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Rural Healthcare Workforce Shortages Defy Easy Solutions

John Commins, for HealthLeaders Media, February 27, 2013

The problem, however, is that many of the government programs that are designed to attract physicians to rural areas center on student debt deferment, reduction, or forgiveness, an incentive we now learn that these young docs don't prioritize.

"When it comes to the actual specialty choice, debt does not seem to be that much of a big driver. It has more to do with people's personality and how well that fits what they want to spend their day doing. What we don't know is whether it had an influence on people's willingness to serve underserved communities," Grover says.

"If you have a large amount of debt and you are worried about making your loan payments, while it may not affect your specialty choice it may affect your decision to serve an underserved population that has a high Medicaid population with lower reimbursements. We already have trouble getting physicians to see Medicaid patients now. And Medicare is always on the edge with the (Sustainable Growth Rate [formula])."

The results of the report also suggest that finding actionable and effective enticements to bring physicians into rural areas could be problematic. Many of the enticements the young doctors cited when they chose a particular specialty were based on personal opinions and preferences such as personality fit, lifestyle choices, work/life balance, and future family plans. It would be hard to develop a rural healthcare physician recruiting strategy around intangibles such as "role model influence."

The AAMC study is limited because it surveys medical school students who've already accepted the burden of amassing debts. The study cannot gauge the intimidating effect of these debts in chasing away would-be physicians from attending medical school in the first place—particularly students from minority groups or lower socio-economic backgrounds.

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