This question has been one that I have pondered and thought deeply about for many years. As a small-town native of Minnesota, returning to practice medicine in a small town has always been my dream. As the years have passed, I have watched many medical professionals come and go from my hometown, often only staying for one or two years before moving on. This is not only disheartening as a prospective employee, but discouraging and disruptive to all those patients within that health system. In a time when patients are more complex and comorbid than ever, continuity of care is beyond important. We know that rural America is no exception to this and, in fact, is more of the rule.
So, what can we do to keep good doctors in small towns? The answer is complex, but the mission is not impossible.
First of all, focusing attention on the bright, young, aspiring medical professionals early on should be at the top of the list. We know that practitioners who grew up in rural areas are much more likely to return to these areas and, most importantly, stay. Rural health systems should be using this to their full advantage, working with local high schools, community colleges, and even middle schools to foster connections early. Helping them achieve their goals will only increase their desire to pay it forward and work for the place that helped them become who they are.
Secondly, rural health care institutions should not just focus on hiring the provider but must consider the provider and their entire family, as well. How far away do their in-laws live? What activities are their children involved in? What are their spouse’s hobbies? All these factors will greatly contribute to the provider making rural their home for the long run. On-site visits should be a must, as it is the perfect time for the institution to put its best foot forward and display the features that not only the hospital system, but also the community, have to offer for a potential employee. This means showing prospective physicians the schools, potential real estate options, a good restaurant and, perhaps even more so, inviting the patient’s family to join in this experience. Rural health care institutions are not just hiring a provider; they are hiring them and their family.
A significant piece of what drew me to my future practice in rural Minnesota was the ability to make critical decisions within a growing healthcare institution that very clearly valued physician quality of life. One of the greatest assets a successful rural healthcare institution has is its ability to integrate healthcare providers’ feedback into the way the institution is run. In the times we are living in, burnout is higher than it has ever been, and with thousands of providers leaving the field since the pandemic, things are not looking up for us. When an institution sees this, and proactively allows its providers to work to a level that they feel comfortable with without repercussions, happiness is found. My future job will allow me time to spend with my family, travel, and still do what I love — something that I’ve never seen offered in a large academic institution. I will work three-day weeks and, if I choose to work more, I will make more. This model of practice allows professionals to feel that by having time off, they are not not meeting the expectations of an institution. Instead, this model asks professionals to take time off, and rewards them should they decide to increase their time worked.
If rural hospitals and healthcare systems used these strategies to recruit the right people the right way, I truly believe that patients would have a better chance of thriving, and rural healthcare systems would continue to grow. When time and family are valued, it reaps benefits for everyone. Though this model will not work for everyone, it is certainly something to consider and aspire to.
For more information on what your health system can do to promote rural provider retention rates, visit RuralCancer.org.
Emily Westergard, DO, is a fellow in hematology and oncology who will be starting her practice at Lakewood Health System in Staples in September.
