At Capitol, plans abound for addressing rural health care

Bob Jeske grew up on a farm and always wanted to practice rural medicine. But it didn't hurt that a state program covered some of his student loans to do just that.

State lawmakers in both parties want to expand the program that takes a big chunk out of Jeske's $182,500 in medical school debt. Their plan is one of many approaches to solving a looming shortage of doctors and other health care professionals expected to hit hardest in rural Minnesota.

Estimates of how many doctors Minnesota will lack over the next decade range from 800 to a few thousand. That doesn't include the dentists, nurses and others an aging population will likely require.

Some areas of the state are already hurting. Northwestern Minnesota has about one doctor for every 770 people, according to the state Department of Health, compared with one for every 342 people in the metro area.

"There's a lot of demand," said Rep. Debra Kiel of Northfield, and not just for physicians. "I've got directors of nursing not only serving in their job, but they're also filling in for shifts at night, on the weekends."

Kiel, a Republican, is sponsoring a bill to expand the program that benefits doctors like Jeske to public health nurses, dental therapists and mental health workers who commit to spending three years in a rural area after they finish school. Senate Democrats included a similar bill in the first batch they introduced this session. Gov. Mark Dayton, a former pre-med student, has said he's "very receptive" to such a proposal.

Jeske works at the Mayo Clinic in Waseca. He'll receive about $100,000 through the program, half of which comes from the Minnesota Medical Association. The program's funding over the past few years is down from years before.

Sen. Greg Clausen, DFL-Apple Valley, wants to nearly quadruple the loan forgiveness program's funding with a $3 million infusion. That would open up 200 new slots, he told a Senate committee last week.

Some say the Clausen and Kiel bills don't go far enough. They want general surgery residents, dental therapists and chiropractors added to the list.

Others have floated separate proposals they say could curb the coming shortage in health care workers.

A task force created by the Legislature says removing barriers for doctors trained abroad who want to practice in Minnesota would add at least 250 physicians to the workforce.

Task force member Mimi Oo said immigrant doctors are better able to serve minority communities.

Oo practiced medicine in Burma for more than a decade and worked as a United Nations physician in Uganda. But she couldn't practice medicine in Minnesota because she had been out of school for too long by the time she arrived.

"We would like to be a solution to this problem," she said. "But we're not allowed to."

Jeske doesn't see himself leaving outstate Minnesota. That's common among participants in the state loan forgiveness program, one reason why proponents say expanding it is a good idea.

Working in a rural area comes with unique challenges, Jeske said, but it also has its high points.

"It's a job where if you want to, you can get yourself ingrained in the community," he said. "You go out to the grocery store or restaurant and you see a lot of your patients."