Approximately 25% of the U.S. population lives in rural areas, but only 10% of physicians practice in rural areas. This maldistribution of physicians over the last several decades has occurred for many reasons:
- Medical education in the United States has become specialized, centralized and urban.
- Many practitioners emerge from medical programs with a staggering amount of debt and go on to practice in urban areas, where they often receive a higher salary.
More doctors is not the answer
Simply increasing medical school slots is not the answer. According to the Robert Graham Center: Policy Studies in Family Medicine and Primary Care, “Sizeable growth of the physician workforce in the last two decades has not resolved the maldistribution of physicians.” On March 24, 2009 — House Energy and Commerce Committee Chairman Henry A. Waxman said that a congressional overhaul of the health care system must not only provide for universal coverage but also for more primary care doctors and nurses to ensure that an insurance card actually gives the holder access to treatment.
Physicians need to be rooted in the rural community
In a joint 2008 statement, the American Academy of Family Physicians and the National Rural Health Association stated that medical education anchored in rural places, nourished and funded through significant federal, state and local community support, and meaningfully connected to both regional academic institutions and local physicians in practice has great potential to address both present and future needs for physicians who provide care to rural populations.
DMU launches program to combat rural physician shortage with incentives
Concerned about the growing physician shortage in rural Iowa, Des Moines University (DMU) has embarked upon a “grow your own” program. DMU and its Area Health Education Center have created the Rural Iowa Provider Education (RIPE) Program.
The RIPE Program provides specialized education, training and tools to better prepare students for service in rural, underserved areas of Iowa. Because one of the known barriers for students choosing a rural medical practice is the tuition debt load from medical school, 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. In return, graduates agree to maintain a fulltime primary care medical practice in an approved Iowa community for a period of four years.
Are plans like DMU’s RIPE the answer to the shortage of physicians in rural areas? Are there other concerns or issues at hand? How would you bring more physicians into rural areas?
You can find more information about the RIPE Program on DMU’s website.