Thursday, November 07, 2013

Doctors in rural areas are older; shortage looms

According to a study supported by the federal Office of Rural Health Policy and other federal agencies, 29 percent of primary care physicians in remote rural areas are 56 or older, Meredith Fordyce, Mark Doescher, and Susan Skillman report for the Daily Yonder. Many will soon retire, and especially because fewer new U.S. medical graduates are choosing to specialize in primary care, rural areas may soon experience a greater shortage of physicians.
Darker states have a greater share of primary care providers in rural counties. (Yonder map)
Overall, rural areas had higher percentages of primary-care physicians (PCPs) near retirement than urban areas, and "as degree of rurality increased, so did the percentage of PCPs nearing retirement," the Yonder reports. In 11 states, 30 percent or more of PCPs are near retirement: North Dakota and Arkansas (30.3 percent), Vermont and Nevada (30.3 percent), Oregon (30.8 percent), Oklahoma (32.3 percent), Florida (32.6 percent), Connecticut  (33.2 percent), California (34.2 percent), West Virginia (36.1 percent) and Massachusetts (42.1 percent.)

In 72 rural counties, all PCPs are 56 or older, and 166 rural counties don't have any PCPs. "Compared to other rural counties, rural counties in the top decile [the top 10%] of near-retirement physicians were characterized by lower population density and lower socioeconomic status as measure by persistent poverty, lower education and lower employment," the Yonder reports.

"The impact of PCPs retirement is likely to come just as demand for primary care services in rural areas spikes due to overall population growth, the 'graying' of rural America and expanded insurance uptake through Affordable Care Act provisions," the Yonder reports.

Several strategies can be employed to help solve this impending issue. The National Health Service Corps and the J-1 visa waiver program both help place newly trained PCPs in locations where they're most needed. Medical schools could focus on recruiting students who have rural backgrounds or on giving current students experience working in rural community settings. Towns facing this issue should actively seek a replacement soon enough so there isn't a gap in provision as well as look into hiring "more than one new PCPs, an interprofessional team, or individual nurse practitioners or physicans assistants," the writers suggest. (Read more)

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