Iowa's Challenge: Enticing Physicians “Into the Field”
The Ups and Downs
of Rural Medicine
A rural doctor recently shared his story about a grandmother who was bitten by a snake.
The elderly woman drove two miles to her nearest neighbor, and together they hopped on an ATV to kill the snake before driving to the emergency room.
The doctor asked her if she was sure the snake was a copperhead. “Yep,” she replied, pulling the critter’s head out of her purse.
Medical practitioners who serve rural communities encounter a wide variety of unusual situations and colorful characters, which is one reason they find the job both challenging and rewarding. But in Iowa, the number of rural physicians falls far short of the demand.
State of Emergency
Iowa’s physician shortage is one of the worst in the country, ranking 45th in the nation for physician-resident ratio, according to the Iowa Medical Society. In addition, a 2024 report by the American Association of Medical Assistants (AAMA) revealed that the state retains only 22% of its medical school graduates and 36.5% of its residency graduates.
Travel Subsidies?
A recent University of Iowa study explores another possible approach to addressing the gap in rural medical care. Noting that health care specialists are particularly scarce in rural areas—and getting scarcer—the U of I researchers suggested that these physicians be subsidized for their travel expenses.
In Iowa, specialists typically visit consulting clinics to treat rural residents, but traveling can be costly and time-consuming for physicians in high demand. Paying them for their travel encourages specialists to continue these clinical visits.
Source: Iowa Capital Dispatch
Two-thirds of Iowa's 99 counties are federally designated as lacking in primary care physicians. More than a third (37%) are classified as completely rural, meaning they have no urban population at all.
Earlier this year, Iowa Gov. Kim Reynolds introduced legislation to increase medical access in rural areas. Her plan would expand the number of residencies by 115 and draw down $150 million in federal funding for the new positions, creating around 460 new physician positions across the state in six years. The bill also would double the state's loan repayment programs for any doctor who practices in rural Iowa for at least five years.
Becoming a Center of Attraction
What can Iowa health care executives do to attract medical talent to the state? Rural health management experts suggest a three-fold recruitment approach:
- Appeal to physicians' greater purpose
- Proactively address potential concerns
- Emphasize non-monetary benefits
Appeal to Their Greater Purpose
Delivering much-needed care to rural populations can be extremely fulfilling, ideal for physicians who seek to have a measurable positive impact on their communities.
Highlight the intrinsic benefits of working rurally beyond the clichés of small-town life. (See sidebar below, “4 Reasons to Practice Rural Medicine.”) Collect materials from the local Chamber of Commerce or tourism office and share videos on YouTube and other local websites so candidates can develop a feel for the area.
Address Potential Concerns Head-On
Anticipated heavy workload, lack of continuing education and networking opportunities, and family considerations can present potential concerns. Address these concerns head-on by communicating:
- Available telemedicine programs and technology
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- Any affiliation with regional institutions and practices that offer networking and educational opportunities
- Available telemedicine programs and technology
- Educational and extracurricular options for school-age children
- Local recreational and cultural offerings (even quirky festivals, farmers’ markets, or local breweries)
Promote Non-Monetary Benefits
Attracting talent doesn’t have to be a “show me the money” situation, especially if:
- Working hours can be more flexible than in an urban-based organization
4 Reasons to Practice
Rural Medicine
Impact on Patients: Rural medicine allows practitioners to significantly impact the health and well-being of their communities, where health care access is often limited.
Work-Life Balance: Rural physicians report better work-life balance and lower stress levels than doctors who practice in urban settings, as well as a more affordable cost of living.
Diverse Clinical Experiences: Rural areas expose doctors to a wider variety of clinical experiences, which is often more fulfilling for health care providers.
Lifestyle Preferences: Rural practitioners enjoy a slower pace of life, less traffic, and a feeling of safety within their communities.
- Sabbaticals are available for research or mission work
- Local institutions offer low-interest home loans
- Childcare and spousal employment opportunities are available
Well Worth the Effort
Whether Gov. Reynolds succeeds in her plan to attract more medical talent to Iowa’s rural areas remains to be seen. Most of the rural doctors currently practicing here already know that the blessings outweigh the challenges.
When Storm Lake physician Kyle Glienke isn’t serving his patients, participating in church activities, or coaching kids’ sports, he works the family farm with his father and brother. He believes farming helps him achieve work-life balance.
It’s also a way for Glienke to stay connected to his roots and relate with the experiences and hardships of his patients. Practicing broad-spectrum medicine in rural Iowa has been highly rewarding for him.
“I think I was meant to be a doctor in Storm Lake,” Glienke said. “I have a very strong feeling of purpose here.”
Sources:
Featured Image: Adobe, License Granted
Des Moines Register
Daily Iowan
Iowa Medical Society
Wolters Kluwer
University of Iowa
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