Alice Walton is starting a healthcare revolution in Bentonville, Arkansas.
In the heart of Ozark country, the heiress to the massive Walmart fortune has built an independent, not-for-profit medical school from the ground up. Her goals? To re-humanize medicine, put holistic principles at the core of medical education, and expand access to high-quality healthcare in one of the nation’s most medically underserved regions.
Earlier this month, 48 students comprising the inaugural training cohort at the Alice L. Walton School of Medicine (AWSOM) set foot on the lush 130-acre campus, to begin their first week of classes and to take initial steps toward what Walton hopes will be a brighter, healthier future for American medicine.
AWSOM sets out to be unlike any other med school in the nation. The core curriculum emphasizes prevention, nutrition, and community-centered whole-person care. Though it includes all essential requirements for producing fully-competent MDs able to pass licensure, prescribe drugs, and enter any desired specialty, it will also train clinicians who can themselves exemplify the principles of good health and balanced living.
An AWSOM Venture
Nutrition, gardening, and cooking are not lip-serviced at AWSOM, they’re key features in the curriculum. So are the arts. In addition to intensive coursework in anatomy, physiology, and pharmacology, AWSOM’s students will also take drawing classes, learning to sketch one another’s faces. The goal is not to train artists, but to teach students how to see with open eyes.
The school is fully accredited as any standard med school would be, and trainees at AWSOM “will get all the science and disease knowledge they need to manage the ‘sick-care’ side of things. But I wanted to create a school that really gives doctors the ability to focus on how to keep their patients healthy,” Walton told Time in a recent interview.
The school also reflects Walton’s desire to give back to her home state, by helping to improve the health and wellbeing of its citizens. Compared with other states, Arkansas is consistently near the bottom on standard measures of public health, and it is ranked 48th out of 50 on healthcare system performance.
Those are ugly realities that Walton has acknowledged, and that she is committed to changing.
“Our state and surrounding regions are medically underserved, and as studies have shown over the past several years, if we don’t take action to address this issue, we’re going to fall further behind,” Walton said in a recent article on Talk Business & Politics.
AWSOM students “will get all the science and disease knowledge they need to manage the ‘sick-care’ side of things. But I wanted to create a school that really gives doctors the ability to focus on how to keep their patients healthy.”
–Alice L. Walton
“It’s also essential that we train and support physicians to successfully tackle the health care challenges of the 21st century, including how physicians care for the whole person in order to proactively support well-being and prevent diseases. In states like Arkansas with a large rural population, it’s also essential that physicians learn how to care for patients no matter where they live, including options like virtual care and telemedicine.”
Harmony, Balance, Connection
AWSOM is set on an idyllic tract of land owned by the Walton family, near Walmart’s headquarters, and close to the place where brothers Sam and James Walton first started the business in 1962. Alice Walton began developing her vision for the medical school in 2021.
At the center of the campus is a majestic 154,000 square foot stone and glass structure created by Polk Stanley Wilcox Architects, that contains state-of-the-art educational facilities, clinic spaces, exam rooms, and simulation centers. The structure, surrounded by miles of forested biking and walking trails, was designed to reflect and to integrate with the surrounding landscape.
“The health care business model must transition from focusing on sick care to valuing and rewarding prevention and disease reversal. This includes recognizing the importance of behavioral, social, and structural barriers to health.”
–Heartland Whole Health Institute mission statement
The building’s green roof –the largest in the state–hosts two acres’ worth of park space emphasizing regional trees and plants like oaks, sumac, and redbuds. The architecture and design are intended to engender the sense of harmony, balance, and connection with nature that the school’s administrators hope to engender in the curriculum.
AWSOM’s founding Dean and CEO is Sharmila Makhija, a gynecologic oncologist and surgeon who previously chaired the department of obstetrics and gynecology at Albert Einstein College of Medicine/Montefiore Hospital in New York. Dr. Makhija has vast experience with community-based medicine and value-based care models, and a strong commitment to helping medically-underserved people.
