Feds Pay to Entice Primary Care Docs to Rural Areas, but Will They Stay?

August 11, 2010

The government is spending money to recruit primary care docs to rural areas, but the isolation and lack of technology is hurting retention rates.

An article in the Washington Post provides details about the Obama administration’s efforts under the new healthcare law “to bring thousands of young primary care doctors to underserved areas… and keep them there.”

According to the article, the administration “recently invested more than $1 billion from the stimulus and the health-care law into the National Health Services Corps to beef up doctor recruitment.” These funds were dispersed to about 5,000 recent medical school graduates, who “accepted [the] federal grants to pay off tuition and school loans averaging $150,000 per student.” The stipulation is that the recipients must agree to serve for 3-5 years in underserved (typically rural) areas.

The NHSC expects about 2,800 medical students to participate in the program next year. However successful the program is in recruiting primary care physicians to serve, it still only amounts to a drop in the proverbial bucket when it comes to ensuring access to these underserved patient populations. The NHSC recently released a report that claimed that “27,000 primary care physicians are needed to meet the needs of about 45 million Americans in medically underserved areas.”

One potential challenge for the program is physician retention. The Post article includes interviews with several young physicians who talk about the unexpected challenges and inconveniences of practicing medicine in rural America, including professional isolation and slow or spotty Internet service and/or wireless access.

The chronic shortage of physicians who choose to practice rural medicine and high turnover rate among doctors who do fill these slots can have a profound impact on the health of local residents. High turnover creates a “void” in services and leaves patients reluctant to bond with new physicians for fear that they, too, will soon pull up stakes. The Post article says that “in areas where doctors are scarce, the impact can be devastating. Residents delay examinations until conditions are chronic and more costly to treat.”

Would you consider relocating to practice medicine in a rural and/or underserved area in return for grants to repay your medical school debt?If you already do practice in a rural area, do you think this article accurately portrayed what it’s like being a physician there? Do you share some of the same concerns as those expressed by the physicians interviewed in the article?The article in several places points out that better Internet access and access to electronic medical records would potentially make it easier to practice in a rural environment. Do you agree that this is an issue, especially with younger physicians, what may hinder recruitment efforts?