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[Cheshyre]

Why does everyone hate rural medicine? Particularly rural family medicine. It would be a shame to choose a school because of an interest in this field only to later regret it.

Who's everyone?

If you want to talk about a patient perspective, then yes, I dislike rural medicine. Coming to college (Country boy in the big city! Out-of-place plaid shirts! A drawl that I never noticed before!) showed me that healthcare was so much better elsewhere.

From a healthcare provider's perspective, there are only a few reasons I can think of for not liking rural family medicine:
1) It's rural. If you're not from a rural area, I can imagine how it would be ungodly painful to live there. There aren't clubs or bars, no massive movie theaters or malls, and more likely than not, there's not going to be a Whole Foods. If you're thinking about your kids, they'll grow up in safe environment. People don't close their garage doors, they don't lock their bikes up. Everybody waves at each other. On the other hand, your kids probably won't have access to a rigorous (and competitive) academic environment that will help prepare them to enter highly regarded colleges. The pace of life is much slower.
2) The usual reasons that make primary care unattractive to many people.

It's late and I've spent all day eating cake. I have no idea what I just wrote. Go easy on me if something is glaringly off.

 

[Drrrrrr. Celty]

Why does everyone hate rural medicine? Particularly rural family medicine. It would be a shame to choose a school because of an interest in this field only to later regret it.

Because most people like CIVILIZATION
lol but yah.. Idk personally I grew up in the suburbs and have been in the city. When I go to the country, I go nuts.. Nothing intelligent to do. People live too far from each other. Idk not my cup of tea.

 

[PunkmedGirl]

Because most people like CIVILIZATION
lol but yah.. Idk personally I grew up in the suburbs and have been in the city. When I go to the country, I go nuts.. Nothing intelligent to do. People live too far from each other. Idk not my cup of tea.

I didn't know rural communities had savages.😱

 

[beckhunter116]

I was fortunate enough to shadow a DO that previously had done rural medicine and was now in the suburbs, so I took the opportunity to ask questions about it. He had 2 main points:

He said rural towns are very leery or strangers, most of the people have lived there their whole life, if not generations there, and they may not trust a new person. You may end up being the 'outsider'.

Also, when you are the only Doctor in a certain time/mile range every problem comes to you and you don't have the luxury to refer them to other people most of the time b/c they don't have access to that type of specialist. In the suburbs and cities, there are plenty of specialist to send patients to and they can easily get there. In a rural community that may not be the case.

 

[Cheshyre]

He said rural town are very leary or strangers, most of the people have lived there their whole life, if not generations there, and they may not trust a new person.

Eh. I grew up in a town of... ~1,200 or ~9000, depending on how you look at the town boundaries. Not always true. If you lived somewhere even smaller, I can see that being possible.

 

[beckhunter116]

Eh. I grew up in a town of... ~1,200 or ~9000, depending on how you look at the town boundaries. Not always true. If you lived somewhere even smaller, I can see that being possible.

I'm sure not every rural town is leery of new people, he just cautioned this when thinking of rural medicine.

 

[Cheshyre]

I'm sure not every rural town is leery of new people, he just cautioned this when thinking of rural medicine.

Yeah, I'm just bored and feel like being picky right now.

 

[FutureCTDoc]

When you're doing rural med there is less access to specialty and subspecialty care. This may be a plus or minus. Consults may be done via telemedicine. Pathology shipped out to the nearest city etc. Doing rural FP can be tough as you are isolated from many of your peers. You may find it harder to get your spiritual needs met. Try and find a synagogue or mosque in a rural town. If you're doing rural G Surg, you must truly be a general surgeon. Meaning doing procedures that a G Surg in the city wouldn't have to.

 

[Daedra22]

Some people love the small town life. I grew up in a small town (<6k people), and moved to Dallas... I will never go back. Living in the city is fantastic. However, most people I knew from home are staying in the country... it has its appeals, but it really depends on your priorities and what you enjoy. I would not recommend setting your heart on rural medicine unless you have spent a significant quantity of time in a small town.

 

[Biology101]

Why does everyone hate rural medicine? Particularly rural family medicine. It would be a shame to choose a school because of an interest in this field only to later regret it.

because it is in rural areas?

