Students like Catalina Yepez could help solve Washington’s shortage of rural health care providers.

A 30-year-old Washington State University pharmacy student who lives in Benton County, Yepez got interested in the field after her dad was diagnosed with diabetes in his 40s. When she tallied the number of family members she knew with the disease, the statistics hit home.

“Diabetes is common among the Hispanic community in Washington, and it’s a chronic disease,” she says. “People are often on a lot of medications, and diabetes can cause complications that will require different meds.”

Yepez worked at Columbia Basin College for a few years after she graduated from WSU Tri-Cities with a bachelor’s in biological sciences. During the Covid pandemic, she interviewed for pharmacy school.

Woman pharmacy student holds a bottle of pills as she talks to another woman
Catalina Yepez checks patients’ blood pressure and glucose levels at a Yakima health fair.
(Photo Robert Hubner)

“The pandemic reminded me of why I went to college in the first place and where I thought I could make the most difference,” says Yepez, who wants to practice rural pharmacy.

About 800,000 Washington residents live in sparsely populated areas that lack access to health care professionals. Much of eastern Washington fits that category, according to the state Department of Health, and so do parts of central and southwest Washington.

To help fill the provider gap, the College of Pharmacy and Pharmaceutical Sciences launched the Rural Health Initiative. Besides recruiting pharmacy students from rural areas and underserved populations, it encourages rural pharmacies to offer more primary care.

The initiative is the brainchild of Mark Leid (’83 Pharm.), WSU’s dean of pharmacy, who grew up in the farm town of Waitsburg. Who better to serve rural communities, he thought, than people from rural areas?

And what better place than the local pharmacy?

“Pharmacies are the front door to the health care system,” he says. “You can walk in and see a pharmacist with no appointment. That person could be up to their neck filling prescriptions. But if you walk in with a question, they’re going to drop everything to answer you.”

An effective program, Leid knew, also had to prepare students for the realities of rural practices.

“While it might sound kind of romantic to say, ‘I’m specializing in rural pharmacy,’ it’s a lot of work and much different from practicing in an urban area,” he says. “You might be the only health care provider for 100 miles.”

The Rural Health Care Initiative has a 10-year plan for growing Washington’s ranks of rural pharmacists. Besides recruiting students, the initiative⁠—which launched in 2022 with an anonymous $2.2 million gift⁠—offers financial support, specialized training, and career connections.

Rural-track pharmacy students are eligible for $10,000 annual scholarships if they spend three years working in rural areas after graduation. Their curriculum includes classes tailored to rural health care, and they do clinical rotations in smaller communities.

“If you don’t know the area, you might have difficulty seeing yourself taking a job in Republic, Omak, or another small town after graduation,” says Angela Stewart, associate dean for rural health and pharmacotherapy professor. “But if you already have connections there, there’s more of a draw.”

Yepez takes classes through WSU’s pharmacy program in Yakima, where she’s on track to graduate in 2025. She and her husband live in Prosser, where her parents and other family members help care for the couple’s three-year-old son.

Yepez also drives to Walla Walla, where her clinical rotation at St. Mary Medical Center led to an internship at the hospital’s pharmacy. Part of her scholarship money helps fill the gas tank.

Besides graduating new pharmacists, the initiative envisions helping existing pharmacists expand their services.

“People think of a pharmacist as the person who hands them their prescription and provides counseling on medications, but pharmacists can and do provide care,” Stewart says.

Among other things, Washington pharmacists can treat burns, cuts, and rashes and monitor chronic conditions like hypertension and diabetes. They can perform basic screenings, manage medication therapy, and evaluate and treat patients with strep throat and uncomplicated urinary tract infections.

Rural pharmacists, who often know their patients by name, can catch health problems early, referring clients to physicians for follow-up care.

Nationally, rural pharmacists are recognized as underutilized health care providers, Stewart says. “Many would love to be doing more than dispensing medications and giving immunizations, but they can’t see ways to free up time to create some of these services.”

To help that happen, the Rural Health Initiative places WSU clinical faculty at rural health care facilities, such as a hospital clinic pharmacy in Centralia.

“Pharmacists go out into these communities and serve kind of like physician’s assistants,” Leid says. “Besides Centralia, we’ve placed a clinical faculty member in Spokane Valley, which isn’t rural but serves high numbers of patients from outlying areas. As funding becomes available, we’ll continue to expand.”

Through a rural residency program, pharmacies will also have access to new graduates. Stewart says the objective is to bring fresh ideas into pharmacies, expand care models, and create new revenue.

“When you put all the parts of the Rural Health Initiative together, I truly think we can make a difference in improving health care for Washington’s rural residents,” Leid says. “And we can make it happen within 10 years.”

 

Web exclusive

Pharmacy care in rural Washington—An interactive map

Learn more

Rural Health Initiative and how you can help support the work

Rx care next door: Tyler Young takes care of his neighbors at Vashon Pharmacy

Telehealth in rural fire departments could help address healthcare challenges (WSU Insider, March 18, 2024)

Watch a video of the RHI and its work.