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The fix to rural America’s healthcare crisis

Posted on Tuesday, November 5, 2019 at 6:15 pm

By Dr. G. Richard Olds 

Imagine going into cardiac arrest and the closest emergency room is more than 30 miles away. Or your child is struggling with depression, but there isn’t a single psychiatrist in your county. Or consider experiencing unexpected pregnancy complications — yet living hours away from a hospital that has the resources to help.

This is the reality for much of rural America — where limited access to care is the norm. Absent action, this public health crisis will worsen over the next decade.

U.S. medical schools aren’t turning out enough doctors to fill the gaps in care that rural America faces. Consequently, the country must look abroad, to graduates of international medical schools, to fill its yawning physician shortage.

International medical graduates have a long history of providing care for underserved populations. Many of them are U.S. citizens who chose to pursue their studies abroad — and now want to return home to practice.

Roughly 20 percent of Americans reside in rural areas. Yet only about 10 percent of doctors work there. As a result, many rural Americans struggle to access care. One recent survey found that at some point in the past few years, one-quarter of rural residents did not get care when they needed it.

Several specialties are especially short on doctors. Nearly 80 million Americans live in federally-designated “primary health care health professional shortage areas.” Roughly two-thirds of rural counties don’t have a single psychiatrist. Just 6 percent of OB-GYNs work in rural parts of the country.

Without sufficient access to care, rural Americans post worse health outcomes than their peers elsewhere. Rural Americans are more likely than those living in non-rural areas to die from heart disease, cancer, and stroke. Americans in urban areas live almost three years longer than their rural counterparts, according to a 2013 study published in the American Journal of Preventive Medicine.

Unfortunately, these trends could worsen over the next several years. The country will need upwards of 122,000 additional doctors by 2032. The Association of American Medical Colleges predicts that “rural and historically underserved areas may experience the shortages more acutely.”

International medical graduates could help turn back these trends. Consider a recent study published in the medical journal BMC Family Practice. The analysis concluded that IMGs are more likely “to look after underserved populations, and to live and work in rural areas” than U.S.-trained graduates.

According to a Johns Hopkins analysis, “Compared with U.S. graduates, international medical graduates tend to practice in primary care and in underserved and rural areas.”

In parts of the country with per-capita incomes of less than $15,000 annually, nearly half of doctors were trained overseas.

For the complete column, see this week’s edition of the Centralia Fireside Guard.