Geographic Maldistribution Of Physicians And Other Hcps

Living on a small farm in Montrose, SD, I have seen the hardships that can go along with living in rural areas. With two parents who commute 30 minutes to work everyday, it was always an almost impossible task to get medical attention for any illness. Experiencing these hardships has helped me gain a great respect for rural clinics, and opened my eyes to the opportunities a rural clinic offers to future medical professionals, such as, myself.

To respond to these legislative changes, there must be an increase in the professional workforce of rural health. The existing workforce will need extensive training to deal with the new aspects of the Affordable Care Act, and new professionals need to be encouraged to practice in rural areas. The following are potential methods for increasing the health care workforce of rural and frontier America:

Texas faces a growing demand for Primary Care services, particularly in rural and underserved regions. The Texas Department of State Health Services reports that 16,830 primary care physicians were in active practice in Texas in 2009, or approximately 68 for every 100,000 people. The national average is 81 per 100,000 people. This shortage is compounded by a prevalent misdistribution of physicians across the state. Of Texas’ 254 counties, 118 were considered whole county health professional shortage areas, or HPA’s, and 71 contained either special populations or geographic areas that qualified for the designation of partial-county HPSA. Twenty-six counties had no primary care physicians in 2009.

There is no falsehood that there has a been a shortage in primary care physicians. Petterson, Liaw, Tran, & Bazemore (2015), anticipated a shortage of over 33,000 primary care physicians by 2035. The American Association of Nurse Practitioners (2012) describes Nurse practitioners as registered nurses who have innovative knowledge, enhanced clinical training and have completed graduate or doctoral degree from an accredited institution. Nurse practitioners are contributing tremendously to the field of nursing and health care by providing high quality primary care especially to low income and minorities nationwide. In reference to Ryan & Rahman (2012), in rural communities, there’s a high demand for primary care and a shortage of primary care providers, however, nurse practitioners are willing to fill the void and provide health care services such in communities even when physicians are unwilling.

In March 2015, the AAMC released a study that stated, of the 20% of the population that live in rural areas, only 11.4 percent of primary care physicians practiced in those locations in 2005. Studies suggest the problems with primary care physicians in those areas will eventually lead to no reasonable access to primary care physicians overall.

One of the characteristics that exemplify rural healthcare is the lack of doctors per capita. Statistics show that there is an unequal distribution of health care; more services are targeted and provided for the urban population. According to a study in Rickett’s book, Rural Health in the United States, 20% of the U.S. population lives in rural areas; however, only 8% of doctors serve the rural community. These residents also face the challenge of finding specialized doctors for their specific needs. In some cases, patients need to travel long distances to get the health care that they need. A study was conducted in which 20,693,828 patients visited a clinic. Based on this study, Patients in the rural areas needed to travel 2 to 3 times

And by doing so, these mutable factors would be changed for the better outcomes for both sides. Further, these two Professors from School of Medicine in Texas, conducted a study “Rural Residence and Migration for Specialty Physician Care” through a random mail survey of people residing in Iowa’s rural counties. The focus of the study was to look for the factors that associate “with migration for specialty physician care” (Borders and Rohrer, 2001).

An American physician who has held numerous leadership positions in the healthcare sector and believes that residing in a small township in rural areas

There are variations across the country on the delivery and successful outcome of health care services not attributed to patients’ health or preferences (Rice & Unruh, 2016). Gawande examined Medicare data in two largely rural cities in Texas, and discovered that one city utilized far more advanced technology and specialists visits (almost 50%), which led experts to make the assumption of “culture and money” being driving factors (as cited in Rice & Unruh, 2016, p. 398). This identifies the lack of consistency, and highlights the need for utilizing best practices. Another study examining commercial insurances found similar outcomes in both cities, which experts presumed it was the result of carefully managing high cost patients (Rice & Unruh, 2016). Comparative research analyzes and highlights best practices, which providers and

From the above article reviews, it can be inferred that the shortage of primary care workforce is projected to be even more in the futures. There is a huge gap in the access to primary health care between rural and urban areas of the US and the projected shortage of primary care professionals will make the situation even worst. There are several ways to address these shortages and the articles have proposed a few of them. Use of nurse practitioners, access to electronic health records, increasing the wages of physicians willing to work in remote areas, and providing initiatives for working in the underserved areas are some of the ways of mitigating the primary care workforce. However, there is still a lot to research, owing to increasing shortage

Throughout this article, the author has discussed the barriers that rural communities are facing in collaboration with the solutions that may work to reduce these barriers that patients face daily. The author elaborated with unknown factors that may stand in the way of those solutions creating a more frustrated healthcare system. The author will propose a solution that may improve the resident’s that are living in rural areas the ability to receive organized healthcare services throughout the community using little to no transportation needed. The Center of Disease Control and Prevention (n.d.) has identified through changing of transportation policies that providing safe, affordable transportation to individuals will cut the cost of healthcare and help support ones’ health.

Rural communities are very prevalent among the United States. The rural populations have higher rates of poorer health compared to urban populations. According to the National Rural Health Association, rural areas have fewer physicians and specialists available to care for them. Rural adults also face barriers due to distance and lack of transportation (Bennett, Lopes, Spencer, & Hecke, 2013). Disparities between rural and urban areas show that rural residents have lower health status overall. Specifically, rural women have fewer accesses to health care than women of urban areas, which have lead to worse health outcomes. Many rural areas across the United States lack women’s health providers, primary and specialty care, screening services, prenatal care, and have more complications accompanied with pregnancy. These areas also have higher incidences of breast and cervical cancer than of urban areas. (The American College of Obstetricians and Gynecologists, 2014). “More than 28 million women 18 and older live in Rural or Frontier America who need access to health care services” (Bennett et al., 2013). Access issues affect almost all of these women. These differences in quality of life are closely related to poorer health outcomes.

Moreover, the incomes for general practitioners in rural regions are higher than those in urban regions in some counties, but it may not be sufficient compensation as they work for longer hours and more difficult working conditions. Furthermore, professional prestige plays a role as more prestigious specialties concentrate in urban areas and by default making rural practice less attractive. Additionally, rural origins and experience in rural settings are influential factors as doctors who are from rural regions are much more likely to go and practice in rural setting compared to those with an urban upbringing (Geographic Imbalances in Doctor Supply and Policy Responses”, para. 2).

Everyone deserves quality health care, whether you live in an urban setting or a rural. For those that live in a rural area, there are many factors that could play a role in health care. Rural areas are places that are located outside of a city or town. “Only about ten percent of physicians practice in rural America despite the fact that nearly one-fourth of the population lives in these areas” (National Rural Health Association). These country-like places lack health care. Some examples could be Molokai as a rural island of Hawaii, or North Carolina in the United States, and of course third world countries such as Africa. Depending on the situation and culture of each specific area, factors may vary. The most important basic factors to consider while giving health care in a rural area are living conditions, economic situations, transportation, and religious views.

Growth of Physicians in Rural Areas........................................................................9 The Future Practitioners of Rural America ........................................................9 Programs for Future Health Professionals.........................................................10