2 strategies for reducing physicians shortages in rural areas

Rural communities need more physicians; however, many residents find it difficult to get residency slots, resulting in a "lose-lose situation," the Lown Institute reported Dec.4.

"The mismatch between medical school enrollment, residency slots, and the need for physicians in the workforce has resulted in a lose-lose situation where perfectly competent physicians face barriers to working while simultaneously, entire regions of the country are without sufficient access to physicians," the report said.

The report offers two ways to increase residency slots.

First, increase residency slots through federal and state funding. The federal government funds most residency spots, and funding had remained stagnant for decades until the pandemic. Both California and Texas have approved multimillion-dollar expansions in funding to increase retention of physicians, and a current bill in Congress could increase residency slots by 7,000 in the next few years.

Second, create more avenues for residents who did not place on their first try to find opportunities in rural areas. Missouri passed a law that created a new category of licensure called assistant physicians — medical school graduates who have not yet matched with a residency. Assistant physicians work in underserved areas under the supervision of licensed physicians. The program, though relatively new, has increased the number of primary care physicians in the state by 3%. Other states have taken similar approaches, allowing unmatched medical school graduates to practice while continuing to try to match with a residency. 

The report also recommends increasing the number of licensed medical professionals, such as nurse practitioners and international medical graduates; reducing burnout; and incentivizing trainees to serve in medical deserts.

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