Training and Retaining
/The UAMS Southwest family medicine residency program has trained local practitioners for over three decades
By Ellen Orr
Though we often think of health as an individual matter—concerning a person’s diet, movement, sleep, medication, and so forth—Dr. Matthew Nix is keenly aware that the pursuit of health is a community endeavor. In particular, he is passionate about the community value of family physicians.
photo by shane darby.
“You can drop a family doctor in a community, and just by the fact that they’re there, practicing preventative medicine, mortality drops, hospitalizations drop, ER visits drop, insurances spend less money,” he said. “It’s vital—and the research proves this—for patients to have that personal physician whom they see over time.”
Matthew is the program director of the family medicine residency program at the UAMS Southwest Regional Campus, located on U of A Way in Texarkana. The residency began training doctors in 1993 and has, over the last 31 years, produced 203 family physicians, including Matthew himself, who completed his residency in 2006. Around 73% of those doctors have remained in Arkansas or Texas, with many in Texarkana and surrounding areas. This is by design.
Dr. Matthew Nix (seated) reviews a case with residents Russell Gregory, M.D., Kaiyang Feng, D.O., Andrew LeGrand, D.O., and Raha Amini, M.D. (left to right) photo by shane darby.
“In the 1950s and ‘60s, all of the [Arkansas] residencies were in Little Rock, and it was very hard to get family physicians to practice outside of Little Rock,” Matthew explained. Studies conducted in that era showed that about 60% of residents stayed within 100 miles of their residencies, and 40% of those stayed within 25 miles.
“So the thinking at the time was, ‘Why don’t we start training doctors where we want them to practice?’” he continued. “And that has involved community-based programs.”
In 1971, Congress developed the Area Health Education Center (AHEC) model. These healthcare hubs continue to harness the resources of academic medicine to recruit, train, and retain healthcare professionals in underserved communities. Today, over 85% of US counties benefit from AHECs, but when Arkansas began establishing them in 1973, there were very few; in fact, Matthew said, Arkansas was the second state to adopt the AHEC system (after North Carolina). By 1976, Arkansas was home to six AHECs, including UAMS AHEC Southwest, located in Texarkana.
At its inception, the Texarkana AHEC was primarily a medical library, located within St. Michael Hospital. While the other five Arkansas AHECs had launched residencies by 1980, “the money ran out at Texarkana,” Matthew said. Enter senator and Texarkana champion Wayne Dowd, who served as president of the Arkansas State Senate during Bill Clinton’s governorship and helped pass much of Clinton’s agenda.
“The philosophy of training physicians in a local community really has worked out very well for this community.”
Senator Dowd, whom Matthew helped care for over the years at the UAMS Southwest Family Medical Center, recalled to Matthew that, in 1991, before Clinton left the governor’s mansion to campaign for presidency, he asked Dowd what favor he could provide, as thanks for his legislative support. As the story goes, Dowd said he wanted a family medicine residency program in Texarkana. In 1992, funding was approved, and in 1993, the first class of residents was accepted.
Matthew, a native of Texarkana, Arkansas, never planned to return to Texarkana, or to practice family medicine, though he did know from a young age that he wanted to be a doctor. Matthew’s mother was a nurse, and he thus spent many childhood hours in hospitals and getting to know doctors and other medical professionals.
“I remember several cases when I needed to wear a tie for something, and it always seemed to happen when my dad was working, so my mom would say, ‘Just come to the hospital,’” Matthew recounted. “She’d find a doctor to tie my tie, and one that she frequently got was [the late] Dr. Donald Duncan. He would tie my tie and talk to me. Just saying some positive things can make a huge impression on a young child. He’s a big part of my ‘pipeline story.’”
Matthew is passionate about the “pipeline”—a constellation of programs for local young people that expose them to healthcare professions and support them through their medical education and career journeys. He cited HOSA—the Healthcare Occupations Students Association—as a major contributor to the long-term health of a community. UAMS and Arkansas HOSA have for many years worked together to execute programs for area K-12 students. Matthew’s own brother, in fact, participated in these programs; he is now a pharmacist at a VA hospital in Florida.
After attending the University of Central Arkansas for undergraduate, Matthew pursued a medical degree from UAMS with the intent to practice as an oncologist in a metropolitan area. When, in his first year of med school, a medical-specialty selector test indicated that he was best suited for family medicine, he scoffed. When he was required to take the assessment again the following year, he received the same results.
During the summer after his second year, Matthew took advantage of a training opportunity that came with a stipend—money he desperately needed. The program sent medical students to small towns to shadow family practitioners. Matthew went to Sheridan, Arkansas. It was during that rotation, he said, that he accepted that family medicine was, in fact, where he belonged.
Dr. Nix examines a patient with two residents. photo by shane darby.
“I always tell medical students, ‘You have to find your people,’” Matthew said, “because personalities do gravitate to certain disciplines. When I was hanging around obstetricians, I found that I didn’t really think like an obstetrician. When I was hanging around surgeons, [I found that] I didn’t really think like them, either. Then I was hanging around family medicine and realized, ‘Oh, these are my people.’”
In his third year of medical school, Matthew chose to complete his month-long family medicine clerkship in Texarkana, primarily so his son could spend time with Matthew’s parents. Then, Matthew “fell in love with the faculty, with the program, with the other residents, with the staff,” he said. “I decided to try to match here [for residency]. And I was accepted.”
What Matthew loves about family medicine—and, in particular, practicing family medicine at the Texarkana AHEC—is working with other professionals and the patients themselves to improve the lives of community members. Family doctors, he said, are trained to understand patients holistically.
Family medicine was not established as a medical specialty until 1969. The American public of the ‘60s was dissatisfied by the available medical care—namely because of the doctor shortage, the inaccessibility of healthcare in small towns and inner cities, and the increasing depersonalization of medical care.
“A famous physician said, ‘There are 57 different varieties of specialists to diagnose and treat 57 different varieties of diseases, but no physician to take care of the patient,’” Matthew recalled. “And that’s what family medicine is.”
Caring for patients and training new doctors have long been Matthew’s primarily occupational responsibilities. But, when he was named program director in 2023, his job duties expanded to include more big-picture tasks. He said that one of his primary goals as director is to raise community awareness of the residency program and the AHEC as a whole. The purpose, he explained, is to encourage even more community involvement in the development, recruitment, education, and retention of high-quality healthcare professionals.
“Texarkana is very fortunate,” he said. “The residency program could not exist without our two extremely supportive hospitals, CHRISTUS St. Michael and Wadley Regional.” He also referred to the many local specialists who volunteer their time to educate the residents, as well as the area corporate partners who sponsor pipeline programs such as MASH (Medical Applications of Science for Health) Camp. “The philosophy of training physicians in a local community really has worked out very well for this community.”