Posted on

Lack of rural physicians: battle with expanding health access in rural areas

Sarah Platkin | January 27, 2023

About 20 percent of Americans live in rural areas, but barely one-tenth of physicians practice there. American countryside is losing medical professionals as well as hospitals, but fortunately, more strategies are being used to address the unequal distribution of medical resource. 

Shortage of rural physicians

Lack of incentives might explain the shortage of rural physcians. Overall, rural residents are typically less wealthy, can only afford lower health insurance coverage and have fewer access to resources. Despite their need for care, rural areas are losing doctors, which inadvertently leads to inequitable access and early deaths. The state of Tennessee is rapidly losing more hospitals in the rural areas than any other state in the country, with a total of 138 hospitals that have been closed since 2010. This is due to the lack of interest in living  and working in rural communities from medical workers, insufficient state funding and high maintenance costs for hospitals in general. 

To ensure equitable medical access in rural areas, it is extremely important to have a sufficient number of doctors in rural communities. Typically, rural communities have lower incomes, which generally leads to a number of health issues including increased stress, diseases caused by poor nutrition, and alcohol and smoking complications. In other words, rural communities are in need of more care. Survival for a lot of urgent health conditions, specifically heart attacks, strokes, mental health crisis, and maternal health depends on timely intervention and the additional travel time to a farther hospital could be the difference between life or death for these rural residents. Other medical conditions, such as hypertension, diabetes, cancer, and other chronic conditions require primary care and continuous monitoring. Late detection and limited follow-up is often fatal. In both chronic and acute conditions, close and accessible care is necessary for convenience, affordability, quality of life, and sometimes even survival. 

Providing incentive for rural medical practice

To help alleviate this medical worker shortage, Dr. Thomas Atkins created a program, working with Ascension Saint Thomas and the University of Tennessee Health Science Center to solve this issue by bringing more doctors to local rural communities. This program, funded by the state of Tennessee, provides specific training and encourages doctors to pursue rural practice. Rural doctors often have a wider array of responsibilities compared to their counterparts in cities, as there are fewer doctors per hospital and number of residents. Due to this relatively higher stress working environment, rural practice demands more experienced and mentally prepared physicians to handle this increased pressure. Logically, it also required some additional medical training to cover multiple specialties as one physician will be handling many different cases. 

 Additionally, in order to help both recruit and retain doctors,  rural hospitals can utilize other strategies. Hospitals can consider increasing pay to incentivize prospective employees. Other than that, introducing telemedicine in these areas for non-emergent cases and some specialty consultations can help ameliorate the current shortage. Finally, it is essential to help physicians in rural positions avoid burnout that can easily come from spreading themselves too thin to meet all of the community’s needs; one doctor cannot carry the weight of an entire rural community on their shoulders—these communities need more of them. 

While it is clear why a need for doctors exists within rural communities, encouraging medical practice in more rural areas of Tennessee can benefit the entire Tennessee community. As rural hospitals become more capable to handle early diagnosis, prevention and produce positive outcomes, they can direct a group of patients away from cities and hence alleviate the burden on already overwhelmed large city hospitals, hence lowering healthcare costs in general. Health of citizens is essential for creating a happy, productive, and engaged community, benefiting the entire state and country.


image from iStock