Rural Recruiting in 2021: The State of Rural Recruiting

By: John Mehall, MD

In part one of our series, “Rural Recruiting in 2021”, we present the current landscape of rural medicine, examining rural physician employment trends, the financial impact of COVID-19 on rural hospital operations, and how underserved populations living in these areas are impacted by the scarcity of physicians within these regions.

Access to high-quality healthcare services for rural Americans continues to be dependent upon an adequate supply of rural physicians; despite efforts to meet shortages in these markets, there continues to be a glaring lack of physician coverage for rural areas.

In sparsely populated rural regions, often geographically isolated with fewer than 500 people per square mile, more than 50% of the population lives in an area where the ratio of primary care doctors to patients often exceeds 1:3,500, when the national average is around 1:2,300. Further highlighting this shortage, while about 20% of the U.S. population lives in rural regions, rural physicians comprise only about 10% of the total number of working physicians in the country.

Sparse population, extreme poverty, high proportions of racial and ethnic minorities, and lack of physical and cultural amenities characterize rural communities most likely to suffer from a shortage of physicians. Residents in these areas are likely to be older, poorer, and in worse health than city dwellers, with a lower life expectancy, and they are more likely to be uninsured. Faced with a variety of socioeconomic obstacles, this already vulnerable population is hit the hardest; limited access to physicians reduces access to preventive care and exacerbates unmet health needs, leading to costly hospitalizations and poor health status.

While the public health implications due to a lack of rural physician coverage are certainly significant, the financial consequences are just as daunting and have never been higher. In fact, since 2010, a whopping 132 rural hospitals have shuttered, with 17 rural hospitals closing in the first three quarters of 2020 alone. COVID-19 has made matters worse, stopping hospitals from performing lucrative elective outpatient procedures that allow them to stay in business, with nearly one out of every four open hospitals showing early warning signs that indicate they are also at risk of closing in the near future.

As rural communities struggle continuously to recruit and retain physicians, this physician shortage is only projected to get worse - the New England Journal of Medicine predicts that by 2030, the number of practicing rural physicians will fall by nearly 25%.

Rural Recruiting in 2021
In our eBook “Rural Recruiting in 2021”, we address some of the main obstacles faced by rural hospitals in their hiring strategies, cover the post-COVID-19 recruitment landscape, and equip recruiters, physician leaders and executives of rural hospitals with strategies and best practices to develop an effective and scalable recruitment strategy for 2021.

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3 Rosenblatt RA: The health of rural people and the communities and environments in which they live. In Geyman JP, Norris TE, Hart LG, eds: Textbook of rural medicine. New York, McGraw-Hill, 2001:3-4.