An ongoing critical shortage of physicians in America’s rural areas requires innovative strategies to meet the healthcare needs of millions of individuals in these communities.
Although 20 percent of the U.S. population resides in rural communities, only an estimated 11 percent of physicians practice in these areas. This imbalance is reflected in data showing that nearly 70 percent of the federally designated Health Professionals Shortage Areas (HPSAs) are in rural areas.
Physician Shortage to Worsen
This situation could worsen due to predictions of a significant U.S. physician shortage in the years ahead. The American Association of Medical Colleges has projected a shortage of up to 86,000 physicians by 2036. With most physicians expected to continue to practice in urban areas, the growing physician shortage will only add to rural healthcare challenges.
The problem is exacerbated by rural Americans requiring more healthcare services than their urban counterparts. On average, rural residents tend to be older, have more chronic illnesses, and have shorter life spans than those living in big cities. Limited medical services in some rural and remote communities also adversely affect residents’ access to healthcare easily.
Incentives like government loan forgiveness programs and medical schools creating rural educational tracks have achieved limited success in solving physician shortages in small communities. A U.S. Government Accountability Office report said only two percent of medical students admitted to the country’s physician residency programs practice in rural areas.
So, how can rural communities respond to the unique challenges of improving healthcare delivery in rural areas?
Advanced Practice Providers Can Help Improve Rural Healthcare Access
One trend gaining momentum is expanding the use of advanced practice providers, such as nurse practitioners and physician assistants. These providers are stepping in to provide primary, geriatric, and mental care in rural areas. They are trained to diagnose, treat and manage patients and often work with physicians or independently, depending on state requirements.
In rural areas, some hospitals increasingly rely on advanced practice providers, a growing trend expected to continue in the years ahead.
NPs, PAs Offering Solution to Care Delivery Issues
Research has shown that using advanced practice providers (nurse practitioners and physician’s assistants) may reduce the primary care physician shortage by 70 percent.
Some of the benefits of using these providers in rural areas include:
● Expands access to primary care, particularly in areas with severe physician shortages.
● Improves health outcomes and patient satisfaction.
● Lowers healthcare costs due to fewer emergency room visits, shorter hospital stays, and reduced medication costs.
● Augments clinical staffing levels at rural hospitals and other healthcare facilities.
● Provides support to overworked physicians with heavy patient caseloads
Practicing in a small community offers various benefits for nurse practitioners and physician assistants, such as:
● More freedom and flexibility to manage patients’ health and practice to the full extent of their license and contribute to a healthier community.
● Expanded hospital-based roles.
● Develop closer patient relationships.
● Enjoy lower cost and slower pace of living.
Advanced Practice Providers Face Challenges
Efforts to recruit and retain advanced practice providers in rural areas have encountered various challenges. They include competition from urban and suburban markets offering higher salaries, better job benefits, and more advanced technology.
Another challenge is the American Medical Association’s opposition to expanding the scope of practice, or scope creep, for non-physicians performing full medical services and procedures, which includes nurse practitioners and physician assistants. This may impede efforts to increase the number of advanced practice providers in rural areas.
The future of a sustainable rural healthcare environment depends heavily on increasing the ranks of providers to meet the ever-increasing demand for care. Attracting more advanced practice healthcare professionals to rural areas allows greater care access, leading to healthier and more productive communities.
Jill Bayless
Jill Bayless is a senior vice president of clinical services at Community Hospital Corporation (CHC).
