“Medical schools have grown tremendously over the past 15 to 20 years, but residency programs have not been expanded,” said Fincher. “So we have a lot more medical students and not enough residency places.”
The cost of a medical degree would also tend to keep new doctors away from a rural practice, Fincher added.
“The average medical education debt out of medical school for most medical students is now over $ 251,000,” said Fincher.
Telemedicine was expected to alleviate some of the health care gaps in rural areas, but technological barriers hamper access to care, even from a distance, Fincher noted.
Broadband internet has been slow to develop across rural America, delaying access to the video and audio streams necessary for a good telehealth visit, Fincher said.
In addition, seniors do not necessarily have the technology for telehealth.
“Our senior population does not necessarily have a smartphone or a computer on which to conduct a telehealth visit,” Fincher added.
Efforts are now being made to expand residency programs in rural areas, which could help bring young doctors to the people who need them, she said.
For example, a rural Appalachian region created a family medicine residency program from scratch last year, recruiting doctors-in-training to work in western North Carolina and eastern Tennessee.
This region’s health professions training center, MAHEC, accepts four to six residents for training at a hospital and clinic in Boone, NC The program is partially funded by a three-year grant of $ 750,000 from the US Health Resources and Services Administration’s Rural Residency Planning Development Program, one of 27 grants awarded in 2019.
“We need to change the way we recruit physicians into medical schools to remove the kinds of our physician workforce that our country needs. And we need to work to make these medical students more exposed to rural environments. and the types of areas that make them feel a lot more comfortable going to rural areas, ”Fincher said.
The US Health Resources and Services Administration has more information on rural residence resources.
SOURCES: Jacqueline Fincher, MD, president, American College of Physicians; Health Affairs, 2019; Rick Pollack, President and CEO, American Hospital Association; Association of American Medical Colleges, report, 2020