Kansas Health Institute | Information For Policy Makers. Health for Kansans.

ST. FRANCIS — “Without the loan repayment programs, it makes things a lot more difficult for recruiting,” said Les Lacy, administrator at the Cheyenne County Hospital in St. Francis.

St. Francis is 180 miles from Denver, 180 miles from Hays, and it is a 35-mile drive to the next closest hospital, not to mention the nearest Wal-Mart.

“Recruiting is so difficult we continue to recruit even when we’re full. We’re always trying to source candidates and establish relationships with people in residency programs,” Lacy said, explaining why he considers government incentives encouraging health care providers to work in rural areas so important. “These kinds of recruitment incentives are vital to us.”

New federal money included in the American Recovery and Reinvestment Act to expand current recruitment programs could help Lacy keep staff members

“We’ve got two physician assistants who have been here for a year or two, but because of the ARRA money and what’s happened with the National Health Service Corps, they’re both candidates for the loan repayment program now,” he said. “I’m really very pleased about that.”

The loan repayment programs help attract medical workers to places like St. Francis. But Lacy said he also tries hard to identify providers who grew up nearby or in similar rural areas.

“From a workforce perspective, it’s important to have people from this area in these training programs,” he said. “As time goes by and things get more difficult, and I think they will, it’s probably the only way we can get staffed. We can get people in here from outside of the area, but they typically don’t stay.

“Having someone here for two or three years may be the model we have to rely on, and it’s better than going without service, but by far the best thing is to have long-term stability with providers who live in the community.”

Continued support important

Dr. Rick Kellerman, chairman of the Department of Family and Community Medicine at the University of Kansas School of Medicine in Wichita, said state and federal loan repayment programs have been “quite effective” in attracting providers to rural and underserved areas.

“They haven’t solved the problem, but without them we’d be in a much worse position,” he said.

Kansas is already starting to see decreases in the number of providers in rural areas. It’s a problem that Kellerman and others anticipate will worsen in the next two to three years as a generation of the state’s current physicians reach retirement age.

Retirement wave coming

“We are seeing, at least in family medicine, that the ages of our doctors parallel baby boomers,” he said. “Within the next two to three years we will see an increasing number of retiring family physicians. We’ve already seen this happen as they approach age 65. Several have reported slowing down.

“We’re very concerned about it, particularly in rural areas. The first wave of baby boomer physicians has started to hit (retirement),” he said, “and we expect that to continue into the next few years.”

And even as retirement approaches for many Kansas providers, the slumping economy is putting new pressures on some of the facilities, such as safety net clinics, that are most reliant on workers funneled to them by the incentive programs,

“Especially in times like these, the numbers (of safety net patients) are going to keep going up,” said Robert Stiles, director of the Primary Care Office at the Kansas Department of Health and Environment’s Bureau of Local and Rural Health. “These clinics are really struggling to meet the increasing needs created by a difficult economy.”

Stiles’ office is getting another boost thanks to an ARRA-funded program. For each of the next three years it will receive $37,795 from a separate ARRA-funded HRSA program at the federal Health Resources and Services Administration. The money will be used to hire a part-time employee to help recruit health care providers.

-Sarah Green is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. She can be reached at sgreen@khi.org or at 785-233-5443, ext. 118.