Tuesday, February 19, 2013

Medical training for rural health care

The California Health Care Foundation estimates that with the Supreme Courts validation of the Affordable Car Act, millions of new patients will be entering the healthcare system by 2014. The foundation explains that California already has a below average amount of doctors per capita than most other states. The Foundation further explains challenges facing California in 2014:
California has an unusually large number of doctors heading into their retirement years. It expects a much higher-than- average rise in the health-intensive 65-and-older population. And it has one of the lowest reimbursement rates in the country for Medi-Cal, the state's primary program offering health coverage for the poor.
One of the many concerns regarding the Affordable Care Act is how the country is going to adjust to the overwhelming increase of patients in the healthcare system.
"The Affordable Care Act will add hundreds of thousands of people to the rolls of the insured. That's good," said Dr. G. Richard Olds, founding dean of the UC Riverside School of Medicine. "But where are the primary care physicians going to come from to serve that population?"
The problem described by Dr. Olds is even more prevalent in rural areas, where doctors and healthcare are already in short supply. Although creative thinking and brainstorming can solve many problems, it seems the only way to solve this problem is to get more doctors into the field, especially ones working in rural areas.

The University of Kansas, a medical school that focuses on keeping graduating doctor’s in rural areas, often faces challenges getting graduates to stay:
They say they have every intention of coming back to rural Kansas but they meet a soul mate, they get married. Their soul mate happens to be from a big city and we never see them again. They get captured in the big city.  Hopefully, if we train them in smaller communities, they can meet their prospective spouses here, they can network here and they have those connections which can be lifelong.
The UC Davis School of Medicine had recently launched a new program that will help train soon-to-be Doctors to practice general healthcare in rural areas. This program is aimed not only at educating young doctors on how to practice in rural communities, but also helping to build ties between young doctors and rural communities.

The program at UC Davis medical school advertises the practice of rural medicine as one that offers many opportunities due to its broad scope of practice:
Students at UC Davis will train for rural medicine in a way far different from their predecessors. Our focus combines team medical practice, advanced information and telecommunication technologies and evidence-based medicine, while still recognizing what has always made rural medicine fulfilling and fun: that broad scope of practice, great relationships with patients and the knowledge that you are making a difference.
The innovative curriculum at UC Davis Medical school will:
Increase student exposure to rural practice, allow for consistent teaching and mentorship by rural physicians, equip students with tools for life-long learning, combine the M.D. and master's degrees in public health, medical informatics or another, related health-care field.
Programs like these could be a saving grace for patients in rural areas. The unique curriculum used by the UC Davis School of Medicine does not just educate students on how to practice rural medicine, but actually exposes them to rural communities. Hopefully, this kind of exposure will help create ties between young medical students and the communities they are working with. Furthermore, the exposure to such medicine at the beginning of a doctor’s career may result in a new population of doctors that value and appreciate the work that needs to be done is rural communities.


Hannah said...

This question is endlessly interesting to me -- how to attract young professionals to rural communities. I love the Davis med school approach of emphasizing the positive aspects of rural medical practice. The description of that practice sounds like the ideal career in medicine: "broad scope of practice, great relationships with patients and the knowledge that you are making a difference." Viewed against the backdrop of a medical field emphasizing efficiency and fees over patient care, the rural medical practice can serve not only as an alternative to big-city medicine - but as a model for it.

Scrampbell said...

A fascinating topic that is definitely trending across medical disciplines. It reminds me of the struggle to recruit farm and rural veterinary students rather than small animal practice specialists. Urban medicine, like small animal practice is much more profitable. This issue brings up the interesting question of how to re-vitalize the rural economy and draw professionals to rural areas while supporting the population in an era where higher education costs are prohibitive. In addition to offering rural based curriculum and education it would be great if there was a long term financial investment such as loan-forgiveness, or perhaps a program that offered scholarship for rural residents matriculating to medical programs.

Erin L said...

Great topic! It is interesting to see the same types of reasons being cited for young professionals to leave rural areas - for example finding a partner in a larger metro area. I remember this same sentiment being expressed by Plumas County officials, that the only doctors who stayed were ones who were married when they came.
I believe that there are some loan forgiveness programs for docs who take jobs in rural areas. But what about other professionals (for example, lawyers)? I would be interested to find out more about how accessible these programs are for professionals started their career in a metro area and want to later tap into rural loan forgiveness if they decide to shift their location.