Rural Medicine – serving more, with less, over huge distances

by John on May 26, 2009

Just saw this stunning statistic in an article in the Nebraska Journal Star:

…rural America—where just 9 percent of the nation’s doctors serve 17 percent of its citizens scattered across 80 percent of its geography—is not an ideal place to find medical care.

I’m not sure if anything captures the current situation better than that snapshot.  Sadly, with impending retirements of significant percentages of existing physicians, steadily decreasing enrollments in primary care residencies, and an upcoming workforce that places more value on quality of non-work life than in the past – we’re looking at this statistic getting much worse.

Perhaps we should rewrite a verse from the Bob Dylan song . . . “Where have all the doctors gone – long time passing..?”

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  • This situation is exactly the reason we need more options for students like Des Moines University's Rural Iowa Provider Education (RIPE) program. DMU has made an on-going commitment to annually provide the equivalent of six full tuition scholarships to students enrolled in the Rural Medicine Educational Pathway, encouraging them to be part of the solution to rural physician shortage in primary care and other specialties.

    These kinds of programs help students work through the tuition debt load from medical school and make a difference in rural communities in need.
  • Excellent program you all have in Iowa, Mike. As you point out, we have to start thinking of long-term system improvements to address the workforce issue.

    And beyond the system needs, we're seeing that the opportunity to point one's medical education in a direction seems to be very satisfying for the students. There's been a tremendous response from medical students in the Wisconsin Academy of Rural Medicine (WARM), here at the University of Wisconsin's School of Medicine and Public Health. It's a passionate bunch of future rural docs.

    Along with increasing the supply of physicians, we must also look at alternate service-delivery models - telemedicine, non-physician primary care providers and even utilizing advanced EMS providers for house calls. There's just no getting around these data trends - we must adjust our models to emerging realities.

    Thanks for the comment!
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