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ABSTRACT Finding healthcare professionals and support staff to work in rural areas is challenging and may become more difficult in the future. Traditional approaches to recruiting and retaining rural healthcare workers have not been unequivocally proven effective, particularly with respect to remote rural areas. Even if effective strategies exist, the changing demography of rural areas and the realities of the current U.S. economy may make them quickly outmoded. New strategies must include technology use, and include immigrants and groups previously overlooked for recruitment to the health professions. | key words: rural healthcare workforce, education, physician shortage, recruitment, nurse practitioners, physician assistants
The changing demography of rural areas and economic realities mean new strategies are needed to attract healthcare workers.
The rural areas of America have fewer than half the physicians, per 10,000 people, of their urban counterparts, and remote rural communities fare even worse. Shortages of nurses, therapists, nurse aides, and other healthcare providers also plague rural communities (Rural Health Information Hub [RHIhub], 2018). The current upswing in the U.S. economy may indirectly affect these rural healthcare shortages, but this effect will be transient. Consistent major challenges are preparing, recruiting, and educating rural residents to enter the healthcare field.
Here it is important to note that studies of the rural healthcare workforce often fail to address differences among rural communities. Use of the term "rural," when referring to communities, covers a spectrum: from those in close proximity to urban centers to those situated in remote frontier areas. Approximately half of rural residents live in completely or mostly rural counties. The other half live outside cities in the 1,253 mostly urban counties (U.S. Census Bureau, 2016)-locales that differ dramatically in their demographic trajectories, socioeconomic characteristics, and healthcare access from the more remote rural areas.
This article focuses on worker shortages in the more sparsely populated counties, locales where these shortages are endemic and, in many cases, becoming more intractable.
Landscape of the Rural Healthcare Workforce
Difficulties with recruiting and retaining rural physicians are not new. Since the 1990s, approximately forty U.S. medical schools have developed rural tracks or concentrations with clinical training opportunities in rural areas, rural-focused lectures, and other incentives.
East Tennessee State University and Louisiana State University rank highest in placement of rural...