Our last post highlighted the particular challenges that rural residents face in obtaining basic, essential healthcare. In many cases, the problem lies in the very simple fact that healthcare providers are too far and few between, making it a logistical nightmare for people to see a doctor. While the problems are well-documented and on the radar of many, what – if anything – is being done to alleviate these struggles? Who will fill the gaping holes that exist in the availability of healthcare?
To be clear, it is not just highly-trained specialists that are lacking in rural communities. Rather, providers of all kinds and backgrounds are under-represented in rural areas. All areas of care – from dentists to psychiatrists – are grossly under-represented, which is not surprising considering that rural physicians comprise only about 9% of all practicing physicians. Filling these gaps is not only an issue of initial hiring, but also of retention.
Healthcare organizations and experts tend to focus on monetary incentives when considering ways to induce providers to rural areas. These incentives include not only significant regular pay, but also things like loan payoff arrangements and sizeable bonus payments. Essentially, relying on the lure of flashing dollar signs to get providers to even consider joining the hospital or group in the first place. For many physicians with crippling student loan debt and young families to look after, this is a legitimate inducement, even if it means relocating to an area they may have never considered before. However, these beneficial financial arrangements solve only the first conundrum of hiring, and do not generally solve the issue of long-term retention. So how to get providers to not only moveto rural communities, but also to stayput? It appears that the most effective strategy lies in pursuing candidates who will appreciate the lifestyle advantages offered by practicing in a rural setting, of which there are many. To begin with, there are many lifestyle factors that simply are not available in urban settings. For individuals who value the activities and opportunities presented by the great outdoors, many of our country’s rural communities offer enticing advantages. Hiking, horseback riding, boating, mountain biking, rafting and countless other activities are typical pastimes available any day of the week in many rural areas. Whereas for most of us, participating in such activities would require a special excursion – likely requiring a flight, a hotel stay and at least a full weekend away from home at minimum – residents of rural areas can partake in those activities any day of the week. A rural setting also might offer an attractive lure for parents of growing children. Children raised in a rural setting may have a completely different outlook on life, community, the importance of spending time outdoors being active, and the comfort, safety and reliability of a close-knit community – all of which are life lessons that cannot necessarily be taught, but rather must be experienced first-hand.
For practitioners who are more concerned with career-focused inducements to residing in rural areas, those exist as well. Physicians in rural communities have greater autonomy in general. Based simply on the fact that there are fewer providers to go around, physicians are often in the position to practice areas of medicine they wouldn’t otherwise see in an urban setting that is swarming with specialists of all types. Whereas in an urban setting a particular case might be sent immediately to a specialist, a physician in a rural setting would likely take on the case herself. This allows (and requires) the physician to use a much greater amount of the broader knowledge and information she’s been taught throughout her career, versus being pigeon-holed into only working on a very specific type of case. Finally, rural physicians generally have the benefit of getting to exercise a more holistic, patient-centered approach to medicine, as they are allowed more time with each patient, thereby enabled to provide more comprehensive care.
The benefits are varied and many, and physicians of all ages, experience levels and specialties are well-advised to consider the career opportunities available in our nation’s rural communities.