“Medical schools have expanded significantly in the last 15 to 20 years, but residency programs have not expanded,” Fincher explained. “So we have a lot more medical students and there aren’t enough residency places.”
Fincher claims that the cost of a doctor’s degree would also take new doctors away from a rural practice.
“The average medical education debt coming out of medical school for most medical students now exceeds $ 251,000,” Fincher said.
Telemedicine was expected to alleviate some of the health deficiencies in rural areas, but technological barriers hinder access even to remote care, Fincher noted.
Broadband Internet has been slow to expand across rural America, delaying access to the video and audio sources needed for a good telehealth visit, Fincher said.
In addition, older people may not necessarily have the technology needed for telehealth.
“Our large population doesn’t necessarily have a smartphone or a computer to do a telehealth visit,” Fincher added.
An effort is being made to expand residency programs in rural areas, which could help bring young doctors closer to the people who need them, he said.
For example, a rural area in Appalachia last year built a residency program in family medicine from scratch, recruiting doctors in training to work in western North Carolina and eastern Tennessee.
The health care training center in this area, 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 U.S. Resource Planning and Residential Planning Administration’s Residential Development Program, one of 27 grants awarded in 2019.
“We need to change the way we recruit doctors in medical schools to get the kind of workforce out of our doctors that our country needs. And we need to work to make medical students more exposed to rural settings and types. of areas that make them feel much more comfortable going to rural areas, ”Fincher said.
The U.S. Health Services and Resources Administration has more information rural residence resources.
SOURCES: Jacqueline Fincher, MD, president of the American College of Physicians; Health issues, 2019; Rick Pollack, president and CEO of the American Hospital Association; Association of American Medical Colleges, report, 2020