How volatile is a rural practice

[JackADeli]

So, I have been looking at rural type heath care hospitals. I was wondering, if anyone has any experience, how volatile is it to the hospital if a major industry declines/departs? What I am thinking about is for example WV. A good number of the communities are heavy coal mine industry. The Cap & Tax bill (I don't know anything specific) is reportedly going to impact coal mining industry. So, If I am employed by a rural hospital as a surgeon, and coal industry declines.... , will the hospitals float....

I see some of these proposed salaries being extremely high (because rural) as compared to other markets. I am just wondering if these rural health systems are state/fed subsidized in a manner to withstand a local decline of industry? What kind of questions should I ask the CEO? I would hate to get a 1yr guarantee and effectively be locked in for 3 years. Then, I find myself in the midst of a major industry decline and the hospital go under or etc....

Well, all above is fairly rambling but I hope the general idea/questions are discernable and someone might have some experience.

JAD

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[EdibleEgg]

I'm not sure globally, but just after I signed the contract in my current position, the largest employer in the town went into bankruptcy with 100% job loss (approximately 1000 jobs lost in a town whose total population is less than 30,000). Hospital volume has remained relatively the same, and in some respects has increased. I've slowly become busier, and I have a pretty good mix of private insurance. I think a couple of the surgeons are slow, but it's really designed that way (over recruited to keep call managable) and they are all employed. I think the bottom line is things are pretty bad economically for the town (somewhere just under 20% unemployment), but I think I'll still be able to earn after I'm weened from the hospital (I'm meeting the guarantee at six months).

 

[JackADeli]

Thanks for replying...
I was always interested in this as it seemed some of the most lucrative offers were for some of the most rural underserved areas....

 

[nd92]

Most rural locations in the United States have already reached rock bottom, so the economy is pretty much based on retirement income and government jobs. The good thing about that is the economic downturn in recent years had little effect on these areas. In regards to West Virginia (where I am located), coal has ceased to be a major factor in employment. The mines have become so mechanized that there are relatively few people actually employed now as compared to 30-40 years ago.

In many ways, a rural area is much more financially stable since it is supported by the factors I mentioned above. Of course, if you are investigating an area where there is a single large factory such as an auto plant that is verging on closure, then you need to be concerned. Most other rural areas (especially in the coal/steel industry) have already dealt with these closures and have reached a steady-state economic situation.