 

[Morsetlis]

Try being one of three docs on a navy/airforce base on an island in the middle of nowhere. Population of 4000. Then they take away one doc to make budget.

I hope family medicine includes brain surgery for when they get hematomas from accidents!

 

[beckhunter116]

Try being one of three docs on a navy/airforce base on an island in the middle of nowhere. Population of 4000. Then they take away one doc to make budget.

I hope family medicine includes brain surgery for when they get hematomas from accidents!

One of the really cool things about FM is that you do get to do so many different rotations, so you learn a little about everything. I think you would probably only get exposed to neurosurgery for a portion of your surgery rotation, but if it was something you were really interested in that's what electives are for during a residency.

Note* I'm not saying that a FM physician will be performing neurosurgery, just that you do get exposure to it during a FM residency.

 

[MLT2MT2DO]

Why does everyone hate rural medicine? Particularly rural family medicine. It would be a shame to choose a school because of an interest in this field only to later regret it.

I'm actually really interested in primary care in a rural area. I have watched the town I grew up in go from ~15k people to ~100k, my current town has outgrown me. Of course I seem to be an anomaly in this case.

 

[Styria]

Why does everyone hate rural medicine? Particularly rural family medicine. It would be a shame to choose a school because of an interest in this field only to later regret it.

Not everyone hates rural medicine. It has more to do with lifestyle, kind of like why some people want derm.

To deal with some misperceptions in this thread, though...

1. Just because an area is rural does not mean there's no access to a city. A small city might only be half an hour away, and most of what you need you'd only have to go into its suburbs for anyway. You don't have to go far from a city to qualify for underserved area loan repayment programs.

2. There are bars in rural areas. Clubs too - American Legion posts, VFW, Moose, Elks, whatever clubs, etc. They all have bars in them for their members. Don't assume every club is a nightclub.

3. Lack of Whole Foods is balanced by people who actually grow their own food. Enough that they'll share surplus with you, which also beats Whole Foods.

4. Children in rural areas travel a little farther, but go to good schools and end up in good colleges. It's the inner-city schools that do most of the failing. Rural children are usually more independent. They're not any less intelligent than the people living in cities.

5. Some rural economies are based on tourist activities. Vacations, hiking, biking, rafting, mountain climbing. If you want an adventurous lifestyle, that's available too.

 

[Mister T]

Why does everyone hate rural medicine? Particularly rural family medicine. It would be a shame to choose a school because of an interest in this field only to later regret it.

Because I hate corn, the smell of cows, the only attraction site being Wal-Mart (and KFC if you're lucky), and of course, "that townie."

 

[Daedra22]

Not everyone hates rural medicine. It has more to do with lifestyle, kind of like why some people want derm.

To deal with some misperceptions in this thread, though...

1. Just because an area is rural does not mean there's no access to a city. A small city might only be half an hour away, and most of what you need you'd only have to go into its suburbs for anyway. You don't have to go far from a city to qualify for underserved area loan repayment programs.

2. There are bars in rural areas. Clubs too - American Legion posts, VFW, Moose, Elks, whatever clubs, etc. They all have bars in them for their members. Don't assume every club is a nightclub.

3. Lack of Whole Foods is balanced by people who actually grow their own food. Enough that they'll share surplus with you, which also beats Whole Foods.

4. Children in rural areas travel a little farther, but go to good schools and end up in good colleges. It's the inner-city schools that do most of the failing. Rural children are usually more independent. They're not any less intelligent than the people living in cities.

5. Some rural economies are based on tourist activities. Vacations, hiking, biking, rafting, mountain climbing. If you want an adventurous lifestyle, that's available too.

What you describe sounds idyllic. There are some towns that have the qualities you speak of, but the small towns I grew up around were poor (45% of the children were in poverty, 35% unemployment, major child abuse problems), had terrible schools, bad air quality (due to the burning of rice fields--asthma was extremely common) and only a few people farmed their own food, instead using extra land to grow crops to sell to big companies. It entirely depends on where you go. Rural areas need doctors regardless of how "nice" they are to live in... but there are definitely good small towns and bad ones. One should not go into rural medicine expecting a happy small town with joyous children and boutique farmers.

