Long before COVID, rural America was in a healthcare crisis—namely, there hasn’t been enough of it. Rural America has an estimated shortage of 40,000 doctors. While 20% of the American population lives in rural areas, only 11% of doctors practice there. And of 7,200 federally designated healthcare professional shortage areas, 60% are in rural areas.
Rural doctors are retiring. By 2030, an estimated one-quarter of current physicians will have left their practices. And new doctors aren’t replacing them. Rural hospitals often pay less; rural communities tend to offer fewer opportunities for working spouses; and rural schools often have fewer resources—a consideration for young families. In addition, medical school culture tends to wow students with specialized medicine rather than family practice, needed most in rural areas. Rural hospitals have been disappearing as well. Tennessee lost 18% of its rural hospitals in the last ten years. Rural hospitals have higher rates of uninsured patients compared to urban hospitals, and have been disproportionately hit by cuts in Medicaid and Medicare—46% of rural hospitals lost money in 2018.
In World Leadership, population is one the four of leadership power sources, but the number of people a society has doesn’t tell the whole story. The population has to be educated enough and healthy enough to do the work society needs done. So, there is incentive for all of us to find a solution.
Potential solutions to the doctor shortage include relieving medical school debt for graduates who practice in rural areas. Hospitals could be helped by adjusting Medicaid reimbursements based on area of need. However, these may not be enough to stem an economic problem of this magnitude—frankly, the commercial model may simply not work under these conditions. As such, this may be a case where government-run health clinics, offered as a public service, make sense. While some will cry foul at introducing even a limited form of socialized medicine, and it is more important to look at solutions than labels. Health clinics, in these specific situations, may be the only real option.
Eli Saslow, “The clinic of last resort,” Washington Post, 23 June 2019, A1.
Eli Saslow, “Who’s going to take care of these people?” Washington Post, 12 May 2019, A1.
Judith Garber, “What’s driving America’s rural doctor shortage?” Lown Institute, 22 Aug 2018, accessed from https://lowninstitute.org/whats-driving-americas-rural-doctor-shortage/#:~:text=A%20rapidly%20aging%20population%2C%20coupled,canary%20in%20the%20coal%20mine.
Peter Jaret, “Attracting the next generation of physicians to rural medicine,” Association of American Medical Colleges, 3 Feb 2020; accessed from https://www.aamc.org/news-insights/attracting-next-generation-physicians-rural-medicine
Photo: AAMC
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