RURAL HEALTH: Program Steers MDs To Underserved Areas
A medical school program designed to lure new physicians to rural and underserved areas has successfully eased a shortage of small- town doctors, according to a study published in the current issue of the Journal of the American Medical Association. The Physician Shortage Area Program (PASP) at Thomas Jefferson University in Philadelphia steered 34% of 206 medical students participating in the program to underserved areas between 1978 and 1991, as compared with 11% of graduating non-PASP students. As a result, PSAP graduates now account for 21% of Pennsylvania's rural doctors, "even though they represent only 1% of graduates" from the state's seven medical schools. Lead study author Howard Rabinowitz found that program retention remained high among the graduates, with 87% of those practicing rural medicine five to 10 years ago remaining in the same practices today and 94% continuing to practice in underserved areas.
The authors emphasize that the "shortage of physicians in rural areas of the United States is one of the most persistent health policy problems in this century, with serious implications for access to care." Noting that medical students raised in rural areas are more likely to practice medicine in such regions, the authors call for state and federal financial incentives to prod medical schools to create similar programs and encourage student participation (Rabinowitz et al., JAMA, 1/20 issue).
The authors note that the results are particularly significant because they show the success of an urban medical school at placing rural doctors. Dr. Roger Rosenblatt, vice chairman of family medicine at the University of Washington, agreed, noting that "most private institutions don't consider this something they should tackle" (Robrish, AP/Los Angeles Times, 1/19). The authors point to their findings as evidence that "medical schools can have an important role in meeting the needs of the public. Similarly, policymakers and educators who are committed to addressing the rural physician shortage can institute programs ... to achieve these goals in a highly effective and long-lasting manner" ( Reuters Health/Fox News, 1/19).