 

[Dr Yiot]

because I get lonely and sometimes if I want to go to applebees past 10 oclock for some half priced boneless buffalo wings, I don't want to drive an hour to get some.

 

[MJB]

Nothing intelligent to do.

Quite possibly the most ignorant thing I've ever read on this board...and that's saying something.

It's ironic too, considering the rest of the original post.

 

[beckhunter116]

because I get lonely and sometimes if I want to go to applebees past 10 oclock for some half priced boneless buffalo wings, I don't want to drive an hour to get some.

 

[beckhunter116]

What you describe sounds idyllic. There are some towns that have the qualities you speak of, but the small towns I grew up around were poor (45% of the children were in poverty, 35% unemployment, major child abuse problems), had terrible schools, bad air quality (due to the burning of rice fields--asthma was extremely common) and only a few people farmed their own food, instead using extra land to grow crops to sell to big companies. It entirely depends on where you go. Rural areas need doctors regardless of how "nice" they are to live in... but there are definitely good small towns and bad ones. One should not go into rural medicine expecting a happy small town with joyous children and boutique farmers.

+1. Yes, there are some small town that are probably that nice...that's why there are post cards of those places and they do have a tourist industry going on there. However, they are probably twice as many towns that are are the opposite. In essence they have no industry in that town hence the rampant poverty.

I agree that every town needs access to quality healthcare, whether it be a small city or an urban mecca.

 

[ShyRem]

I actually wouldn't mind rural medicine.

However, I can tell you there are definitely places that are leery of strangers. Where I am now folks don't understand why I don't want to stay and do residency here and practice here. I tell them about the wariness, the "unfriendliness" for lack of a better word. They freely admit to it... seem proud of it... and say "well, if you're here for 20 or 30 years then we'll decide if we like you." Lemme see... you want me to stay in a place for 20 or 30 years, be your doctor while you decide if you "like me" enough to be friendly and this is supposed to entice me to stay here? I express that sentiment and they say "well, when you put it like that..." 🙄

Now on the other hand, not every place is like that. I've been in some small rural places that are very nice and friendly where I would absolutely love to be someday. Not rich rural places, just friendly. Friendly doesn't have anything to do with rich. We'll see where life takes me.

 

[Lynndaleena]

I want to give my perspective on this as someone who plans on going into rural primary care and as the daughter of a rural primary care physician.

When our family was young, my parents decided to move us from the suburbs to the country so my dad could take over a Family Practice clinic in rural Indiana, in the middle of corn fields (our county still doesn't have any stoplights!) And it was a pretty big adjustment, including only 1 grocery store nearby and it was still a good 10 min drive away. But what I have discovered from not only watching my dad practice but hearing what people tell me about my dad is that it is so rewarding to practice in rural areas. My dad has seen so much stuff he did not see while in the city, where people would just go to specialists. And for an example (things like this happen often) one day not too long after we moved there, my mom was sitting in a little coffee shop waiting for the car to be fixed and there was a group of old men sitting around and one stood up and proclaimed to the rest of the group that the new doctor saved his life (not realizing who my mom was) and he would be dead if it wasn't for my dad. Yeah, if you don't like the idea of being a local celebrity, don't go into rural medicine 🙂 It can also be pretty hard work, people calling at home with problems or coming up to him in the grocery store to ask him about problems, you just have to learn how to deal with that kind of stuff while still being friendly. And being one of the few doctors around (1 of 4 in a bi-county area) he definitely spends a lot of time working, but like I said, it's definitely rewarding.

And yes, sometimes people are not very accepting to new people in their community, but with a little effort, people will start to accept you. And remember to return the welcoming favor to other new people in town.

To address the kind of people living in rural areas.... yeah, there may be a lot of people who didn't go to college or whatever, but these are the people who are working on farms growing your food, or working in factories making the stuff you buy. Sure it's not a glamorous life, but that doesn't make them worth anything less. Also, a lot of intelligent people grow up in these areas, just because they don't live in the city doesn't make them any less intelligent, I hate when people get the elitist attitude that if you're smart you'll move out of the country. Some people like the rural life, including me, and I can't wait to start a rural practice once I get done with my schoolin' 🙂

If you can't tell, I'm a little passionate about this....

 

[Cheshyre]

This is my reply, since some of these seem to be aimed at my post.

