Hospitals and healthcare providers across the U.S. are facing a severe shortage of qualified doctors.
A 2017 study commissioned by the American Association of Medical Colleges found that the United States will see a deficit numbering between 40,800 and 104,900 by 2030.
Nowhere is the shortage more pronounced than in rural areas where nearly 20 percent of the U.S. population lives but only ten percent of physicians practice.
The reasons for the shortfall may range from physician reluctance to give up the creature comforts of urban areas for the more limited amenities found in small towns, to the fear of burnout due to the increased workload, to the stigma that doctors in rural areas aren't as competent as their urban complement.
Regardless, the need for emergency medicine physicians has never been greater. In this post, we outline six benefits you can accrue by working in a rural ED. We hope that what you read may entice you enough to give up the bright lights of the city in favor of a more bucolic, yet equally fulfilling, small-town way of life.
Benefits of Working in a Rural ED
1. Better Standard of Living
While it's feasible to conclude you may make more money working in a metropolitan hospital, the cost of living in rural America is often much lower, which means your standard of living can be higher. For instance, you can afford a larger home and more property than you could living in the city. Not only that but crime rates are typically lower, traffic is much less, and the lifestyle is decidedly more family-friendly.
2. Student Loan Forgiveness or Repayment
It's likely that you accumulated debt during your time in medical school. Working in a rural hospital is one way to offset that. Many states offer financial incentives to physicians willing to work in rural areas, including loan forgiveness and repayment — an amount that increases the longer you remain in the setting. Check the Rural Health Information Hub website to see a list of qualified providers.
3. Expand Your Breadth of Experience
The lack of nearby specialty hospitals or clinics could mean you perform procedures you might not otherwise when working in an urban market.
You will learn to serve a variety of roles, too, from primary care physician to pediatrician to dentist to OB/GYN and more. Also, because the percentage of the population in rural areas skews higher, you will see more older adults with chronic conditions.
Not all the care you provide will be emergent either. Yours may be the only facility where patients can see a doctor anytime day or night, all of which means you’ll get the opportunity to expand your breadth of experience and advance more quickly.
4. Practice with Greater Autonomy
In rural hospitals with a limited number of physicians, you get the opportunity to practice with greater autonomy where you are the ultimate decision-maker. You will learn to be a “jack of all trades” and manage aspects of care that you would not in settings with a wider variety of available services. If independence and self-sufficiency are important to you, a rural setting may be the way to go.
5. Become a Valued Community Member
You can make a more significant impact on the hospital’s community reputation and patient satisfaction in a rural setting than in a more populated area. You become a familiar face and valued member of the community, trusted and appreciated by the patients you serve.
Unlike urban medical centers, where you are just another physician in the rotation, you will connect personally with your patients, many of whom you will see time and time again, not only in the hospital but outside of work as well. Your patients will become friends with whom you build cherished, personal relationships for years to come.
6. Provide More Personable Care
Because rural EDs may be less busy than their urban counterparts, you can spend more time with your patients, getting to know them on a personal level. You learn of their struggles and invest in their care to a degree that may not be possible in an urban hospital.
Challenges of Working in a Rural ED
While the benefits of working in a rural ED are several, we would be remiss if we didn’t at least mention some the challenges: inadequate staffing, lack of resources or support, difficulty recruiting, and higher turnover to name a few.
These are not insurmountable, however. Even though the number of on-site physicians is limited (perhaps to even one), support is available through the following means:
NPs and PAs
Nurse practitioners and physician assistants play a vital role in patient care thanks to the lower cost of staffing and ease of recruiting (as compared to physicians) — factors particularly salient in a rural setting.
Virtual scribes work off-site and communicate with providers via a headset. The scribe has firewall access to the EMR and can record the doctor's encounter with the patient in real-time.
Because the scribe is not physically following the provider, they can look up and report lab results as the doctor enters a patient’s room and capture the relevant findings required for appropriate documentation and coding. This gives the doctor more time to spend with the patient addressing his or her needs.
The use of telemedicine can help smaller rural facilities fill the need for hospitalists to take care of patients after they leave the ED. Telemedicine is ideally suited for small-to-medium-sized facilities with an average daily census of fewer than 60 patients. Also, the fact that doctors have a faster way to obtain licensure thanks to a compact created by the Federation of State Medical Boards makes the use of telemedicine all the more feasible.
The need for emergency medicine physicians to fill roles in rural hospitals has never been greater. The benefits are numerous, and the challenges are manageable.
If achieving a better standard of living for you and your family, paying off student loans more quickly, gaining a fuller breadth of experience, or any of the other benefits listed are meaningful to you, then perhaps a career as a rural ED doctor is worth considering.