The nation’s physician supply is especially sparse in rural America, creating burdens for rural residents and headaches for rural health care organizations seeking staff. But it also is producing a bumper crop of employment opportunities for health care professionals who are ready for the perqs and quirks of rural medicine.
You don’t have to dig too deep to uncover statistics about the great needs in rural medicine. According to the National Rural Health Association, only about 10 percent of physicians practice in rural America despite the fact that nearly one-fourth of the nation’s population live in those areas. In rural communities of fewer than 10,000 residents, there are about 90 physicians per 100,000 persons; in major metropolitan areas, that ratio is about 300 physicians to every 100,000 persons.
Physician shortages in rural areas deepen health care disparities. On the whole poorer and older than residents of urban areas, rural residents are less likely to have employer-provided health care coverage or prescription drug coverage. Their access to medical specialists and mental health services is more limited. When they need to see any type of health care provider, they are likely to have to travel greater distances than urban Americans.
“The need in rural areas is tremendous,” says Larry Severidt, M.D., director of medical education and the family medicine residency program at Broadlawns Medical Center in Des Moines. An adjunct DMU faculty member who was in rural practice in Iowa for nearly 25 years, he points to the 2012-2013 “opportunities directory” produced by the University of Iowa’s Office of Statewide Clinical Education Programs.
“The list shows 91 Iowa communities are looking for family physicians to fill 131 practice opportunities, and 22 communities with 39 other opportunities in community health, urgent care and other areas,” Severidt says.
Opportunities to work in health care across rural America are as abundant as sweet corn during a Midwestern summer.
“Provider recruitment is our single biggest issue,” says Jay Christensen, M.H.A.’01, chief executive officer of Mahaska Health Partnership, an inpatient/outpatient health care center in Oskaloosa, IA, and a member of the DMU Board of Trustees. “We’ve done a lot of different things. We offer student loan assistance and attractive and competitive sign-on benefits. We initiated a hospitalist program, which means new physicians won’t have any call; they can have almost a purely clinical practice.”
Practicing in rural areas comes with unique professional and lifestyle realities and rewards. Primary care providers can expect to treat patients of all ages, with a variety of conditions and – depending on how long they practice in an area – over many years and multiple generations. For health care professionals in pursuit of and prepared for that, the rewards are many.
“One thing that’s appealing to me about rural medicine is the diversity. It’s an opportunity to do family practice, which is my love, as well as emergency medicine and obstetrics,” says Bill Bensen, a second-year DMU osteopathic medical student from Aberdeen, SD. “When my son, Micah, was two, he could count up to five, but five wasn’t a finite quantity. To him, five was infinity, everything.
“That’s the thing I love about rural medicine,” Bensen adds. “It prepares you to practice for five.”