2. There are bars in rural areas. Clubs too - American Legion posts, VFW, Moose, Elks, whatever clubs, etc. They all have bars in them for their members. Don't assume every club is a nightclub.

Of course - unless you live in a 'dry' area, there are going to be places to get a drink. On the other hand, I've never gone back home and gone to a bar. They're.. not exactly places I'd want to ever go to. Frankly, they look like places where people drink to find the bottom of a bottle.

Plus, I'm pretty sure you can't just go to an American Legion post.

3. Lack of Whole Foods is balanced by people who actually grow their own food. Enough that they'll share surplus with you, which also beats Whole Foods.

True. I was writing for the city-dwellers who might be thinking of going into the country. I have no need or love for WF, and my family had a garden large enough to offset about a third of our grocery costs. To get more exotic items (such as ethnic groceries), my family would throw a couple coolers in the car and head off to the nearest big city. It'd take up a Saturday, but I loved those trips.

In any case, it'll be harder to say "wow! I want some real vanilla beans / high-quality balsamic vinegar / prosciutto! / doban jiang / $20 gruyere", and simply drive out and get some. Is it a big deal? Not for me, but I can imagine that it would be for some people. That was my point.

4. Children in rural areas travel a little farther, but go to good schools and end up in good colleges. It's the inner-city schools that do most of the failing. Rural children are usually more independent. They're not any less intelligent than the people living in cities.

Who said rural children were unintelligent? Yes, rural children are generally more independent, and in my eyes, they generally (read: generally) have more common sense regarding daily living.

In any case, I assure you that a high school in a wealthy suburban area is going to send more kids to elite colleges than my farm town high school. There's going to be less offered in terms of AP courses as well. Is it possible to make it out? Of course, so long as you aren't aiming for Harvard. I made it into Johns Hopkins, WUSTL, and Northwestern myself.

The academic culture of a rural high school may be much less competitive. Considering the atmosphere of elite colleges, I find that kids from said wealthy suburban areas experience less of a culture shock if they get there.

Again though, hard work equalizes most things at the high school level. It's just that it seems like in more urban areas, kids get exposed to more regarding preparing for college / what you should be doing once you get into college. In my town, it was difficult to find people who had gone down the pre-med track and could help me with what to expect. On the other hand, in the suburbs near my college, it seems that everybody has a sibling or neighbor who's gone to a good college and can explain what needs to be done to be successful in pre-law/health/engineering/whatever.


I thoroughly enjoy rural life and am seriously considering eventually ending up there again. There is a sense of community that will never be replicated in an urban setting. It's calm. There's essentially no violent crime and almost nothing in the way of burglaries / theft. I'm an avid cyclist and in urban areas, cars will buzz so close that I can check if my teeth are clean. Back home, people are used to dodging tractors rolling at 20 mph, so, it's no big deal to pass me. You most likely won't have to worry about your kids doing coke at school. On the other hand, what I've listed in my posts are all things that people who haven't spent significant time in rural areas have to think about before committing to practice there. Things are different.

 

[JeetKuneDo]

Because I'm Chinese, I can't really see too many Ranch 99's or dim sum restaurants in rural places.

 

[Lynndaleena]

Because I'm Chinese, I can't really see too many Ranch 99's or dim sum restaurants in rural places.

Actually, we don't have any chain restaurants, but we do have a locally owned little Chinese buffet in our little town (like quite little, only around 3,000 people)! It's kinda nice though when you want Chinese but don't feel like driving 45min to a bigger town... Still might not be what you want, but you'd be surprised what you might find in these small towns.

 

[Morsetlis]

I wonder if rural towns are more likely to be racist toward Asians. My doctor told me that this is one of the reasons he didn't practice in the town he grew up in.

 

[Cheshyre]

I wonder if rural towns are more likely to be racist toward Asians. My doctor told me that this is one of the reasons he didn't practice in the town he grew up in.

As an Asian who grew up in a small town -

Eh.

Of course, especially during elementary - high school, there are always going to be a certain number of idiots. Bruce Lee, chink, the pot/pan thing - I've pretty much heard it all and I'm willing to bet most of the Asian kids on SDN have as well. It's not too big of a deal, and I can't imagine that it wouldn't happen in a city. Also, one of my Caucasian friends said that if she ever dated an Asian, her dad would be less than approving. Again though, I'm sure that could happen in a city as well.

