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Rural Areas Face Healthcare Crisis

November 20, 2006

Madeline Vann

Louisiana's famous crops include sugar cane, cotton and ... doctors? If Richard Streiffer, professor of family and community medicine, has his way, Louisiana will grow a new crop of primary-care physicians to serve in rural areas.

At the end of the summer, AmeriCares gave the Tulane Rural Medical Education program (TRuMEd) $100,000 to continue its efforts. Primary-care doctors in Louisiana are aging, says Streiffer, and are not being replaced.

Rural areas in particular have a hard time attracting physicians at all, resulting in a widespread "health professional shortage area" designation across most of rural Louisiana. Current data indicates that one out of four rural Louisianans has no access to a primary care physician.

"Family physicians are the group most likely to choose to work in rural practices," Streiffer says, "and students from rural areas who want to return to those areas are the best candidates to eventually become rural family doctors. Hence, our program works to identify young people at the undergraduate level who have the intent to practice rural family medicine. We have a selective admissions process for them to enter medical school and then they are exposed to rural medicine issues throughout their medical education."

The program was initially funded by a federal training grant. Streiffer says the damage from Hurricanes Katrina and Rita exacerbated the lack of primary-care physicians in all parts of the state, competing with the critical need in rural areas, and making the TRuMEd program even more important.

"We cannot afford to further delay the long 'pipeline' in producing rural physicians. Hence, we intend to regain the momentum of TRuMEd with support from AmeriCares," says Streiffer.

Rural populations are sicker, older, poorer, more often medically uninsured and face greater distances to obtain health care, meaning that their need for access to health care is often challenged when compared to urban populations.

"Ultimately, it's the rural poor and elderly who will benefit the most when they have more family doctors in their areas to take care of them. It's also good for the local economy. It is not easy for a rural community to retain or attract new jobs when health care is not available locally."

One of the new program goals to be supported by the AmeriCares grant, according to Streiffer, is to work with community leaders in several areas of the state to begin developing local recruitment efforts as well as financial resources for potential medical students at the local community level.

"Local leaders who are invested in seeing a bright future for their small community may be in the best position to help us identify and then help to steer and financially support promising young people into a career in rural medicine," says Streiffer.

Tulane University, New Orleans, LA 70118 504-865-5000