Small town doctor, big town impact
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Featured in Physicians Practice, July 9, 2018

By Mike Gianas

Rural America often seems to reflect the deficiencies of our healthcare system in the most profound way. Even though it represents a much smaller portion of the population than urban and suburban areas, it signifies the front lines of many of the issues we face today.

Those who live in remote regions of the country are statistically more disadvantaged than those in metropolitan areas, both socioeconomically and with respect to access to healthcare services. Rural communities are challenged by lower incomes, less access to technology, and higher levels of poverty. It’s an older population, and they’re more reliant on social services than those living in urban centers. It’s also the segment of the population that needs us most yet receives the least amount of medical resources.

The number of physicians per 10,000 people is 13 to 31, rural versus urban, according to the National Rural Health Association. They continue to lack coverage and, even for those who have coverage, they often live hours from the appropriate care they require. What’s astounding is the shortage of specialists when comparing rural to urban communities. The discrepancy is a shocking 30 specialists in remote areas to 263 available to metropolitan areas per 100,000 people.

As a result, this population runs an increased risk in being diagnosed for serious illnesses outside the appropriate time to begin early treatment. They make up the largest portion of our uninsured, and their overall health status is below that of their urban counterparts. In addition, they have the least amount of behavioral health resources available to them while trying to combat the opioid crisis. Their youth is twice as likely to commit suicide.

Fortunately for these regions, there are still advantages for physicians willing to practice in these areas, ways in which they can do so, and a growing number of incentives to help them get there.

Doctors in smaller communities tend to earn slightly more than their counterparts in large metropolitan areas. The rural population has a lower physician density and increased need, which equates to less competition and higher income potential.

Temporary physicians and advanced practitioners such as locum tenens gives providers the opportunity to practice in these areas of the country. Those providers are meeting critical needs in these regions while also earning more money, enjoying a better work-life balance, and exploring new settings without the bureaucracy faced by their employed counterparts. This lifestyle can result in overall job satisfaction. Supplemental staff has been a valuable staffing solution in all areas of the country, particularly in rural communities, since the outset of the physician shortage.

State policy initiatives have also begun in recent years, such as those to expedite licensure procedures so providers can more quickly access the rural areas most in need. Medical schools are beginning to focus on rural healthcare as well, both with respect to specific training and encouraging doctors to practice in these communities. Schools are recruiting rural students into medicine, as they are more likely to return to rural communities after graduation. Schools are also offering programs to incentivize all students to train in underserved areas.

By constantly focusing on rural America and consistently supporting healthcare solutions that are successful there, we can work together to provide these areas the care they need—and deserve—from those in medicine.

Mike Gianas of Redemption Creative LLC is a Dallas-based healthcare marketing consultant with the National Association of Locum Tenens Organizations® (NALTO®), the only professional association of temporary physician staffing firms committed to a code of ethics and to maintaining the highest industry standards.

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