By Susan Hundertmark, October 1, 2008, The Huron Expositor

It all started with a Google search of a rural health centre to use as a model for a new family health team building in Seaforth.

The search led to a phone call, which led to a three-day visit of Hazard, Kentucky's Centre for Excellence in Rural Health.

And, as the Gateway Rural Health Research Institute held its official launch in Seaforth on Friday, Dr. Baretta Casey, director of the Centre for Excellence in Rural Health in Hazard was hoping the two "sister centres" could eventually share findings about rural health issues.

"We tried to show you a little southern hospitality and healthcare," she said. "And, it goes to show you that if you get the right people on the bus with the right vision and get people around you to support you, it'll happen."

Gwen Devereaux, a local physician recruiter, was the one Googling the Hazard centre and organizer of the trip to Kentucky.

"We really believed we wanted to model Kentucky and bring it back and as Dr. Casey said, 'Once the toothpaste is out of the tube, it ain't going back.' We saw what was possible down there and it was amazing," said Devereaux.

Casey said the Hazard centre, which has been operating for 18 years, began when a prominent Kentucky legislator decided to do something about the poor healthcare services in his state and managed to get $1.2 million in seed money to start to solve the problem.

Instead of just building a clinic, Casey said organizers decided it was also important to provide a multi-professional team, to do clinical research about the region's health problems and to train healthcare professionals to respond to the workforce shortage.

Providing services in family medicine, obstetrics and gynecology, clinical psychology for both adults and children, internal medicine, a dental clinic and pharmacy, the four-storey Hazard centre also trains family medicine residents, dental residents and osteopathic family medicine residents.

"Our mission is to improve the health of Kentuckians and to do that, people have to be first," she said.

Academic programs at the Hazard centre also include a doctorate in physical therapy, masters in social work and bachelors in clinical leadership and management, and a bachelors in clinical lab research.

"Since inception, we've graduated 48 doctors and 70 per cent are still in rural Appalachia. No one else in the U.S. has that high a percentage," she said, adding that they train 18-21 medical students every year.

Ninety per cent of the doctors in physical therapy are working in rural Appalachia as are 100 per cent of the graduates of the masters program in social work.

"That is what having academic programs in rural areas can do for you," she said.

The Hazard centre starts trying to attract students into healthcare in Grades 7 and 8 with a weeklong Scrubs camp, continuing with a three-week daycamp for Grades 9 and 10.

"We know if we can enlist and excite students, we can keep them there. They might change their focus but they never lose their zeal for healthcare," said Casey.

While the Hazard centre had almost no research funding three years ago, it now has over $4 million in research grants, both from governmnent and private donors.

"It takes too long to help a patient with research right now - sometimes 20 years from the bench to the bedside. We want to make interconnections to universities so that as soon as the bench research proves somethings works, it gets to the patient in a rural community in one year," she said.

Casey told the Gateway board that to be successful at attracting funding for research, it's important to "be two steps ahead."

"While you're getting your first project off the ground, you need to be writing proposals for the next two or three."

She added it's also important to publish every project's outcomes.

"Many times people do research and they don't use what they found to pass it on to others where it can be of benefit," she said.

Casey said the centre's greatest accomplishment is a dental van that visits every school in the area providing dental care to every student from Kindergarten to Grade 5, regardless of their ability to pay.

"The first year, 47 per cent of the children had urgent dental care needs and some of the Grade 5 students had never seen a dentist in their lives," she said.

Casey said she hopes she can work with the Gateway Institute in Seaforth, possibly looking at the similarities and differences in health findings in rural Kentucky and rural Ontario.

"I hope we can continue to be sister centres and encourage each other - there will always be low points and it's good to keep each other propped up," she said, adding that the biggest difference between Kentucky and Ontario is the mountainous terrain in the Appalachians.

"I'm astounded at how much we're alike," she said.

She encouraged the Seaforth centre that having a rural research centre will have big economic impact on the area.

She said the Hazard centre did a research project its economic impact, discovering that one family doctor brings $1.6 million in economic activity to the region.

"Every time you bring in a research grant and have to hire someone, that's an economic impact. Your centre is a huge economic driver," she said.

Casey advised the Seaforth group to do a lot of marketing.

"Don't be afraid to brag or no one will know about you. The more you tell your story, the better off you are," she said.

"We have very lofty goals to get where Dr. Casey has been. We've made some progress and we've named it Gateway," said Devereaux.

Dr. Claudio Munoz, the lead researcher for Gateway, has been talking to Devereaux for the past five years about the possibility of a research centre in Seaforth and was part of the tour to Kentucky.

"It wasn't until we visited Kentucky that we knew there was no way back - we had to build," he said. "This (the centre in Hazard) is an amazing centre located in a town of 5,700, very comparable to Seaforth."