Lawmakers Could Offer Incentive to Recruit More Rural Doctors
Lawmakers could reimburse medical students who take jobs in rural communities for five years.
Pershing General Hospital is where many Lovelock residents get their health care. The town of less than 2,000 residents is about 90 miles from Reno. Like many of Nevada's small towns, it is difficult to hire more doctors. It has two doctors and one physician's assistant. Officials say they would like to double that.
"We have a nurse shortage right at the moment," Patricia Bianchi, CEO of Pershing General Hospital said. "We need a physician in the clinic at the moment. We need an emergency room physician. It's constant recruitment."
Bianchi says the hospital is doing well, financially, but that rural hospitals spend more money on supplies and shipping than larger ones. Keeping doctors can also be a challenge because they cannot pay the large salaries that urban hospitals can.
"That's one of the biggest complaints I have from patients out here is that they don't have providers who stay for very long," Dr. Kamin VanGuilder, Pershing General Hospital said.
Assembly Bill 358 would encourage new doctors to move to small towns for work. If passed, graduates from the UNR or UNLV Schools of Medicine could get the tuition portion of their student loans reimbursed by the state. In exchange, they would have to work in the rural areas of Nevada for five years.
"In the state of Nevada as a whole, we're ranked 47th in physician recruitment and the rurals are actually twice as bad in trying to recruit," Assem. Gregory Hafen II, R-Pahrump said.
Rural hospitals are struggling across the country. Since 2010, nearly 100 rural hospitals have closed down. That includes the Nye Regional Medical Center in Tonopah.
"We're seeing medical facilities actually close down because they don't have the physicians or the staff or anything else to man them," Hafen said. "Tonopah is a great example. We have been struggling to try and man that facility and we haven't been able to do it."
Hafen says some rural residents have to drive four to six hours to get medical treatment. His goal is to get more doctors into the rural areas.
Joseph Lewis is a first-year student at the UNR School of Medicine. He says he likes the idea of a loan repayment plan because he expects to rack up some debt, in order to become a doctor.
"Loan repayment is a big issue for a lot of medical students right now," Lewis said. "You get your MD and that's awesome but you end up owing a lot of money at the end that isn't repaid for, honestly, decades."
Lewis is part of the university's rural outreach program. He has worked in areas like Dayton and Silver City.
"If we're able to combine those two and make it something that will keep physicians in Nevada after we graduate, I think that's a worthwhile thing to add," Lewis said.
Rural residencies are also available as far away as Elko and Wells. The Association of American Medical Colleges says 77 percent likelihood that students who complete a rural residency in Nevada will stay in the state for work.
"I believe those are areas that going out there and living in are worthwhile and something I can see myself doing in the future," Lewis said.
Many agree that a loan repayment program would only encourage more people to do the same.
"It's a way for them to get a portion of their loans forgiven, paid back, and get exposed to the rural communities that they may or may not be familiar with and they may fall in love with it and want to stay," Hafen said.
VanGuilder received a similar loan repayment program. She is in her fourth year at Pershing General Hospital. She says rural areas provide different opportunities. She says family practitioners in cities usually deal more with medicine than procedures but that small hospitals allow her to do both. That provides variety and valuable experience. She also likes working in Lovelock.
"I enjoy small towns," VanGuilder said. "I'm kind of a small town girl but I really enjoy the community, the faculty, the staff."
Bianchi says living in a small desert town is not for everyone. Lovelock does not have shopping malls, movie theaters, bowling alleys or a golf course. She says it has a lot of other positive aspects though including the schools, community atmosphere, and recreation.
"If they are an outdoors person and like to horseback ride or motorcycle ride or bike ride or go to Tahoe and ski, then this is what's attractive to them," Bianchi said.
Lewis says he thinks the legislation would help health care in smaller communities, and says it could also encourage small-town kids to pursue a career in medicine, possibly moving back to their hometowns when they finish medical school.
AB358 is currently in the Assembly Ways and Means Committee. The legislative session has less than five weeks left.