From the Bronx to Bentonville
Born and raised in Montgomery, AL, both of Makhija’s parents were educators—her father a college chemistry professor and her mother a high school biology teacher. Her maternal grandfather was a general practitioner/surgeon in India. Makhija says she knew she wanted to be a doctor by the age of 9, and urged her parents to allow her to spend a summer trailing her grandfather as he made his rounds.
In an interview on The Doctor’s Art podcast, Dr. Makhija says her parents taught her to be curious, to ask questions, and to inquire of herself every day, “What did you do today to make someone else’s life better.” It’s an ethos that has guided her throughout her career.
Though she worked in a highly technical subspecialty, Dr. Makhija always brought a holistic perspective to oncology, focusing not just on the tumors and the treatment regimens, but on the patients and their families.
She says she first learned of Alice Walton’s intention to build a medical school several years ago, via recruiters specializing in women in leadership roles. At the time, she was intrigued but also quite happy in her role at Montefiore, and not necessarily interested in making a major life change—especially one that would require a leap from New York City to a small town in Arkansas.
But she had conversations, and offered suggestions, and gradually became more engaged. This was a chance to be involved in dialogs that could completely re-envision what medical education could be. Makhija urged Walton and the planners to think big:
“If you’re going to talk about a whole-person approach, get more deep about it and look at it more holistically,” she recalls sharing with the would-be school’s board.
She says it was Alice Walton’s dedication—and the enthusiasm she inspired in the group of spectacular board members she’d attracted—that ultimately convinced Makhija to take on the role as the school’s inaugural dean.
“Listening to Alice and the passion she has….she could be doing anything she wants. And she’s choosing to tackle one of the most complex areas in our world! What an opportunity, to work beside her and to try to implement this vision.”
ARCHES
Makhija has played an active role in developing the school’s curriculum which is centered on six core principles summarized by the acronym, ARCHES:
- Art of Healing
- Research
- Clinical
- Health Systems Science
- Embracing Whole Health
- Science of Medicine
These themes are woven into longitudinally integrated courses, clerkships, and electives.
The curriculum includes 50 hours of nutrition-related content, far exceeding the 20-hour average at med schools across the country. This includes practical culinary training—the school wants to make sure future physicians know how to actually cook healthful meals. They’ll also learn about gardening via the school’s teaching farm. The students will have opportunities to design and develop research and community service projects.
“Listening to Alice and the passion she has….she could be doing anything she wants. And she’s choosing to tackle one of the most complex areas in our world! What an opportunity, to work beside her and to try to implement this vision.”
–Sharmila Makhija, MD, Founding Dean & CEO, Alice Walton School of Medicine
Makhija says she and the AWSOM faculty strive to nurture a new generation of physicians who see patients through the lens of “What matters to you?” rather than “What’s the matter with you?”
Though some of AWSOM’s training elements are unashamedly touchy-feely, Walton, Makhija and their board also stress that students will get a lot of nitty-gritty, practical experience in real-world clinical settings. And this begins within the first weeks of training.
“We’ve incorporated something called Early Clinical Experience, so within the first two months of being in medical school, they are in the clinic. We’ve teamed up with Mercy Hospital System, which is our educational partner. They’re a 55-hospital system in the heartland, with 2 sites in Arkansas. One of them is just 7 miles away from us. We’ve picked one of their primary care specialists that’s just incredible. She has a whole group of primary care docs practicing value-based care,” Makhija told The Doctor’s Art.
Students will shuttle between classes and clinical simulation rooms, and actual clinics alongside doctors who are putting things into practice.”
High Ideals plus Real World Grit
From the get-go, AWSOM students will learn about dealing with payors, the impact of IT and AI on clinical practice, public policy, and organizational behavior. While they hone their clinical and ‘people’ skills, they’ll also be gaining valuable leadership skills. The training is guided by very high ideals, but Walton and her team are determined to ensure that their grads are capable of addressing and transforming the daunting healthcare challenges they will face out in the trenches.
