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Report on growing rural primary care shortage lists locum tenens as part of solution

Posted by VISTA Staffing on Jun 19, 2013 1:32:00 PM
The WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) Rural Health Research Center recently released a report on The Future of Family Medicine and Implications for Rural Primary Care Physician Supply.  The study, written by Roger Rosenblatt, MD, MPH, and colleagues at the University of Washington School of Medicine, examines trends in specialty choice among new physicians, the rural primary care physician shortage, and the changing dynamics of rural health care delivery. It includes a list of initiatives and policy efforts that will help ease the shortage of primary care physicians in rural areas, and that list includes providing locum tenens support to protect rural physicians from burnout and isolation. 

Here’s a quick rundown of the study. To read the entire document, go to http://depts.washington.edu/uwrhrc/uploads/RHRC_FR125_Rosenblatt.pdf .  

Rural locations rely heavily on family physicians who account for about half of all rural physicians in large rural areas and about two-thirds in smaller and more isolated areas.
There has been a sharp decline in the proportion of U.S. medical graduates choosing family medicine over the last decade, with most family medicine residency positions filled by students who graduated from medical schools outside of the United States.

The proportion of students choosing family medicine careers will likely remain far below the numbers required to replace rural and urban family physicians leaving the field because of death or retirement.

The pipeline to attract physicians to rural primary care is dysfunctional; rural youth are not recruited to medical school; women, who make up an increasing percentage of physicians, and international medical graduates, are not attracted to rural living.

The report details several private efforts and federal and state policy options that could help increase and sustain the number of family physicians in rural practice including:

Making it more attractive and financially viable for physicians to practice in rural areas through programs such as improved Medicaid reimbursement, practice development subsidies, tax credits for rural/underserved practice, locum tenens support, malpractice immunity for free care, payment bonuses, subsidies for electronic health records, and Medicaid reimbursement of telemedicine.

Increasing the number of medical students recruited from rural communities by providing education and support that would prepare them for medical careers.

Changing medical school curriculum and admission policies to admit more students from rural backgrounds, providing financial support, and helping disadvantaged students get into medical school.

Providing financial support for residency programs that train rural physicians through rural practice training tracks, and focusing on the skills required to succeed in rural practice.

It’s rewarding to see locum tenens recognized as part of the solution to the shortage of rural primary care physicians because, in fact, the locum tenens industry in the US was established to provide respite to rural providers.

In 1976, Therus Kolff, MD, MPH, and colleagues at the Health Systems Research Institute, a non-profit formed by the University of Utah, the Intermountain Regional Medical Program, and the Robert Wood Johnson Foundation set out to develop innovative solutions to rural healthcare challenges. Dr. Kolff led a team that managed 22 clinics and five hospitals in nine western states and served as team leader for Yellowstone National Park Medical Services.

This team realized that their physicians were at risk of quick burnout because they were on call essentially all the time and never felt they could get away from their practices. They decided they needed a “circuit rider” to provide coverage and give these doctors time off with the peace of mind that their patients would be cared for and their practices managed responsibly. Dr. Kolff went on to establish the first commercial locum tenens company in 1979 and is currently a medical director for VISTA Staffing Solutions.

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About VISTA Staffing Solutions

VISTA Staffing Solutions has over thirty years of experience providing award-winning customer service to clients and providers alike. Headquartered in Salt Lake City with additional offices in Atlanta and Houston, and employs approximately 1,000 people between corporate staff and field clinicians and contracts with over 2,500 physicians across 60+ specialties and subspecialties. VISTA helps U.S. hospitals, medical practices, and government agencies optimize their physician staffing, ensure quality and continuity of care for patients, and maintain financial stability. As a leading provider of U.S. Locum Tenens and Permanent Physician Search Services, VISTA also operates VISTA Select, a first-of-its-kind technology and services solution utilizing advanced data and analytics to provide healthcare organizations with customizable workforce optimization solutions.