What's Up Doc?

I live in a fairly small city with a population of about 40,000.  The nearest large city is 90 miles away, a 90 minute drive.  Between my city and that large city, it is mostly wide open spaces. 

We have many doctors, but not many specialists.  We have one hospital – or as they call it, a Regional Medical Center.  As I and thousands of others in the “baby boomer” generation grow older, we will likely have more need for Cardiologists, Gastroenterologists, Orthopedic Surgeons, and more.

I just learned that my Pulmonologist, the only one in the city, is leaving the state next month.  My OB/GYN left the city a couple years ago.  Now we have only one remaining.  We have two gastroenterologists, one of whom is near retirement age.       

Many physicians do not want to practice in cities with a poor economy.  While many rural areas are in economic decline, because we have a large military base, our city has not suffered quite as much as most small cities or the rest of the nation.  So the economy is not really a factor here.

A survey conducted a few years ago revealed that only 4 percent of medical residents ranked communities with fewer than 25,000 residents as their top choice of where to practice. More than half chose to practice in areas less than 10 miles from their residency programs, which are overwhelmingly located in big cities.  While our population is higher than 25,000, it certainly cannot be called a big city.

I recently learned that in many specialties, the highest earners are found in towns of 50,000 to 250,000 in size, not in the largest metropolitan areas.  There is less competition; insurance company reimbursements are actually higher in small to mid-sized cities; and the cost of practicing is lower in these cities.  Fewer malpractice law suits are generally filed in smaller cities, making the cost of malpractice insurance lower as well.

Sub-specialized physicians – those who need to be part of a major medical center with advanced equipment and every specialty at their fingertips – do not fit into this higher-income category.  With those specialists, their patients travel to them, and income and competition are not affected the same as most primary specialties.

I have taken that 90-mile drive to the “big city” to see various specialists over the years I have lived here.  As I get older, I have become more concerned about this lack of specialists.   Since they could actually earn more, or at least spend less to practice here, why do we have fewer physician specialists?  From everything I have read, it may be less about money, and more about proximity to family, fine dining, cultural availability (the arts) and various other reasons unrelated to the economy.

So for those of us living in my city and many other rural communities, we have a choice of moving to a bigger city or continuing to drive great distances for medical care.  For many, neither option is possible, making it a frightening situation for many poor and elderly residents.

*************************

To learn more about Julie Klein and Xpress Healthcare, please visit http://LearnMoreAndApply.com