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Healthcare Crisis in Rural US

It's no secret that health care in the US is in transition and care can be difficult to come by. CNNMoney.com has a nice piece about the struggles in rural health care. As a publication and job board, The Physician Recruiter and TheRecruiter.com can attest that healthcare jobs and physician jobs in rural America are the most difficult to fill. Qualified candidates willing to take these positions are fewer and fewer. Many rural health care facilities are going the J-1 route with their hiring, and not always by choice.

The full CNNMoney article.....

Doctor-starved: America's heartland in crisis.

After closing his country practice Dr. Downs Little, wife Mary and their dog live in a hotel 400 miles from home so he can work part-time at a hospital.By Parija Kavilanz, senior writerMarch 26, 2010: 11:52 AM ET

NEW YORK (CNNMoney.com) -- For one doctor practicing in America's heartland, the new health care law and its incentives to keep doctors on the farm is a start, not a solution, to the medical care crisis afflicting rural America.

"It's good that there will be an increase in Medicare and Medicaid payments to primary care doctors who work in underserved areas," said Dr. Downs Little. "But there is still a lot of work to be done."

For Little, 60, these new measures came too late.

Little, a primary care internist, closed his Lottsburg Va.-based practice on Dec. 31. Lottsburg, located in Northumberland County, is in one of the nation's designated Health Professional Shortage Areas (HPSA).

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The decision to shutter his practice after 10 years left 1,200 patients scrambling to find a new doctor and his wife Mary, a former banker who became his office administrator, three part-time clinicians and a full-time receptionist out of a job.

Up until last year, Little said his "old-fashioned" practice had stayed competitive with the bigger hospitals in the area even though more than 70% of his patients were on Medicare.

Medicare typically pays doctors significantly lower than private insurers for comparable services.

Then the recession hit, badly bruising Lottsburg businesses and eroding jobs. "Our net revenue dropped 28% last year," said Little.

"What kept my business going all these years were the payments from my privately insured patients which subsidized the losses from Medicare," Little said. "I lost half of those patients in 2009 and I couldn't cover my losses and my business expenses," he said.

Downs' situation isn't an isolated one, he warned. "It's being repeated throughout rural America and in many areas that already have a shortage of doctors," he said.

Doctors shun the country life

The shortage of rural physicians is a "huge problem," said Dr. Howard Rabinowitz, professor of family and community medicine at Thomas Jefferson University's Medical College.

"About 20% of the population lives in rural areas but only 9% of physicians practice there," said Rabinowitz who has studied the issue for more than 30 years.

He said insufficient insurance payments, administrative hassles tied to insurance claims, and rising business and malpractice insurance expenses are among the most commonly cited reasons for why rural medicine is losing appeal among doctors.

The United States has about 66 million people living in areas, both rural and urban, that the government recognizes as underserved, according to the Department of Health.

The agency estimates that about 7,438 primary care physicians are needed to bridge this shortfall.

In addition, Rabinowitz said trends at medical schools are further exacerbating the rural medical care crisis.

Fewer people from rural areas are applying to go to medical schools, he said, and about half of the students from rural areas don't want to go back to their communities to practice medicine.

So every time a rural community loses one of its physicians, the impact is severe because these communities can't easily fill the doctor vacancy, Rabinowitz said.

"If five or 10 orthopedic surgeons leave a large metropolitan area such as Philadelphia, my guess is that none of their patients will have problems finding another doctor," he said.

But that's not true in rural areas. "If you lose one doctor in that community, people may have to drive 45 minutes to find another one," he added.

Little's former patients face exactly that scenario. He was the only primary care internist for a community of about 1,500. "The next closest internist is about 45 minutes to an hour away," he said.

"When you lose a primary care physician in a rural area, you lose the core basis of medicine," he said. "A country doctor is the complete physician because we cover a much broader array of medical issues for a community."

Will the new measures fix the problem?

"Nothing will fix everything," said Rabinowitz. "But if things get even marginally better, then people become more optimistic and may look for opportunities, even in rural areas."

At the same time, he said unless rural doctors are better paid, there's little hope of improving their numbers.

Medicare already gives a 10% bonus payment to physicians who provide care in certain types of doctor-starved communities.

Under the new health care legislation, beginning in 2011 and ending in 2015, those same doctors will receive an additional bonus depending on the type of care they provide.

"After 2015, Congress would have to act to make [the bonuses] permanent," said Dr. Lori Heim, president of the American Academy of Family Physicians (AAFP)

Additionally, all primary care physicians will now receive a Medicare payment bonus no matter where they practice as long as more than 60% of the care they provide is primary care in nature, according to the AAFP.

