Fifteen percent of Americans live in rural areas with limited access to healthcare. In part due to the limited access to care, the same group is more likely to suffer from strokes, heart disease, accidental deaths and chronic lower respiratory disease, according to the CDC.
"They also have higher rates of poverty, less access to healthcare and are less likely to have health insurance," the CDC states. "All of these factors can lead to poor health outcomes."
Not only that, but disparities in access to healthcare and public health services for this population also frequently include issues like geographic distances to services, infrastructure limitations and provider shortages for these areas, according to the Rural Health Information Hub.
The major gaps in healthcare for rural Americans are not new, but some physicians say new approaches to addressing them may be key. Could international education for physicians help transition more into becoming rural healthcare providers?
Two physicians, G. Richard Olds, MD, president of St. George's University on the island of Grenada, and Vijay Trisal, MD, chief medical officer at Duarte, Calif.-based City of Hope, think so.
In a Feb. 6 opinion piece published by North Forty News, Dr. Olds said COVID-19 made already difficult healthcare situations for rural populations worse. That, combined with the fact that the country is facing a growing physician shortage, calls for new solutions — some that look at encouraging medical school education within rural communities and some that look to the outside.
"Medical graduates from rural communities are far more likely to practice in places like their hometowns than those from more populated areas," Dr. Olds wrote. "The second [solution] is to look beyond U.S. borders — to international medical schools — for the next generation of rural physicians. … In low-income areas, many of which are rural, more than 42 percent of doctors are international grads."
Additionally, in a Dec. 26 podcast interview with Becker's, Dr. Trisal explained that the U.S. could do well to streamline medical education and reduce costs to address provider shortages as is done in other countries, like India.
"When I grew up, 95 percent of the colleges were all government colleges. So there was not this, 'Hey, you can pay money and get in,'" Dr. Trisal said. "Even the folks who were in the most downtrodden areas who could not pay had as much ability to get into a good medical school as somebody who had billions of dollars. So that, in itself, created an environment where you have a great group of people here in the United States who would want to go to medical school, but because of the limitation of how much it costs will not choose to go. … There are good medical schools in India, good hospitals in India that are private hospitals where you can pay and get the best care that is available anywhere in the world."
A report from the Center for American Progress points out that while internationally trained physicians can be a solution to rural care shortages, many times international physician graduates are immigrants, and even though rural areas can and do benefit from their care, there are many barriers that can get in the way of them being able to be a provider in rural areas.
"Federal laws do allow these underserved communities to benefit from immigrant doctors, but the current path for immigrant doctors to practice anywhere is paved with a patchwork of federal immigration policies and mismatched state licensing regulations that do not truly work in anyone's best interests — neither those of the physicians nor those of the underserved rural communities," Silva Mathema, PhD, a senior policy analyst of immigration policy at the Center for American Progress, wrote of the report's findings.