10 Minutes on Rural Health

Here’s a sample of what I learned in less than 10 minutes of a presentation given by Dr. Mark Doescher recently at the Association of Health Care Journalists conference. I was amazed at how much info Dr. Doescher, the director of the Office of Rural Health Care in the School of Public Health at University of Washington, got out in such a short amount of time.

Twenty percent of the population in America is served by rural health systems. In these particular areas, there is a rapid growth of racial/ethnic minority groups as well as the aged population 65 and older. Neither one of these trends is unique to rural areas, but I do believe what Dr. Doescher meant is that there are higher rates of growth in rural areas. Additionally, the rates of poverty in rural areas are also climbing at a fast rate. As Dr. Doescher put it, there “is an exportation of poverty” happening.

Rural areas account for only 10 percent of the physicians in America. Some organizations predict that there will be a 100,000 doctor shortage by the year 2025 (AAMC, COGME). Largely due to the fact that the physician work force is aging and MD programs are producing few doctors than in the past. Given that they already attract fewer doctors, rural areas will be doubly affected.

Most doctors in rural areas are general physicians, with a lack of specialists for areas such as surgery. But trends indicate that although the total numbers of doctors coming out of medical schools is decreasing, the number of those who go on to earn specialist status is increasing. This is in part due to the differential pay among general medicine and specialties, with the latter earning more. Ultimately, rural areas who rarely attract specialists, will now have an even smaller pool from which to draw. In general, few doctors are trained in rural areas. If you are not trained in a rural area, it is highly unlikely that you will practice in a rural area, another factor in the shrinking pool.

One last thing I that struck me as important, was that rural is a broad term. Yet, large rural, small rural, and isolated rural all fall in this category, but each have unique needs.

And this is only what I was able to write down. There was so much to Dr. Doescher’s 10 minute talk.