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What is the Most Likely Reason Rural Communities have Physician Shortages?

Author Healthcare Career Blogger | 13.04.2009 | Category Hospitals, Locum Tenens, Medical doctor jobs, OB GYN jobs, Orthopedic Surgery, Physician Career Path, Physician Shortage, Physicians

If we were on the popular tv game show Family Feud (now hosted by John O’Hurley, of Seinfeld fame), the question might be put to us this way:

Name a reason that big cities tend to have more doctors than rural communities:

Would you name either of these two reasons?

• Affluent areas pay higher salaries than rural areas
• Physicians tend to settle down near the place they were trained

And the Survey Says …

Both! Affluent communities in and around big cities are where the majority of medical schools and teaching hospitals are located. As doctors leave school and move forward with their careers in physician residency jobs, they tend to settle near the large teaching hospitals where they trained.

For example, San Francisco and Washington DC are loaded with medical schools, as well as high-income residents:

• San Francisco, California, had 117 primary care doctors per 100,000 residents.
• Washington, D.C., had 102 primary care doctors per 100,000 residents

Whereas, in these more rural communities with fewer medical schools and lower household income:

• McAllen, Texas, had just 45 primary care doctors per 100,000 residents
• El Paso, Texas, had 47 primary care doctors per 100,000 residents

Who were the researchers that did the study?

The nonprofit group that conducted the survey was The Dartmouth Atlas, funded by The Robert Wood Johnson Foundation. The purpose of this group is to provide research, information and analysis about hospitals, doctors and healthcare markets.

For the research, the nonprofit group evaluated 306 regions nationwide, using data from the government, the American Medical Association, and the American Hospital Association.

The study also found that areas with more doctors tend to have a decreasing amount of hospital beds. But some rural areas have far more beds per capita than more heavily populated areas. For example:

• San Francisco suburb of San Mateo had 1.45 hospital beds per 1,000 residents
• While Mississippi’s Jackson and Gulfport both had 4.44 beds per 1,000 residents

What does this all mean for consumers and registered voters who are looking for healthcare reform?

Dr. David Goodman, a professor of pediatrics and community and family medicine at The Dartmouth Institute for Health Policy and Clinical Practice in New Hampshire, which publishes the Atlas had these suggestions:

• Congress should require the federal Centers for Medicare and Medicaid Services to use its payment policies to try to limit hospital growth in regions that have too many beds.
• National healthcare reform, should it be implemented, should set up a national commission to direct training dollars to high-need specialties such as primary care physicians

And what is the recommendation for communities that need to attract high quality physicians for staff openings? First, they start by attracting locum tenens in hopes that these physicians may choose to settle in their areas permanently. Once a physician has had a chance to live in a new place, and experienced the alternative to the fast-paced, busy metropolitan lifestyle, they may be more inclined to make the move a permanent one.

What else does it take? Great pay and benefits, less stressful work environments, and a desire to try something new are the top motivators to change for medical doctor jobs in specialties like OB/GYN and Orthopedic Surgery.

Physician Jobs Lead to Substantial Student Loan Repayment Award

Author Healthcare Career Blogger | 31.03.2009 | Category Colorado Physician Jobs, Education, Locum Tenens, Medical doctor jobs, OB GYN jobs, Physician Career Path, Physician Recruitment, Physicians, Pschyriatry Jobs

As the doctor shortage worsens in rural and high-need areas nationwide, states are stepping up incentives to recruit physicians of all types. New York State alone has pledged $22 million to its Doctors Across New York Program and Michigan is working hard to abate a projected physician shortage of 6,000 doctors over the next ten years. Physician recruitment agencies are focused on these areas and fast-tracking physician specialists for permanent and locum tenens jobs.

Why offer payback incentives in a field known for high salaries? The simple fact is, practicing medicine in what the U.S. Department of Health and Human Services refers to as a designated Health Professional Shortage Area – or underserved market – isn’t as lucrative as physician jobs located in larger market areas. So, in exchange for student loan payback incentives, qualifying doctors agree to work in shortage areas for three to five years and dedicate one-third of their practice to treating patients with Medicaid, Medicare or no insurance at all, depending on the requirements of individual state and federal payback programs.

The Colorado Health Foundation’s Physician Loan Repayment Program is currently awarding eligible doctors up to $50,000 a year for a maximum of three years if they serve in a qualified rural or urban Colorado community. Currently, 57 percent of the state’s 64 counties lack enough primary-care physicians to sufficiently serve the population. The program awarded more than $2 million to 18 physicians in 2008. Physician recruitment agencies are ideal sources to find physician jobs and locum tenens opportunities in these areas as well as highly coveted positions located in Metropolitan areas.

Student loan payback incentives have been around for a few years. After Hurricane Katrina devastated New Orleans, the state of Louisiana developed the Greater New Orleans Health Service Corps, an organization offering incentives of up to $110,000, including student loan repayment and income guarantees to doctors, dentists and other medical professionals willing to work in post-disaster conditions – a move to lure needed doctors into the ravaged city and to stanch an outmigration of doctors eyeing greener pastures. The federal government provided $15 million to finance the Louisiana program and the state awarded 81 grants to attract physicians for primary care medical doctor jobs, OB GYN jobs, psychiatry jobs, dentists and a handful of nurses and counselors.

For doctors less interested in pay and more inclined to utilize their skills to help what most would consider the underprivileged, states across the country have various programs in place that offer doctors loan repayment in exchange for medical services. Oregon’s Rural Health Services Loan Repayment Program offers to repay 20 to 25 percent of the loan principle for health professionals who agree to work in a rural
hospital, a rural health clinic or pharmacy located in either a federally designated Health Professional Shortage Area or state designated Area of Unmet Health Care.

For doctors not interested in practicing medicine, The National Institute for Health offers health professionals up to $35,000 in student loan repayment for a commitment as a medical researcher. Not such a bad deal, say loan payback proponents.