You don’t have to have a rural background to consider rural practice opportunities: There are many reasons to consider living and practicing in rural communities. Primary care physicians, surgeons, and other medical professionals provide quality health care to those living outside larger communities and many small communities, are actively recruiting. There are advantages and disadvantages in living in smaller communities, just as there are in larger cities. However, when you’d have to drive around on your way to the office just to finish a cup of coffee in the morning versus a 45-minute “white knuckle” commute—well, think about it. Shorter commutes mean more time with family or for recreation.
Yes, rural communities need more physicians, which is well known and well documented. Some medical schools and residency programs have responded to this need. Arizona, Minnesota, Alabama, Wisconsin, West Virginia, Virginia, New York, Nebraska, Kentucky, South Carolina, Michigan, and several other states are home to medical schools and residency programs oriented toward medical care in rural areas. University of Washington School of Medicine is a regional resource for the states of Washington, Wyoming, Alaska, Montana, and Idaho. This list is by no means complete, and medicals schools are beginning to recognize the need for rural oriented programs.
Quality medicine, quality of life
With physicians coming out of training with such high debt loads, rural communities may offer significant advantages in being able to provide very nice lifestyles and reduce debt at the same time. Smaller communities may make incoming physicians eligible for more federal and/or state loan forgiveness programs; many communities offer their own loan repayment programs as recruitment incentives. Also, more and more smaller communities are growing practices that include medical providers who cover the hospital and make call more attractive.
In addition to the lifestyle benefits of living and practicing in rural areas, the cost of living is generally significantly less in rural areas. For example, the CNN cost of living website reveals that a salary of $160,000 in Milwaukee, Wisconsin, is needed to have the same standard of living that a salary of $150,000 in Stevens Point, Wisconsin, would provide. Another excellent tool for comparing cost of living is Sperling’s Best Places website, which calculates that it is 29 percent cheaper to live in Fairmont, Minnesota, than it is in the Twin Cities. Websites are very useful for comparing cost of living, crime rates, schools, air and water quality, etc.
Approximately 25 percent of the US population lives in rural areas, but only 10 percent of physicians practice in rural areas. In addition, rural areas average 30 dentists per 100,000 of population while urban areas average 60 dentists per 100,000 people. However, it should be noted that the definition of “rural” varies widely. Federal, state, and other organizations will have different figures depending on methodology, but generally there are more medical and dental practitioners in urban settings than there are in rural areas.
Why choose the rural life?
More than 1,900 physicians responded to LocumTenens.com’s “2007 Physician Survey on Practicing Rural Medicine,” which showed that 48 percent of the respondents prefer rural practices and 30 percent preferred rural living. Of the 800 physicians who have practiced in rural areas, 45 percent thought the frustration of practicing was about the same as in urban areas and 37 percent thought practicing in rural areas was less frustrating.
In the same survey, 52 percent of the physicians surveyed reported a closer relationship with patients in rural practices and more than one third said they liked rural life more. It is interesting to see that 53 percent of the surveyed physicians said practicing in rural areas is generally more profitable than practicing in urban or suburban areas.
The 2006 Carsey Institute Report, “Demographic Trends in Rural and Small Town America,” showed increasing growth in rural areas. Seventy-one percent of 1,458 non-metropolitan counties gained population between 1990 and 2000. While gains slowed in the second half of the 1990’s they picked up again after 2001. Factors that have contributed to growth in rural population are related innovations in communication and transportation that enable people and businesses to relocate in more areas.
Over the last several years, the population growth of some rural states is due to more Americans looking for less crowded places to live and work. According to Robert Land, demographer at the Metropolitan Institute at Virginia Tech, “This is part of a long diffusion of population of the country because of the interstates, airports and the Internet.” Less crowding is related to lower crime, as well as better air and water quality.
No one community is right for everyone, so how do you find the right fit for you? Usually it is more effective to select a region or small number of states that are of interest to you and your family. Then it is very easy to connect with recruiters who live and work in communities that have the potential of meeting your needs. 3RNet—the National Rural Recruitment and Retention Network, www.3rnet.org —is a not-for-profit network currently consisting of 48 non-profit members who recruit medical professionals to rural and underserved areas. More than 5,000 communities across the country can be accessed via the website. ASPR (www.aspr.org) is an organization of in-house recruiters and all are listed on the website.
As mentioned earlier, the web offers a variety of tools that are very helpful in comparing cost of living, crime rates, schools, home values, and other information that is very helpful in making decisions about where to live and practice. Some websites also provide examples of communities that are offer more security to families.
Selecting a good fit for you, the practice, and the community is based on asking the right questions. For the last several years, graduating residents have consistently ranked geographic location and lifestyle as the number one concern as they search opportunities. In-house recruiters will able to provide a great deal of information about their states and communities since they live there. Ask about recreation, schools, community resources and the cost of housing— ask anything important to you and your family. In smaller communities, the medical center and community resources are usually connected to the recruitment process. This makes it easier for you to obtain information.
Tim Skinner is the executive director of the National Rural Recruitment and Retention Network (3RNet), www.3rnet.org.
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