Since closing his practice, Little has been working part-time in other underserved areas.

For the past three months, Little, his wife and their dog Churchill Sunday have been living in hotel while he fills in as a primary care doctor at a community hospital in Bluefield, Va., some 400 miles from their home in Lottsburg.

"The irony is that I am making 50% to 100% more working part-time than I was in my practice," he said.

Healthcare and Hospital Systems Among Leaders For Job Growth Companies

CnnMoney.com is touting the 10 "Best Companies For Job Growth" today. Among their 10 are 3 medical systems. Just goes to show that hospital jobs, whether they are physician jobs, nursing jobs or other medical jobs are in high demand and growing.

Here are the 3 on their list:

6. Scripps Health

Job growth: 15%
U.S. employees: 11,444
2010 Best Companies rank: 40

The San Diego-based hospital system has been growing its workforce consistently over the last few years as the industry overall has flourished along with Scripps itself, thanks to cutting edge programs like robotics surgery and human genetics research.

Scripps currently has about 400 positions open for registered nurses, imaging techs, laboratory and pharmacy staff as well as clerical and support staff. As a large corporation with expanding businesses, Scripps is also recruiting managers and professionals in accounting, finance, information technology, human resources, compliance, biomedical and quality assurance.

8. Children's Healthcare of Atlanta

Job growth: 13%
U.S. employees: 6,536
2010 Best Companies rank: 74

The only children's hospital in Atlanta has grown tremendously, mostly because of a population explosion in the area. "There are just more and more kids to take care of," said Linda Matzigkeit, senior vice president of strategic planning and human resources.

After completing a major expansion last year, the health care provider bulked up its staff of doctors, nurses and nurse practitioners. Matzigkeit says there are plans to add about 30 more physicians and another 50 to 75 nurses this year. In a move to go paperless, technology jobs are also on the rise. "We'll probably add another 40 to 50 in technology in 2010," she said.

10. Meridian Health

Job growth: 12%
U.S. employees: 21,303
2010 Best Companies rank: 79

This central New Jersey-based hospital system showed some healthy job growth last year, in part because of a $300 million expansion at its flagship Jersey Shore University Medical Center. But the entire Meridian system is also expanding in the months ahead as patient volume remains on the rise.

Plans are already in the works to merge with another New Jersey hospital and further grow the Meridian partner sites, which include ambulance services, physicians' practices, occupational health sites, surgery centers and diagnostic imaging. The bulk of the jobs available will be for nurses, pharmacists, therapists, assistants as well as housekeeping, maintenance and food service, according to John Sindoni, senior vice president of human resources.

Top Blogs & Digital Edition

Well our little blog here was named to “Top 50 Blogs for Job Seekers in the Healthcare Field” by the folks at Healthy Hitting:

"Physician Jobs and Healthcare Careers: Learn more about becoming a doctor, as well as other jobs in healthcare. Includes jobs open to physicians."

It's an honor to be recognized for our effort to bring news and information on medical jobs and physician jobs.

Additionally, the latest digital edition of Physician Recruiter is live.

Health Execs Will Be in High Demand in 2010

Not surprisingly, recruiters are predicting that medical jobs will be among the most in demand in the next year. What is a little surprising and encouraging is that most executive recruiters are predicting an increase in demand for their services next year. This is an optimistic sign. Whether it's physician jobs or sales jobs or accounting jobs, if companies are paying more fees to source and hire recruits, it means that the overall job market is improving.

This from MSNCB...

Health care leaders top list of in-demand execs

Report finds more recruiters also expect job market to improve in 6 months

NEW YORK - Health care industry executives are expected to be the most sought-after in the new year, according to a monthly survey of executive search professionals released on Monday.

Health care likely will lead the demand for senior-level staff in the first quarter, followed by clean technology, life sciences, high technology and the energy and utilities industry, according to the survey by ExecuNet, a private network for business leaders.

The report also said that more executive recruiters think the executive employment market will improve. Fifty-four percent expect the market to get better in the next six months, up from 50 percent who said so a month ago,

A reading above 50 indicates increasing recruitment activity. ExecuNet's index has been at 50 or higher for the past four months, after spending much of 2008 and 2009 below the 50 mark, reflecting shrinking demand.

Executives who work in business development, sales and engineering, as well as operations management, face the brightest prospects in the new year, according to the survey.

Recruiters also predicted increased demand for their services in 2010.

Executive search firms predict a 19 percent increase in assignments received from corporate clients, the highest since early 2008, the survey of 153 recruiters found.