HUMBLE: Right. It went right down the line. You could tell the NAU did their homework and they said they started from the right place, which is like, what is it that we need? You know, as a university up in the northern part of the state, what is it that we need? And they hit it.

They identified exactly what we need in order to improve the health status of folks in rural Arizona. And they built a plan that would have done exactly that. And right now it's the one that's they say, paused. I hope that doesn't mean canceled.

DINGMAN: And help folks make the connection between the financial incentives this program would have offered and why that has a direct impact on more medical students going into primary care.

HUMBLE: Yeah, great question. So, you know medical school's expensive.

DINGMAN: Yes

HUMBLE: And unless you have wealthy parents or grandparents, like, you're gonna end up taking out some loans. And when you finish your, when you're a doctor, like, you are gonna make more money. If you're a specialist, like a ENT or a heart surgeon or a neurologist or something like that, you're gonna get paid more, which means you can pay your more quickly.

If you're in pediatrics, family medicine, primary care, you're not going to make the same salary. You get rewarded in other ways because you're really making a huge difference, but you don't make the same salary. And so if you come out with a lot of debt when you're finished with medical school, you get pushed into specialties that you might rather have gone into primary care, but the financial reality is, look, I gotta specialize so I can get rid of these loans.

So an NAU's program was A, less expensive over the course of time, B, provided the residency slots and incentives for to practice in rural areas. Financial incentives too. So I hope somehow it comes back.

DINGMAN: Well, we have just about a minute left here, Will, and I want to ask you. Arizona did just receive $167 million in federal money for rural health specifically. That was not as much money as people hoped. It was actually the sixth lowest I allocation in the country.

Will that money help fill the gap that the pause of this program is leaving? How do you see these things interacting?

HUMBLE: Depends on where the governor's office ends up focusing that $167 million. We asked for $200 million, we got $167 [million]. The governor's office is in the process of saying what we're not going to do that we had planned to do.

I met with the policy adviser just last week and urged him, please don't cut what you had planned to do with residency positions. And so hopefully they don't cut that.

But this Rural Health Transformation grant, if it continues over five years, gives whoever is the next governor four years in order to decide, look, we want that NAU plan. We need that inventory of primary care folks. We're gonna fund the NAU system which would become self sustaining. It is sustainable. And if you get that bolus of investment up front.

DINGMAN: Last question for you, Will. Very quickly, can you just paint a picture for us? What is the state of primary care in Arizona? Like, how many primary care doctors do we need?

HUMBLE: So it depends where you live. So like if you live in, you know, Phoenix or Scottsdale, you know, here in the Valley or in the center part of Tucson, there's primary care. There's people at the community health centers that you can go see as you get into the rural. And nurse practitioners, not always MDs, nurse high practitioners actually make really good primary care folks.

And, but if you're in the rural parts of the state, that's where the real, the lack of care is. And so there's no single answer. So many listeners will say, well, I can't. I don't have a problem making my appointment. And I don't either. I go to Mountain Park Health center and I get my appointments real easy.

But as you get into more rural spots, it's harder and harder to find somebody to help you manage your diabetes or blood pressure or stuff like that.