- 90% of physicians in rural areas are Family Doctors
- If you took all family docs out of non-shortage rural areas, 70%
would become shortage areas
- Family docs are best equipped to meet varied needs of rural population
How does one make it work?
1) One can really shape their practice to what they enjoy doing. The
speaker has done her own C-Sections.
2) Also, although it's hard to hide from patients, patients are
incredibly loyal. People care for one another and there's time for
building relationships
3) Can implement the "Medical Home."
4) You get to see the big picture. See patients at little league,
picnics, etc. So you get to treat the disease and the whole patient.
5) Marriage between docs is possible, but not easy.
6) Reimbursement is just as good as or better than urban colleagues.
Higher for a hospital-owned clinic. Clinic refers back to
hospital...stay local and supports hospital.
7) Call limitations. Used "Docs who Care" to supplement on call. Can
be reduced to as little as once per week and one weekend per month.
8) More mid-level practitioners. Can get two mid-levels for the price
of one doc. Can really support each other and complement each other's
work.
9) How to get here? Choose your learning path and don't lose your
focus. Pay attention to all rotations as you will be applying all
skills and lnowledge that you gain. Choose residencies/experiences to
best prepare you for being the "only" doc in town.
10) Choose your town wisely. Know who you are, who your spouse is, and
who your children are. Visit without them knowing you're there. Get a
feel for the lay of the land.
Some myths about Rural Practice:
- you will be poor
- you will be paid in livestock & pie
- you will always be on call
- you have to do everything
Little foxes to watch for when choosing career path:
- Know your personal limits. Your marriage and family must be more
important than medicine at all times. There's a high divorce rate.
"Medicine is a jealous mistress." Patient is friend and friend is
patient. Need to define roles in different settings. Can be very
difficult to handle this balance.
- Know the boudaries of you medical knowledge. Have a good referral
team. Find the people you are comfortable working with.
- be wary of benefits/incentives
- You will be expected to be a leader in your community. This can be a
reward for some and a challenge for others.
Questions from audience:
Q: Do you have to pay more for malpractice insurance if you have a
greater scope of practice?
A: Yes, but it depends on the state
Q: Why did you reduce your scope of services?
A: Personal priorities and comfort level. It's important to define
your own niche.
Q: What are challenges in moving from big to small towns?
A: Speaker had a process of adjustment. Greatest challenge was not
having restaurant and other cultural opportunities. There's evidence
to show that docs that come from urban setting have larger retention
in rural setting than those that come from rural setting.
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Review:
Overall, this session was valuable for busting myths about rural
practice. I think a lot of people remove this possibility without even
investigating or testing the water. In today's connected world, I
imagine that rural practice is increasingly rewarding for those who
are afraid of losing touch with the urban culture. Rural USA also
presents a huge opportunity for social justice work. You can make a
huge difference in your community. You can be on the school board and
create policies that directly affect your pediatrics patients on a
systems level. The challenges presented are similar to international
health and are encmpassed in "global" health. How can we tell others
how to do things without doing things right at home?
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