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Pioneer of Rural Track Residency Passionate About Improving Health Care Access in Rural Communities


Growing up in rural Middle Tennessee, Thomas Atkins, MD, saw firsthand the need for improved access to health care outside of cities and metropolitan areas.

“People in my community would have to decide between taking off work and driving all the way to Nashville to get care for something, or just dealing with being sick so they don’t lose the paycheck,” he said.

Dr. Thomas Atkins is shown with his wife and daughter at his graduation.

A 2022 graduate of UTHSC, Dr. Atkins is the first rural track resident in the College of Medicine – Nashville’s family medicine program. The pilot program is a state-funded effort to eliminate a shortage of physicians in rural areas, highlighting UTHSC’s dedication to improving the health of every person across the state of Tennessee.

The three-year residency, based at Ascension Saint Thomas River Park in McMinnville and Ascension Saint Thomas Rutherford in Murfreesboro, will train Dr. Atkins not only how to practice medicine in a hospital setting, but also how to manage the problems specific to rural communities, where patients are typically underserved.

“As a rural provider, you have to know a lot about a lot,” Dr. Atkins said. “You might be the only physician within 50 to 100 miles, so you have to be ready for anything that comes through the door, and you have to be confident in a lot of stuff.”

The lack of access to quality health care in rural communities is why Dr. Atkins wanted to study medicine. When he left his hometown of Pleasant View, he always intended on returning to a rural community, if not the one where he grew up. He completed his undergraduate degree at Vanderbilt University – some 30 miles from Pleasant View – and he knew he wanted to stay in Tennessee for medical school as well.

“I feel a real connection to the state, and after I interviewed at all the medical schools, I felt the deepest connection to UTHSC. The faculty there all seemed great and willing to work with me toward my goals,” Dr. Atkins said. “Then, when I got there, I really liked the inclusive environment and the opportunities the school afforded. The students were hard-working and very willing to help other students, and it felt like everybody was on the same team.”

When Craig Glass, MD, associate director of the family medicine program, reached out about the new rural track residency, Dr. Atkins was almost immediately on board. Upon graduating, he, his wife, and their young daughter moved to Middle Tennessee, not far from his hometown and his family, where Dr. Atkins is now pioneering the rural track residency.

Dr. Thomas Atkins

Over the next few years, Dr. Atkins will be exposed to the disparities rural communities face in accessing quality health care due to economic factors, educational shortcomings, geographic isolation, and other causes. One of the issues Dr. Atkins is interested in is the lack of screening opportunities for preventable diseases.

“If you only have a handful of providers in an area, and people have to choose between a paycheck and going to see the provider, they may miss their screenings for preventable things like complications from hypertension or COPD or cancer screenings. There’s a higher incidence of those in rural and underserved populations,” Dr. Atkins said. “People in these underserved communities also often have less access to their medication and refills because there aren’t enough providers in the area, so you often see poorly managed or under-managed diabetes and hypertension and things that go along with that.”

According to Dr. Atkins, it takes a certain kind of person to want to practice medicine in a rural community, and that’s a big reason there’s a shortage of rural physicians. He said many doctors don’t want to leave the comforts of a big city, where there are typically more opportunities for advancement at hospitals and private practices. Plus, being the only provider in a relatively large area can be daunting, but it’s a challenge Dr. Atkins looks forward to facing.

After completing his residency, Dr. Atkins plans to begin practicing in rural Tennessee. In addition to treating underserved patients, he also hopes to get involved in health care policy to help shape the way the government and lawmakers handle health care issues. “I want to do everything I can to alleviate the burden of a lack of physicians that we have in Tennessee outside the major metropolitan areas,” he said.

Until he becomes part of the solution to that issue, Dr. Atkins said he wants to assure people in rural communities that the landscape is changing, adding that more physicians are getting excited about bringing health care to those underserved populations. He also hopes more medical students will consider practicing in rural areas because of the impact they can have in a community.

“From my point of view, rural medicine is amazing. You can do so much good for so many people. You can be a pillar of that community that people look to and rely on, and I think that brings a lot of fulfillment,” he said.