Rural Georgia faces doctor shortage; state legislature considers ideas but won't increase Medicaid reimbursement

Counties in black have no doctors; dark gray means no
pediatrician and no obstetrician/gynecologist; light gray
means no pediatrician or no ob/gyn. (AJC map)

As in many other states, rural Georgia is facing a doctor shortage: nine of its 159 counties have no doctor, 64 have no pediatricians, and 79 have no obstetrician-gynecologists. Georgia has more counties than any state but Texas, but is "worse than the national average for needy areas short of primary health-care providers, according to federal data assembled by the Kaiser Family Foundation," Ariel Hart reports for The Atlanta Journal-Constitution. "Health outcomes for Georgia patients lag accordingly, with the state ranked among the worst 10 states for most measures." Lack of a nearby doctor means some of Georgia's 2.4 million rural residents don't have the time, money, or transportation to access medical care in a neighboring county. 

Though state legislators have formed health-care study committees and passed some laws, the shortage is still a problem. Rural medical providers often struggle because Medicare and Medicaid (with disporoportionately rural rolls) reimburse at lower rates than private insurance. The state's Republican-led legislature did not expand Medicaid under the Patient Protection and Affordable Care Act, saying the state couldn't afford it long-term. Some GOP legislators have said they would consider Medicaid expansion with a work requirement, Hart reports. 

Daniel Singleton, a rural doctor from Buena Vista in southwestern Georgia, told Hart that there would be more rural doctors if they were decently paid. But state Rep. Terry England, a Republican who chairs the House Appropriations Committee and leads a two-year task force on rural development, said the state doesn't have the money to raise the Medicaid and Medicare reimbursement rates so that doctors don't lose money when they take such patients.

The money isn't the only problem, according to Singleton. Working in a rural area may not appeal to doctors who didn't grow up in rural areas. "Medicine is an elite profession," he told Hart. "Unless you’re a country boy from South Georgia, it’s very very difficult to motivate someone to come back and live in a place like this."