Community paramedics, one solution to growing rural doctor shortage

Many small clinics and hospitals in rural Minnesota have a hard time recruiting primary care doctors. In part that's because fewer medical students choose primary care as their focus. And those who do are in high demand.

That situation may get tougher under federal healthcare reform, which makes the story about community paramedics on Morning Edition today by MPR News' Tom Robertson, all the more significant.

At a rural healthcare conference in Duluth in June, Bill Finerfrock, executive director of the National Association of Rural Health Clinics in Fremont, Michigan, said some provisions of the federal law will lead to more demand for primary care doctors and could pit urban and rural areas against each other.

"The workforce issue is especially concerning from a rural perspective," said Finerfrock. "If I look at Massachusetts, they did health reform and the mandate dramatically increased the demand for health care but there was no expansion of the workforce. That led to delays in appointments and to services."

He noted that healthcare reform does contain provisions designed to increase the number of primary care doctors, but "those are going to take several years before they produce the kinds of providers we need. Demand is going to occur much sooner than the system's ability to provide the providers we need. We will see an effort to recruit, to take providers from rural communities to work in cities." He said urban jobs may be more appealing than rural jobs because the hours could be shorter and the pay greater. "We're running the risk of seeing a migration of providers from rural to urban areas."

The lack of primary care providers has led some to look for new healthcare solutions, like the use of specially trained paramedics to look after basic health needs. They're called "community paramedics" and according to Robertson's report, we could see hundreds across the state in the near future. You can hear his story here.

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