Healthcare facilities located in rural communities face a variety of challenges, from a lack of specialized staff to a patient population that traditionally has greater health problems. However, one of the most pronounced difficulties is the challenge of recruiting physicians for rural healthcare locations. Insufficient staffing can pose a critical problem in communities where rural hospitals may be the only option for care for many miles in any direction.
Rural areas have less physicians
According to the National Rural Health Association, there are only 39.8 physicians per 100,000 people in rural areas. This compares to 53.3 physicians per 100,000 people in urban areas. Rural communities are also susceptible to higher levels of poverty, traditionally have higher tobacco use, and are less likely to use primary care. This disparity between availability of care and community need for healthcare services can result in negative outcomes for patients.
However, it can be difficult for rural facilities to recruit new healthcare professionals to address this problem. Many physicians don’t want to live in small towns, and they may think that facilities are out of date or the work isn’t exciting. The workload may also be higher in rural facilities, where they don’t often have access to specialists who would take on specific cases in an urban setting.
Rural facilities have a lot to offer
However, even with those limitations there are many benefits to working in rural facilities. They offer a broad scope of practice, financial relief for physicians through loan repayment programs and grants, and a real sense of mission and purpose in the work.
So how does a rural location find and attract physicians? Brock Slabach, senior vice president of the National Rural Health Association, offers a few strategies that can help.
- Use incentives and reimbursement programs: Both federal and locally funded programs are options for encouraging a physician to work in a rural location. Programs like the National Health Service Corp will pay off part or all of a physician’s student loan debt and is a great way to bring them into your community. Paying out signing bonuses is another way to bring in a physician who may no longer have loan debt.
- Find mission-minded physicians: Many physicians like the idea of caring for medically underserved populations, and they are willing to travel around the world to offer that care. Working in rural areas can offer the same satisfaction to physicians looking to give back to a community.
- Hire J-1 visa physicians: Very often, physicians from foreign countries have training on par with their U.S. counterparts (and in many cases were trained in the U.S.), but they may be more willing to move to a rural part of the country for the work experience.
- Appeal to the spouse: Rural communities are great for raising a family. A physician may be more apt to come to your facility if their family is looking for a small-town experience.
- Go local: Plan for the future by finding kids interested in going into medicine and encourage them through community outreach programs. They are more likely to come back home after medical school and residency.
- Bring in locum tenens: Locums physicians offer a lot of benefits to rural facilities. They can provide continuity of care during a gap between permanent physicians or allow a facility to bring in a needed specialty for the short-term. The other benefit is finding a locums who likes your town and offering them a permanent job.
Benefits you will only find in rural healthcare
Rural healthcare is also leading the way in population health. Physicians working in rural areas are often able to expand their skills by addressing more than just the cases they see in the hospital. They are able to work locally to look at how disease is affected by physical environments, social and economic factors, clinical care, and healthy behaviors. Focusing on all four of these areas has been found to increase both quality and length of life in rural locations. It also makes for a more well-rounded and community-minded physician.
“People in rural areas are great. They are always appreciative of the help they get. Working in an environment where you are valued and appreciated is extremely rewarding,” says Slabach. “Depending on the circumstance the pace may be a little bit less hectic. Plus, you don’t have traffic to deal with to get to the clinic — the hospital may even be just a short walk away.”
Slabach also recommends promoting your facility’s positive attributes. Is there something unique about the patient population? Does your location offer outdoor recreation opportunities? Are there benefits for families? The answers to these questions may be helpful in your recruiting.
Use locums to help create new departments or programs
When physicians leave a rural facility it not only affects patient care but can cause the facility to lose revenue and make it even harder to recruit. New physicians prefer to come into established departments rather than thinking they are responsible to see patients as well as build-up the department.
Locum tenens physicians can be a great help in maintaining departments while recruiting for a permanent physician. One benefit of locums is they are only there for one reason: to offer patient care. They don’t have any vested interest in the outcome of the department, or any partialities in terms of how the new program is going to be set up and run.
New hires won’t have to fight with existing physicians about the set-up of the program because the existing physicians are just visiting, and by nature are purely there to support. This can be a very appealing selling point to prospective candidates.
By focusing on patients, a locums provider can free up time and energy for your new hires to focus on how they want to set up the program. Additionally, locum tenens help with the onboarding for your new staff, since they provide the back-up that allows new hires to do things like see people in clinic, form relationships in the community, and take a reasonable call schedule.
The challenge can be overcome
Recruiting physicians for rural healthcare facilities can be difficult, but it can be accomplished. By identifying the strengths of the community and facility, highlighting the benefits of rural healthcare, and seeking out a good match for the community, rural facilities can find the right physician for the right job.