{"id":4954,"date":"2012-03-01T11:43:53","date_gmt":"2012-03-01T17:43:53","guid":{"rendered":"http:\/\/stateimpact.npr.org\/oklahoma\/?p=4954"},"modified":"2012-12-27T13:30:37","modified_gmt":"2012-12-27T19:30:37","slug":"the-cause-and-cure-of-oklahomas-doctor-deficiency-might-be-money","status":"publish","type":"post","link":"https:\/\/stateimpact.npr.org\/oklahoma\/2012\/03\/01\/the-cause-and-cure-of-oklahomas-doctor-deficiency-might-be-money\/","title":{"rendered":"The Cause and Cure of Oklahoma’s Rural Doctor Deficiency Might be Money"},"content":{"rendered":"
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Joe Wertz \/ NPR StateImpact<\/p>\n

Bob Abernathy, a family practice doctor in Cordell, says the lifestyle of a rural physician doesn't appeal to young medical students.<\/p>\n<\/div>

Bob Abernathy has been a physician for about 30 years. He grew up in the country, and enjoys his life and medical practice in Cordell, a town of about 3,000 in the western part of the state.<\/p>

Two of his sons are in medical school, but neither wants to follow their father\u2019s path.<\/p>\n

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AUDIO BY LOGAN LAYDEN<\/h5>\n

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The Abernathy\u2019s are a case study. Rural Oklahoma suffers from a doctor deficiency, and medical officials say the cause and treatment are the same: money.<\/p>\n

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Click above to see an interactive map on primary care health shortages in Oklahoma counties. Nine entire counties have been designated primary care health shortage areas.<\/p>\n<\/div>

There are about 175 doctors for every 100,000 residents in Oklahoma, which is the second lowest <\/a>ratio in the country, data from the U.S. Census Bureau show.<\/p>

When it comes to primary medical care, all but six of the state\u2019s 77 counties have \u201cmedically underserved\u201d populations, according to<\/a> the U.S. Department of Health and Human Services. Nine counties \u2014 in their entirety \u2014 have been designated Health Professional Shortage Areas.<\/p>

The shortage hasn\u2019t gone unnoticed by lawmakers.<\/p>\n

State Aid<\/h3>

The Physician Manpower Training Commission is one of only a few state agencies Gov. Mary Fallin wants to give more money to.<\/p>\n

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Joe Wertz \/ NPR StateImpact<\/p>\n

Donna Jones, an ex-nurse who now owns the Sunshine Cafe in Cordell, says healthcare options are limited for those in rural Oklahoma.<\/p>\n<\/div>

Despite an almost entirely flat<\/a> 2013 budget proposal, Fallin and her administration have proposed<\/a> spending more than $3 million to establish 40 new residency programs to train physicians in rural parts of the state.<\/p>

Currently, Oklahoma has five such residency programs, says Rick Ernest, the commission\u2019s executive director. The proposed funding would increase the commission\u2019s budget by 70 percent, and allow it to double the number of rural residency programs to 10 from five.<\/p>

Training location makes a big different in medicine, Ernest says.<\/p>

\u201cIf you want a rural doctor, you have to train them in a rural area,\u201d he says, citing research showing most doctors end up practicing within 50 miles of where they were trained.<\/p>

Rural residency programs help train doctors who are already committed to the idea of working in a small-town practice. But the symptoms of Oklahoma\u2019s rural doctor deficiency are worsened by medical trends<\/a> seen throughout the country.<\/p>\n

Cash for Commitment<\/h3>

Rural medicine is general medicine, but many young doctors are steering away from primary care and family practice.<\/p>\n

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Russell Kohl, a family practice doctor in Vinita, says state-funded incentives for rural doctors haven't kept up with the cost of medical school.<\/p>\n<\/div>

Pay is part of it, and specialists often have more earning potential than family care doctors. That\u2019s a big deal, because the average medical student graduates with more than $140,000 in student loan debt<\/a>. And most up-and-coming doctors won\u2019t be able to make a dent in that during their years in relatively low-paying residency programs.<\/p>

Oklahoma is so desperate for rural doctors that it\u2019s subsidizing medical students, residents and doctors.<\/p>

One of the programs helps medical students with their loans by giving them $15,000 a year for up to four years. Another gives $1,000-per-month stipends to family practice residents for up to three years.<\/p>

In exchange for loan assistance and stipends, med students and residents must commit to working in rural medicine for as long as they were subsidized, Ernest says. For example, a med student who received two years of loan assistance must practice for at least two years once they become doctors.<\/p>\n

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