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Click here for ACGME program information for Physicians - including residency programs, faculty, resident work hours, and compensation stats.

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Addressing the Rural Physician Shortage

The physician shortage is more acute in Rural America where recruiting firms like LocumTenens.com do at least 60% of their business. Consider these statistics from the National Rural Health Association (NRHA) and the federal Office of Rural Health Policy: Roughly 25 percent of the U.S. population lives in Rural America, but only 10 percent of U.S. physicians practice there. 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.

State-Sponsored Solutions

Well aware of these types of situations and statistics long before they began getting rather extensive play in the news media, some state-sponsored, healthcare-focused organizations have begun taking action: —To further improve the number of physicians practicing in rural Oregon, Oregon Health & Science University’s Area Health Education Centers (AHEC) program is preparing to expand their delivery of rural education programs to include the Oregon Rural Scholars Program. The program will have 3 core elements:

1. Identify, recruit, admit and provide financial assistance to medical school applicants who demonstrate interest in and aptitude for rural practice.
2. Provide an enriched rural-centered curriculum.
3. Provide retention support and professional development for practicing rural physicians.

Outcomes data from similar rural programs in the United States strongly suggest that medical school applicants provided with this type of program are far more likely to enter rural practice and to remain in practice in rural areas.

—In Georgia, the population has increased by 25% during the past decade (to 9 million), and its 65-year-old-plus population is expected to expand by at least 1.1 million through 2030, according to the U.S. Census Bureau. After a recent report issued by the Georgia Board for Physician Workforce indicated that the state ranked 34th out of 46 states in the number of medical school graduates per capita, the oldest and largest of the state’s medical schools (Medical College of Georgia and Emory University School of Medicine) increased enrollment for the first time in some 30 years--by about 10% in an effort to follow Association of American Medical Colleges recommendations to increase enrollments over the next decade. The college is in discussions with the University of Georgia to expand the program using an old naval base on its Athens campus.

Federal Fixes

Now more federal legislators are starting to take notice, too: U.S. Sen. Lisa Murkowski (R-Alaska) has introduced legislation to give $1,000 tax credits to physicians for each month they work in a frontier area or treat a high percentage of patients from such areas. At deadline, Murkowski was scheduled to serve as chairwoman for a February 20 field hearing of the U.S. Senate Health, Education, Labor and Pensions Committee on the proposal. Introduced by Senate Majority Leader Harry Reid (D-Nevada) on February 14, the Resident Physician Shortage Reduction Act of 2007 proposes to expand the number of Medicare-supported physician residency training positions in resident physician shortage states' teaching hospitals. A state is considered to have a shortage of resident physicians if its ratio of resident physicians per 100,000 people is below the national median level. Nevada currently has 199 physicians in training, and would be eligible for an additional 93 positions under the bill. As a result of this legislation, teaching hospitals in approximately 24 states would be eligible for increases in their resident caps. Concerned about a looming doctor shortage in Florida, Sen. Bill Nelson (D-Florida) recently co-sponsored Reid’s bill, said that if the legislation passes, Florida hospitals would gain more than 347 new physician training positions, the most in the nation. “As our population grows and ages, we need to make sure we have enough doctors to meet their needs,” he said, noting that physicians often choose to reside in areas where they train.

-- Billie Wickstrom

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