“I hope my biggest impact will be the lasting change that access to health care provides. The School of Medicine can play a big role as it educates generations of medical professionals in whole-person care. If the work we’re doing helps improve quality of life, then I’ll feel I’ve made a positive impact.”
–Alice L. Walton
AWSOM has engaged more than 100 full-time clinical faculty members, some of whom will rotate in from Stanford University, thanks to Walton’s congenial relationship with Stanford School of Medicine’s dean, Lloyd Minor, who’s also from Arkansas, and who is chairing AWSOM’s board of directors.
Other key board members include Ralph Snyderman, MD, Chancellor Emeritus, Duke University, Toby Cosgrove MD, the former President and Chief Executive Officer of Cleveland Clinic, who championed the establishment of the renowned Cleveland Clinic Center for Functional Medicine a decade ago. AWSOM will be developing clinical partnerships with the Cleveland Clinic to provide further learning opportunities for students.
It is no small thing to create an entirely new medical school from scratch, especially in today’s turbulent medical and economic landscape. But by all accounts, AWSOM is off to an excellent start.
The school attracted roughly 2,000 applicants for the first 48-student cohort, and they came from all over the country. No doubt, Walton’s commitment to cover the $70,000 annual tuition fees for all students in the school’s first five training cohorts—a bill that will ultimately top $67 million—is part of the appeal. Her generosity makes attending med school possible for many students who would not otherwise be able to afford it.
A Far-Reaching Vision
Alice Louise Walton is the daughter of Walmart co-founder Sam Walton. Though she never held an executive position within family business, in her youth she would accompany her father to New York when he was seeking investors to support the opening of new Walmart stores in the rural south. At the time, it was a prospect that aroused laughter from a lot of big-city financiers. Among other things, those early experiences taught her about perseverance. She herself worked for years in equity management and investment banking.
With an estimated net worth of $116 billion, Walton is now the richest woman in the world, and among the wealthiest people on the planet. She’s had a longstanding interest in improving American healthcare, which grew out of her own less-than-optimal encounters with the healthcare systems following an auto accident.
As a business person, Walton is also irked by the fact that the US consistently has the highest levels of healthcare spending worldwide, yet our rankings on nearly all measures of population health are quite low compared with other industrialized nations.
In 2019, she founded the Heartland Whole Health Institute, which is a research and policy development organization focused on realigning financial incentives within medicine and establishing value-based care models that improve care quality while lowering costs and improving access.
“Our state and surrounding regions are medically underserved, and as studies have shown over the past several years, if we don’t take action to address this issue, we’re going to fall further behind.”
–Alice L. Walton
According to the Institute’s mission statement, “The health care business model must transition from focusing on sick care to valuing and rewarding prevention and disease reversal. This includes recognizing the importance of behavioral, social, and structural barriers to health.”
One aspect of this transformation—and one to which HWHI has made a major commitment—is development of a data infrastructure that makes precision medicine and personalized medicine the norm across all healthcare delivery systems. The institute is dedicated to testing and implementing care delivery and payment models that can be replicated all over the country.
Several of the Institute’s board members and advisors are also on the board of AWSOM, and the Institute will be working closely with the school on curriculum development, as well as research and partnership opportunities for the school’s grads. AWSOM and HWHI are co-located on the same campus, along with the Crystal Bridges
Museum of American Art, which Walton founded in 2011.
Together, these institutions create a hub of creativity and innovation where the biomedical sciences, the arts, information technology, and public policy can cross-pollinate, synergize, and engender system-wide transformations. Call it, “Alice’s Wonderland.”
“I hope my biggest impact will be the lasting change that access to health care provides. The School of Medicine can play a big role as it educates generations of medical professionals in whole-person care,” Walton says in her mission statement about the project. “If the work we’re doing helps improve quality of life, then I’ll feel I’ve made a positive impact.”
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