Dearth of Doctors in Rural America
Experts project the growing U.S. doctor shortage will become even more acute in
rural America, where firms like LocumTenens.com do at least 60% of their
business. Just as baby boomer physicians begin retiring, younger physicians are
seeking greater work-life balance than their predecessors did. So who'll
provide medical care to all of those migrating baby-boomer retirees?
Rural America Hardest Hit by U.S. Physician Shortage
Experts project the growing U.S. doctor shortage will become even more acute in
rural America, where physician recruiting firms like LocumTenens.com do at
least 60% of their business. Consider these statistics from the National Rural
Health Association (NRHA), the U.S. government and other sources:
Roughly 20% of the U.S. population lives in Rural America
(65 million people), but only 10% of U.S. physicians (MDs) practice there.
Roughly 89% of all MDs and 82% of all osteopaths (DOs)
practice in urban areas across the United States, according to the National
Rural Recruitment and Retention Network.
There are 2,157 Health Professional Shortage Areas (HPSA's)
in rural and frontier areas of all states and US territories compared to 910 in
urban areas.
Twenty percent (20%) of non-metropolitan counties lack
mental health services versus 5% of metropolitan counties.
The New Freedom Commission on Mental Health (2004)
indicated that 60% of rural area residents live in mental health professional
shortage areas, and that 65% receive treatment for mental health problems from
their primary care providers.
Changing Lifestyle Preferences
A 2006 World Journal of Surgery article offers insight into these statistics
through describing how the lifestyle preferences of today's physicians differ
from those of "the good old rural general surgeons" from decades past. In his
article, an Iowa-based health systems executive says the latter viewed
practicing rural general surgery as "a calling" that brought doctors with a
desire to be 'big fish in small ponds' together with communities that needed
and respected them.
In contrast, he says about today's general surgeons, "The first questions are
usually about the 'on call' rotations (How many nights and weekends a month am
I on call?), the number of weeks of vacation, continuing medical education, and
the closeness to major transportation centers, major shopping centers, and
cultural centers."
LocumTenens.com's August 2007 physician survey findings echo the administrator's
observations. Among almost 800 responding physicians with rural health
experience, more than half (54%) said they like urban or suburban life more,
even though more than half of those profess to prefer practicing rural
medicine.
A brief article from the April 4, 2008 issue of The (Torrington, Wy.) Telegram
also is illustrative. In recounting three Community Hospital vacancies left by
recent or pending family practitioner departures, the author states that "the
three doctors all left for personal preference reasons, rather than
professional reasons."
Coming Baby Boomer Retirements
In a February 2008 USA Today article about the growing U.S. surgeon shortage,
reporter Robert Davis writes, "As the 79 million baby boomers begin entering
retirement age, so are their doctors. From 1985 to 2006, the percentage of
doctors 55 and older rose from 27% to 34%, and the AAMC (Association of
American Medical Colleges) predicted in a 2006 report that members of this
group—roughly 250,000 active physicians—will retire by 2020. The impact often
is most severe in rural America, where only 9,334 of 211,908 physicians are
general surgeons, according to AMA data."
Interestingly, a wave of boomer physicians will be retiring in the middle of a
migration of retiring baby boomers from large metro areas to smaller
communities and rural areas, if decade-old demographic projections prove
accurate.
A 1999 American Demographics article cites projections from William Frey, at
that time a demographer with the Milken Institute in Santa Monica, Ca., that
"states in the 'new' West will lead the nation in elderly migrants to rural
areas, beginning en masse around 2010." Frey projected that western states with
relatively small populations, lots of open space, mild climates and lots of
natural beauty—namely Utah, Alaska, Idaho, Wyoming and Colorado—would gain the
highest percentage of people age 65 and older between 2000 and 2025.
It's a good thing baby boomers generally will be healthier, wealthier and better
educated than previous generations of retirees, because many will have to
travel to receive good medical care.
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