Posted originally at physicianspractice.com on March 3, 2020
By Mike Gianas for NALTO
Small towns and rural communities suffer most from the deficiencies of our system of healthcare delivery. As a result, this segment of our population is the most disproportionate to their urban and suburban counterparts in overall health and in socio-economic factors that define them. This includes suicide rate, poverty level, household income, addiction, access to technology, education, mental health services, chronic illness and maternal mortality.
The physician shortage directly correlates with the severity of these issues among our lesser populated communities. The number of physicians per 10,000 people is 13.1 in rural areas, versus 31.2 in urban communities. The disparity in the number of specialists is even more exacerbated, with only 30 per 100,000 people in rural areas, versus 263 per 100,000 in populations living in urban communities. Therefore, family physicians make up 42 percent of the outpatient physician workforce in rural areas—as opposed to the 15 percent they represent as a whole nationwide—and the population is largely relegated to generalists as it is their only choice for care.
To make matters worse, the shortage of rural providers is compounded by the closure of more than 100 rural hospitals in the last decade. In addition, there are 400 more facilities now risking closure as well. Roughly 60 million people—roughly 1 out of every 5 Americans—live in this stark reality.
How Do We Solve This Issue?
Who are the physicians wanting to work in rural communities and solve this epidemic? We’re learning it’s those who come from rural America. A number of our medical schools are now concentrating on giving more opportunities to this segment of our population to become tomorrow’s physicians and then return home to practice. They’re offering special residency training in underserved areas with additional benefits for staying afterwards in exchange for loan forgiveness not offered to their counterparts practicing in other areas of the country.
The traditional approach of recruitment and retention is getting more difficult. Relocating a new physician and their family to these regions is a tall order. Competitiveness between facilities is at an all-time high. Compensation alone is often not enough to attract providers and avoid the costs incurred from being short-staffed during a permanent search, which has no guarantee of success.
The Role of Locum Tenens
A combination of addressing the needs of current staff while infusing it with locum tenens is the way to address the shortage of rural healthcare providers. Focus on offsetting the major worries of today’s doctors such as burnout, help decrease student debt, emphasize autonomy, and support flexible schedules and time off with supplement coverage that ensures the continuity of your practice.
Remember that locum tenens was born out of the physician shortage of rural America and our need to relieve the full-time doctors who practiced in these same areas. An increasing amount of today’s physicians are choosing locums to supplement their income by taking assignments in smaller communities considered underserved populations. Here, they’re able to practice medicine without the bureaucracy they find within large healthcare organizations, while focusing on treating patients, exercising more autonomy, paying off debt, trying new settings and enjoying the travel aspect of being a temporary physician.
It’s also important to note that many of our retiring physicians aren’t fully retiring from practicing medicine altogether. Instead, they practice locums part-time by continuing to meet demand, whether that of their fellow baby boomers or the next generation. Addressing the shortage of rural healthcare providers begins with providing opportunities for individuals from these areas to be successful in medicine, while at the same time tapping into the locum tenens workforce.