The Impact on Rural New Mexico of a Family Medicine Residency

Pacheco, Mario; Weiß, Deborah; Vaillant, Karen; Bachofer, Sally; Garrett, Bert; DODSON, WILLIAM H.; Urbina, Chris; Umland, Berthold E.; Derksen, Dan; Heffron, Warren A.; Kaufman, Arthur

doi:10.1097/00001888-200508000-00007

Cited by 28 publications

(21 citation statements)

References 12 publications

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“…It has been well documented that individuals residing in rural communities experience exacerbated health issues, requiring a higher level of health care and physician involvement. 5,6 Many physicians contemplating a rural practice fear being overworked by these increased patient needs. Furthermore, the unique rural health care infrastructure may also present a challenge to physicians.…”

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confidence: 99%

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Factors Influencing Family Physician Scope of Practice:

Reitz

Horst

Davenport

et al. 2018

Fam Med

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Background and Objectives: Despite the efforts of many organizations to increase the volume of rural health care providers, rural communities continue to experience a shortage of physicians. To address this shortage, more information is needed as to how specific factors contribute to family physicians’ choice to purse rural full-spectrum practice. Methods: Interviews with 21 key informants guided a grounded theory analysis around the question of “What factors contribute to the decision to, and maintenance of, practicing full-spectrum rural medicine?” Results: Analysis revealed two categories of factors that influenced choice of scope and maintenance of scope across a career: contextual and developmental factors. Contextual factors included the national health care landscape, the local setting, and personal factors. The developmental factors pertained to the point in the physician’s career, and include preprofessional envisioned scope, current scope, and ideal future scope of practice. Conclusions: Results describe how a rural physician’s scope of practice generally narrows as her/his career progresses. The results elaborate on how the larger health care landscape, local community, and personal factors all intersect to inform a physician’s decision to pursue and/or continue practice. Results of the study were consistent with preexisting literature, but provide additional depth and suggest a theoretical relationship among factors.

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confidence: 99%

“…Furthermore, the unique rural health care infrastructure may also present a challenge to physicians. [5][6][7] In rural areas, physician reimbursement, both in private practices and hospitals, is lower and often delayed, creating more stress for the physician. 5 All of these barriers decrease the likelihood of a physician's choice to practice rural medicine.…”

mentioning

confidence: 99%

Factors Influencing Family Physician Scope of Practice:

Reitz

Horst

Davenport

et al. 2018

Fam Med

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“…The Department in New Mexico is recognized as an innovator in rural medicine, in community-based medical education, 3,4 and in service to rural and marginalized populations. [5][6][7][8] Most of these innovations have focused on increased access to primary care.…”

Section: S23 He a Lt H Co M M Ons In Ne W Me X Icomentioning

confidence: 99%

“…Data demonstrate that students and residents who have learned in these sites are 2 to 3 times more likely than other students to practice in comparable sites after graduation. 4 …”

Section: Service-learning Modelsmentioning

confidence: 99%

“…These models double or triple the rate of retention of graduates who practice in underserved sites. 4 6. Sustained funding: The investment in building the Health Commons sites and service, initiated with $2 million in federal funds (from the Health Resources and Services Administration's CAP) over 4 years, led to products that are highly attractive to public and private funders.…”

Section: Lessons Learnedmentioning

confidence: 99%

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The Health Commons and Care of New Mexico's Uninsured

Kaufman

Derksen²,

Alfero³

et al. 2006

The Annals of Family Medicine

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PURPOSE A seamless system of social, behavioral, and medical services for the uninsured was created to address the social determinants of disease, reduce health disparities, and foster local economic development in 2 inner-city neighborhoods and 2 rural counties in New Mexico. METHODSOur family medicine department helped urban and rural communities that had large uninsured, minority populations create Health Commons models. These models of care are characterized by health planning shared by community stakeholders; 1-stop shopping for medical, behavioral, and social services; employment of community health workers bridging the clinic and the community; and job creation. RESULTSOutcomes of the Health Commons included creation of a Web-based assignment of uninsured emergency department patients to primary care homes, reducing return visits by 31%; creation of a Web-based interface allowing partner organizations with incompatible information systems to share medical information; and creation of a statewide telephone Health Advice Line offering rural and urban uninsured individuals access to health and social service information and referrals 24 hours a day, 7 days a week. The Health Commons created jobs and has been sustained by attracting local investment and external public and private funding for its products. Our department's role in developing the Health Commons helped the academic health center (AHC) form mutually benefi cial community partnerships with surrounding and distant urban and rural communities.CONCLUSIONS Broad stakeholder participation built trust and investment in the Health Commons, expanding services for the uninsured. This participation also fostered marketable innovations applicable to all Health Commons' sites. Family medicine can promote the Health Commons as a venue for linking complementary strengths of the AHC and the community, while addressing the unique needs of each. Overall, our experience suggests that family medicine can play a leadership role in building collaborative approaches to seemingly intractable health problems among the uninsured, benefi ting not only the community, but also the AHC.

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Closing the Gap: Finding and Encouraging Physicians Who Will Care for the Underserved

Bennett

Phillips²,

Teevan³

2009

AMA Journal of Ethics

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Geographical distribution of U.S. physicians does not promote equitable access to health care. In 2006, nearly 75 percent of U.S. counties or partial counties were designated Health Professional Shortage Areas (HPSAs), meaning that the population-to-physician ratio in these areas exceeded the minimum (3,500:1) considered necessary for adequate access [1]. Meanwhile, experts estimate that, in aggregate, non-HPSAs have a surplus of more than 70,000 physicians [1]. Though HPSAs may be urban or rural, the problem is particularly acute in rural areas. While 21 percent of Americans live in rural areas, fewer than 10 percent of physicians practice in these areas [2]. As a result, rural residents (and the urban underserved) receive fewer preventive services and suffer from worse health outcomes [3,4]. There is debate over whether a physician shortage is imminent, but the evidence for physician maldistribution is clear [1,5,6]. Equitable access to health care is threatened when physicians disproportionately practice in urban and suburban areas.

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The Impact on Rural New Mexico of a Family Medicine Residency

Cited by 28 publications

References 12 publications

Factors Influencing Family Physician Scope of Practice:

Factors Influencing Family Physician Scope of Practice:

The Health Commons and Care of New Mexico's Uninsured

Closing the Gap: Finding and Encouraging Physicians Who Will Care for the Underserved

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