A question on rural health....

[Beau Geste]

I'm curious -

I understand rural primary care to include FPs, Peds and GPs, (maybe OB/GYNs?), but what other specialties are there that could allow you to work in a rural population?

Thanks!

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[tiredmom]

How rural are you talking? Most Ob/gyn's don't want to be the sole-practitioner in town. I'm from rural east Texas, where my hometown of 80,000 is very medically advanced for the area... multiple hospitals, large MD practices of nearly every specialty outside ones you only see at large university centers. Most of the small towns around it (think 1,000-10,000 pop) have a few FPs. If you need a hospital based practice (like ob) you need a hospital nearby that you can get to quickly. Good luck.

 

[Beau Geste]

I guess mostly in rural Illinois you have the small towns (<10,000) but a lot of towns (> 5,000) have hospitals. So I'm curious if you could specialize in, say, neuro, gas, rads, etc. (those more hospital-based positions that could also have clinics) and still stay in more of a "rural" population. Now, by "rural" I mean cities of 50K or less that are not suburbs of a major city. For example, I would probably consider Carbondale-Marion IL rural because there are about 50K people between the 2, but the surrounding areas are VERY rural (<5k towns) and the closest major city is St. Louis that is 2 hours away.

My definition of rural may not be the same as a med school's though but I can't think of a better "label" - "hometown" medicine? I don't know, but hopefully you guys can get the gist of what I'm talking about

 

[pingouin]

I guess mostly in rural Illinois you have the small towns (<10,000) but a lot of towns (> 5,000) have hospitals. So I'm curious if you could specialize in, say, neuro, gas, rads, etc. (those more hospital-based positions that could also have clinics) and still stay in more of a "rural" population. Now, by "rural" I mean cities of 50K or less that are not suburbs of a major city. For example, I would probably consider Carbondale-Marion IL rural because there are about 50K people between the 2, but the surrounding areas are VERY rural (<5k towns) and the closest major city is St. Louis that is 2 hours away.

My definition of rural may not be the same as a med school's though but I can't think of a better "label" - "hometown" medicine? I don't know, but hopefully you guys can get the gist of what I'm talking about

There's a big need for psychiatrists in rural areas. Sometimes the mental health issues are worse than in urban areas due to lack of resources (no transportation, money, social service agencies) and treatment (few providers, those who are around are at capacity) at the onset of symptoms. A lot of times more specialized treatment is needed than what PCPs are comfortable providing.

 

[DireWolf]

Derm.

A great example is the town I went to college in. Population of 18K. One derm in town. His waiting list to get in was 9 months.

 

[TX515]

GP+surgery

 

[Beau Geste]

Thanks, guys. I was just curious of the possibilities. I know adcoms like to ask what kind of specialty, but I think so early in the stage I'm more concerned with where I want to practice, but of course, I could change my mind once I get to med school

 

[Doctor Bagel]

There's a big need for psychiatrists in rural areas. Sometimes the mental health issues are worse than in urban areas due to lack of resources (no transportation, money, social service agencies) and treatment (few providers, those who are around are at capacity) at the onset of symptoms. A lot of times more specialized treatment is needed than what PCPs are comfortable providing.

just what i was gonna say. my brother does med/peds in a town with about 10k people, and psych is a huge, huge need. of course, psych's a huge need in portland, or, so maybe that's true everywhere.

to the original question, if you're thinking of practicing in a town with like 50k people, i think you could do anything. i grew up in a town with around 40k people (not a suburb), and we had a cardiologist, a dermatologist (he's sort of crazy, though, so people leave town to see other dermatologists), anesthesiologists, oncologists, orthopedic surgeons, etc.

 

[Doctor Bagel]

Derm.

A great example is the town I went to college in. Population of 18K. One derm in town. His waiting list to get in was 9 months.

so true. the nutty derm in the town i grew up still makes tons of money, even though every doctor in town will tell you see someone else. also, i went to college in a town of 45k, and it took me a good four months to get in to see the one dermatologist in town.

 

[scpod]

Now, by "rural" I mean cities of 50K or less that are not suburbs of a major city.

I live about 25 miles from one of those just under 50K "rural" cities. Actually, in my state, there are probably less than 10 cities with more than 50K people. Anyway...this city has two hospitals, one with a level two trauma center, the other is a level three.

Here is a sampling of the number of listings from the Yellow Pages:

Physicians and Surgeons- MD and DO
Allergy- 2
Anesthesiology- 2
Cancer- 7
Cardiovascular Diseases- 25
Cardiovascular Surgery- 5
Child Psychiatry- 1
Dermatology- 7
Diabetes- 1
Endocrinology- 3
Family Practice- 39
Gastroenterology- 5
General Practice- 1
General Surgery- 11
Gynecology- 15
Gynecology & Obstetrics- 21
Hand Surgery- 1
Hematology- 3
Impotence- 2
Infectious Diseases- 3
Internal Medicine- 30
Maxillofacial Surgery- 1
Nephrology- 7
Neurology- 5
Neuro Surgery- 8
Obstetrics- 4
Opthalmologic Surgery- 1
Opthalmology- 9
Orthopedics- 7
Otorhinolaryngology- 2
Pain Management- 3
Pediatrics- 8
Physical Medicine & Rehab- 2
Plastic Surgery- 8
Psychiatry- 9
Pulmonary diseases- 5
Radiology- 2
Reproductive Endocrinology- 2
Rheumatology- 3
Sports Medicine- 4
Thoracic Surgery- 3
Urological Surgery- 2
Urology- 9
Vasular Surgery- 10

Keep in mind that there is some overlap, but there are also cases where only the practice is listed and not all the physicians. For instance, I know that there are seven doctors in the single "Hand Surgery" category and one of the orthopedic practices (counted as one) has six doctors. There are several anesthesiologists at the single practice listed, but I don't know how many.

There aren't too many specialties that aren't covered. You can do just about anything in a "rural" city of your specifications.

 

[tiredmom]

I agree... areas of around 50K should be able to sustain most practices. The academic center specialties I've heard of tend to be most peds specialties... peds rheum, peds cards, peds neuro, developmental peds, etc. When my dad moved to our hometown (which was around 60K when he started practice ~30 yrs ago), he was the first rheumatologist in town (and the only until the last 10 yrs), there were <8 surgeons, ~20 generalists, ~8 peds... now the town is ~80K and has >300 doctors.

 

[Beau Geste]

Wow! And cool... It's nice to know that my interests won't be too limited by population size. Thanks for answering my question you guys!

 

[pingouin]

What about allergy/immuno or endocrinology? I'm just thinking that the hospital I work for has outpatient clinics for both allergies and diabetes, and I know that some people drive 2-4 hours each way (including from Carbondale) a couple of times a year for clinic appointments.