In June, Mike and Gillian Goodrich gifted $10 million to the University of Alabama at Birmingham Marnix E. Heersink School of Medicine toward a program to train primary care physicians in rural communities. Dr. Irfan Asif, chair of the Department of Family and Community Medicine and associate dean of Primary Care and Rural Health at UAB, said the program will address shortages in primary care across the state.
“Alabama is in the bottom five, I would say, of states for primary care. If you look at all the rankings, we’re usually maybe 46 or 47 in the country in terms of the number of primary care providers for the population that we have,” Asif said in an interview with the Daily Yonder.
“Primary care is meant to prevent and treat different conditions, things like diabetes, high blood pressure, making sure you get your cancer screening, making sure you get your immunization. If you don’t have somebody who’s working on trying to prevent diseases from happening, then you end up with a lot of disease. And in Alabama, we have a lot of disease here.”
More than 2.1 million residents, about 42% of the state’s population, live in rural areas, according to Alabama Public Health, and of those 16.4% are uninsured, compared to 14.1% of residents who live in urban areas of the state. State residents also have high rates of obesity (38.9% of rural residents are obese, according to the APH) and diabetes (14.2% of the rural residents, according to Rural Health Information Hub). High blood pressure, heart attack and mental health issues also are prevalent, Asif said.
“I would say that that is because you don’t have people in primary care,” Asif said. “I’ve been here at UAB for eight years, and what I’ve been trying to do is think about how we can address that shortage of primary care, and my hope is that (this gift) ultimately improves the health of this state or this region of the country.”
The Goodrich Rural Innovation in Training for Alabama, or GRIT, will primarily focus on expanding the healthcare workforce pipeline by attracting medical students and boosting the ability to train residents to be primary care doctors, Asif said. The goal is to train them in Alabama and keep them there, he said.
The issue is important to donors Mike and Gillian Goodrich. Mike Goodrich, a construction-firm executive, explained their goals in a statement. “For a number of years, Gillian and I have been concerned about access to quality healthcare in rural Alabama,” Mike Goodrich wrote. “Small-town hospitals are closing or reducing services to local citizens. We have worked…to develop a comprehensive program that will attract and retain primary care residents and physicians in rural communities.”
Providing medical students in the state with the tools they need to succeed can be the key to keeping them there, Asif said.
“Folks tend to stay close to where they last trained, and so typically more than 50% of people stay within 50 miles of where they trained last in medicine,” he said. “My whole philosophy is let’s recruit them from Alabama, let’s train them, and then hopefully retain them here in Alabama. That’s been working. We’ve hired a number of people in the past several years who’ve come out of this model.”
That philosophy requires scholarships, support for residency positions and improving access to technology and equipment within practices.
“(Residents) don’t want to train in a practice that has old, or maybe no, technology, or has you running paper charts and workflows from the ‘70s or ‘80s,” he said. “We want to have upscale practices, so when students go to those practices, they know what the future looks like. We’re trying to innovate with more technology, more telehealth programs, more remote monitoring for patients … to make sure that when students train there, they can see what that looks like, and then they want to stay.”
Anupam Agarwal, M.D., senior vice president for medicine and dean of the UAB Heersink School of Medicine, said the program is a partnership between the Goodrich family and UAB.
“From the start, the Goodrich family shared our concern about growing gaps in access to care across rural Alabama…we have built GRIT into a comprehensive pathway that supports learners from early exposure through training and into practice,” Agarwal said in a statement.
The workforce pipeline will begin before college, starting with high school outreach programs that introduce teens to health care careers. From there, undergraduate and medical school programs introduce students to the field of primary care. One program allows supervised medical students to work with patients during their first year of training.
“Students get to work with their patients over the course of four years,” Asif said. “We give them 10 patients, and they serve as health coaches, helping them with screenings, vaccines and any other health needs they may have, such as healthy eating or smoking cessation.”
