A targeted Rx for rural health care

Opinion Editor’s Note: editorial Represent the views of the Star Tribune Editorial Board, which operates independently of the newsroom.

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Few things are more fundamental to Minnesotans’ quality of life than access to medical providers. That’s why it doesn’t take long for alarm bells to ring when we dive into the data collected by the state health department’s Department of Rural Health and Primary Care.

While health care workers across Minnesota are grappling with burnout and retirement, the problem is especially acute outside the metro area, where the average age of doctors is a decade older than their urban counterparts — 58 vs. 48.

According to the Office of Rural Health’s 2022 Chaos Analysis, “one in three rural physicians plan to leave their profession within the next five years, exacerbating existing shortages.”

Another data point underscores concerns about the need for more doctors. Per capita, far fewer doctors are already serving rural areas of the state than urban areas. The population-to-physician ratio for urban areas is 245. For rural areas, it is 894.

There isn’t a cure-all for this workforce crisis. But a sensible solution is to train more physicians interested in practicing outside the Twin Cities. Fortunately, a new proposal between the University of Minnesota Medical School and CentraCare, a St. Cloud-based health system, aims to achieve just that. Appropriate response: “How can we make this happen?”

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Last week, the two organizations announced they are working to open a new branch of the U’s medical school in St. Cloud to recruit doctors interested in practicing in a small town or rural setting. As the Star Tribune reported on January 16, it will be the state’s “first new medical campus in 50 years.” While cost details are still emerging, it’s a timely, innovative idea.

Minnesota already has three physician training sites. The Mayo Clinic in Rochester has a medical school, and the U of U has two medical school locations — one on the flagship Twin Cities campus and another in Duluth, which opened in 1972.

The Duluth campus is already well known for its focus on primary and rural health care. If the new St. Cloud Medical School campus opens, which would require approval from the U’s Board of Regents and CentraCare’s board, it would have a similar required focus.

The collaboration will play to the strengths of both organizations. The U trains 70% of practicing doctors within the state. CentraCare’s hospital-and-clinic network will provide valuable hands-on training for students and graduates.

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It is hoped that students attracted to the new campus will bring an inherent interest in rural or small-town practice. And that they will build community ties to the area while they complete their education and training, making them less likely to leave.

Statistics provided by the organization support this approach. An impressive 81% of medical school graduates who have gone through CentraCare’s family medicine residency program in the past seven years are practicing in Minnesota. Of these, 59% are in rural areas and 73% are outside the seven-county metro area.

Among graduates from Duluth Medical School campuses, 63% live in Minnesota and 44% work in communities with a population of less than 20,000.

CentraCare will house the new campus in a remodeled building once used by information technology workers who now work remotely. The St. Cloud location is also logical. The designated “health professional shortage area” for the primary care blanket is mostly outer Minnesota. But they have a disturbing concentration in central and western Minnesota.

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Stearns County, where St. Cloud is located, and the eight counties that border it either have deficit areas, or the entire county has been designated as a deficit area. The problem is particularly acute in counties north and west of St. Cloud. Here it is wise to create a pipeline for education and training of students. The new campus could open as early as 2025, with 20-24 students enrolled in each class.

The initiative has garnered national acclaim. “Challenges in accessing care in the nation’s most rural communities contribute to health care disparities for patients. Building new medical school campuses that provide training opportunities and expand the number of physicians who can treat patients in underserved communities is an important part of addressing and improving rural health disparities, ” said Dr. Jonathan Jaffrey, chief healthcare officer of the Association of American Medical Colleges.

The employment shortage is greater than that of doctors. Other approaches are needed to increase the ranks of nurses, pharmacists, mental health providers, and other caregivers. But U and CentraCare leaders set out a targeted, effective remedy. It deserves the support of Minnesotans as it moves toward becoming a reality

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