Most rural American communities have a shortage of practicing physicians, dentists, pharmacists, registered nurses, and other medical personnel. Nearly 82 percent of rural counties are classified as medically underserved areas.

Only 11 percent of clinically active physicians, who graduated from medical school between 1988 and 1997, practice in rural areas. Nearly 30 percent of rural registered nurses are over 55, while the median age of rural physicians is 48. More than half of rural general surgeons are over 50.

These aging trends among health care practitioners are exacerbated by medical professionals choosing to practice in urban communities and in lucrative specializations. This national trend is particularly harmful to rural areas since rural health care is largely dependent on primary-care practitioners.

In 2008, only 20 percent of Physician Assistant program graduates started in family practice, the lowest ever with declines expected to continue. While 33 percent of Nurse Practitioners begin primary care careers, the percent retained in primary care has declined at 1 to 2 percent per year and likely will continue to decline under current health care policies.

Lower pay, longer hours, and a more stressful work environment all contribute to the decline in rural, primary-care practice. As a result, rural people are becoming less healthy, have fewer family physicians, and the resulting lack of preventive care contributes to more serious (and more expensive) medical problems down the road.

As Congress debates health care reform, it is crucial that solutions to these unique rural challenges be found. Perhaps more importantly, new methods of financing health care must not worsen the rural health care shortage by providing even more economic disincentives to rural, primary-care medical professionals.

The “health care for all” rallying cry must mean more than universal access to health insurance. For rural Americans it must also mean access to qualified medical professionals.

Contact: John Crabtree, 402.687.2103 x 1010 or johnc@cfra.org for more information.