Access to doctors in rural Colorado example of national problem facing health care reformers

The principal goal of health-care reform is to cover some 47 million uninsured Americans, many of whom live in rural areas, but even after rural Americans are given insurance they still face a growing problem of access to local doctors. "Access is so much more than that," Terri Hurst, policy analyst for the Colorado Rural Health Center, told Jennifer Brown of The Denver Post. "You have to have a provider in your community. Even if we gave everyone in our state an insurance card today, everyone still wouldn't have access to health care."

Around 800,000 Coloradans are uninsured, Brown reports, but Colorado also faces 75 job openings for doctors in rural areas of the state, up from 62 two years ago. Four counties in Colorado have no practicing physicians, six counties have only one (Post graphic). Programs like the "rural track" at the University of Colorado Denver School of Medicine seek to place more new doctors in those jobs. "The Colorado Democrat cited a study showing that if all medical schools enrolled as few as 10 students per class in a rural track program, the country could double the number of rural doctors," Brown writes. Some rural doctors are making $50,000 to $80,000 a year after paying staff, rent an utility bills, Brown reports, adding the average loan debt for medical school graduates in 2008 was $155,000.

Doctors are paid by procedure, so many aspects of a rural primary care physician's job aren't compensated. "Sitting with a patient and figuring out their health needs to be valued as much as doing a technical procedure," Dr. Mark Deutchman, director of UC's rural track program. "Heck, maybe it's more valuable. We're not rewarding physicians to take care of people; we're rewarding them to do things on people." (Read more)

The National Rural Health Association says rural residents are twice as likely to die from non-auto-related injuries, receive less treatment for chronic disease and report lower rates of overall health, Lisa Hare of the Yankton Press & Dakota reports. “This is the most critical issue before Congress,” John Crabtree of the Center for Rural Affairs told Hare. “People most affected are, ironically, the most scared of change.” (Read more)