Finding Personnel

Along with health insurance coverage, the availability of doctors, nurses and other medical personnel affects access to health care in rural areas. People living in areas with fewer doctors, hospitals, and clinics must travel further to obtain needed services, and as a consequence, often delay treatment.

Although the number of trained doctors has risen sharply since the 1960’s, physicians continue to favor more urban areas, leaving non-metro and rural residents underserved. And while statistics will show that there isn’t really a nursing shortage, per se, many trained nurses are choosing not to practice.

According to Dr. Janet D. Allen, Dean of the School of Nursing at the University of Texas, “Experts point to heightened productivity requirements in our hospitals, the loss of nursing positions over the last decade during the downsizing of hospitals, the aging of the nursing workforce (in both practice and education), increasing use of technology necessitating greater levels of training, and the 30 percent decline in nursing enrollments over the last five years. The decline in nursing enrollments has been attributed to public perception of the difficulty of clinical nursing positions and to the growth of other opportunities for women, who still constitute the majority of nurses.”

In the Midwest, the number of physicians practicing in rural areas has declined steadily. While General and Family Practice physician numbers have remained flat, specialists including internists, pediatricians, and OB/Gyn are more than twice as likely to practice in metropolitan counties than in non-metro counties including rural areas with cities up to 10,000. The Center for Disease Control provides charts and graphs by region and can be viewed at:
http://www.cdc.gov/nchs/products/pubs/
pubd/hus/charts/2001/hus01f24.pdf

Even communities that are successful in their recruitment efforts find that retaining physicians, nurses and EMS staff, over time, is difficult. The following web-based articles provide more information on personnel issues.

Recruiting New Rural Practitioners
Dr. Robert Bowman, University of Nebraska Medical Center
http://prairiepublic.org/features/lifesupport/ innovation/telemed.html

Rural Communities feel Sting of Nursing Shortage
http://community.bouldernews.com/news/
statewest/09lnurs.html

Low Medicare Pay adds to Rural Physician Shortage
http://www.ama-assn.org/sci-pubs/amnews/pick_02/gvl10311.htm

Recruiting Rural Physicians by William Pike
http://www.libertyhaven.com/politicsandcurrentevents/
healthcarewelfareorsocialsecurity/recruitingrural.shtml

Keeping Doctors North: Recruiting and Retaining Physicians in Un-served Areas by Jason A. Shack and Alison D. Baker http://www.utmj.org/issues/76.3/pdf/NVDocNorth76-3.pdf

Funding for Life Support is provided by a grant from USDA Rural Development