By the time the students graduate, they’ve cared for the same patients for four years like they would if they were in primary care, he said. The program provides them with clinical skills, as well as soft skills like the intimate relationships with patients and their health, and the responsibility that comes with that.
Asif said GRIT will not solve the rural healthcare access crisis in Alabama single-handedly, but that it begins the process of getting more physicians into rural communities in the state.
And seeing that process begin is the gift’s purpose, Gillian Goodrich said.
“Small towns make up the fabric of Alabama,” she said in a statement. “We believe that this program is an exciting step to ensure rural Alabama will have the healthcare services that allow residents to continue to enjoy the benefits of rural life.”
Facts Only
* Mike and Gillian Goodrich gifted $10 million to the UAB Marnix E. Heersink School of Medicine in June.
* The funding is for a program to train primary care physicians in rural communities.
* Dr. Irfan Asif stated Alabama ranks in the bottom five for primary care providers.
* More than 2.1 million residents, approximately 42% of the state’s population, live in rural areas according to Alabama Public Health.
* 16.4% of rural residents are uninsured compared to 14.1% in urban areas.
* Rural residents have higher rates of obesity (38.9% of rural residents) and diabetes (14.2% of rural residents).
* Dr. Asif attributes health disparities to the shortage of primary care providers.
* The GRIT program focuses on expanding the healthcare workforce pipeline by attracting medical students and training residents in Alabama to retain them there.
* The model involves high school outreach, undergraduate/medical school exposure, and supervised patient work for four years.
* The program aims to provide students with modern tools, including technology and remote monitoring, in practice settings.
Executive Summary
Mike and Gillian Goodrich donated $10 million to the University of Alabama at Birmingham Marnix E. Heersink School of Medicine to fund a program aimed at training primary care physicians in rural communities. This initiative is supported by Dr. Irfan Asif, chair of the Department of Family and Community Medicine and associate dean of Primary Care and Rural Health at UAB, who noted the need for such a program given Alabama's low ranking for primary care providers. The program, called GRIT, focuses on expanding the healthcare workforce pipeline by attracting medical students to train and retain them in rural areas of Alabama.
The motivation stems from concerns about access to quality healthcare in rural Alabama, as exemplified by the closing or reduction of services at small-town hospitals. Dr. Asif outlines a philosophy centered on recruiting students from Alabama, training them there, and hoping they will stay, suggesting that retention is supported by providing modern training environments that incorporate technology like telehealth and remote monitoring. The program also includes early exposure through high school outreach and allows medical students to work with patients for four years, serving as health coaches in areas such as screenings and vaccinations.
Full Take
The narrative frames a philanthropic investment as a direct solution to systemic workforce shortages and rural health disparities rooted in historical access issues. The core tension lies between the desire for localized, high-quality care and the established pull factors that lead medical professionals to urban centers. The argument pivots on the principle that improved infrastructure (training pipelines) facilitates retention, which in turn addresses public health outcomes associated with poor access to preventative care.
The proposed solution—attracting and retaining residents through specialized training environments incorporating modern technology—suggests a belief that geographic location is less of a barrier than perceived quality and contemporary relevance of the practice setting. This moves beyond simple access provision toward cultivating an ecosystem where professionals choose to remain in rural settings, implying that the cost-benefit analysis for practitioners must be recalibrated by offering educational parity. The focus on embedding the training within Alabama suggests an attempt to leverage regional identity as a retention mechanism, which forces a consideration of whether this cultural appeal can overcome structural economic disadvantages.
The pattern observed is the use of high-level philanthropic framing (the $10 million gift) to address deeply entrenched socio-economic problems (rural healthcare deserts and health crises). The underlying assumption that innovation in training pipelines will inherently solve access crises overlooks potential systemic barriers, such as the lack of infrastructure outside of clinical training itself. The implication for human agency is whether this model empowers local communities or functions primarily as an externally imposed mechanism for workforce redistribution. What factors beyond medical training—economic opportunity, social infrastructure, and quality of life—must be addressed concurrently to truly ensure that physicians choose to remain in rural Alabama?