If you lived somewhere with a racist background, then perhaps it could be a bigger issue. On the other hand, I know Asians who live in the most backwater parts of Tennessee and Arkansas and still fare pretty well, so, maybe not. I guess you'll just have to visit the town you're interested in and find out.

The only time I've ever been shocked was when I was volunteering at a hometown hospital cafe (they start all new volunteers there). While I was busing tables, an elderly woman said "Chang! Chang!" to get my attention. When her younger companion (around 40ish) corrected her, she just said "Ching Chang Chung, all the same." The looks on the other people at the table were hilarious.

 

[FutureCTDoc]

One other reason no one wants to go into rural medicine is that it is generally primary care with its attendant poor compensation. Most people really don't relish the thought of 80 hour weeks, awful call schedule and making 120K. Rural areas lack the cultural advantages of a city. There are no plays, limited ethnic cuisine, limited options in terms of houses of worship. Life in a rural town isn't that wonderful. If you have kids and want them to get a high powered high school education prepare to send them to boarding schools as many communities don't offer the APs and IBs that suburban districts do. Be prepared for poverty. In many rural areas the rate of poverty meets or exceeds that of the inner city. I grew up in a semi-rural area. I have contemplated rural practice and have found it to be too confining in terms of the ability to practice a specialty or subspecialty. However if you really love that lifestyle and are willing to put up with the issues of an aging and declining rural population good luck.

 

[MLT2MT2DO]

One other reason no one wants to go into rural medicine is that it is generally primary care with its attendant poor compensation. Most people really don't relish the thought of 80 hour weeks, awful call schedule and making 120K. Rural areas lack the cultural advantages of a city. There are no plays, limited ethnic cuisine, limited options in terms of houses of worship. Life in a rural town isn't that wonderful. If you have kids and want them to get a high powered high school education prepare to send them to boarding schools as many communities don't offer the APs and IBs that suburban districts do. Be prepared for poverty. In many rural areas the rate of poverty meets or exceeds that of the inner city. I grew up in a semi-rural area. I have contemplated rural practice and have found it to be too confining in terms of the ability to practice a specialty or subspecialty. However if you really love that lifestyle and are willing to put up with the issues of an aging and declining rural population good luck.

Actually if you do a bit more research, being a rural PCP usually pays quite a bit better than a PCP in a city.

 

[Cheshyre]

One other reason no one wants to go into rural medicine is that it is generally primary care with its attendant poor compensation. Most people really don't relish the thought of 80 hour weeks, awful call schedule and making 120K. Rural areas lack the cultural advantages of a city. There are no plays, limited ethnic cuisine, limited options in terms of houses of worship. Life in a rural town isn't that wonderful. If you have kids and want them to get a high powered high school education prepare to send them to boarding schools as many communities don't offer the APs and IBs that suburban districts do. Be prepared for poverty. In many rural areas the rate of poverty meets or exceeds that of the inner city. I grew up in a semi-rural area. I have contemplated rural practice and have found it to be too confining in terms of the ability to practice a specialty or subspecialty. However if you really love that lifestyle and are willing to put up with the issues of an aging and declining rural population good luck.

Okay, you're not really describing rural life so much as you're describing the poorest parts of Appalachia. True - rural areas tend to have a lower per capita income. Also true - cost of living is lower in general. You won't see people driving BMWs around, but you also won't see the boarded windows of the inner city.

 

[Daedra22]

Okay, you're not really describing rural life so much as you're describing the poorest parts of Appalachia. True - rural areas tend to have a lower per capita income. Also true - cost of living is lower in general. You won't see people driving BMWs around, but you also won't see the boarded windows of the inner city.

... sometimes you will see boarded-up houses. Houses that should have been condemned which have not been, because the city doesn't care. You cannot generalize and say that most small-town people have it okay. As I said previously, poverty--and I mean real I-live-in-a-rat-infested-hole-poverty--was rampant in my hometown, and the tiny towns around it. Actually, the town I lived in had it pretty good. The gangs completely took over a couple of the surrounding cities.

Yes, there are gangs in small towns. They can be just as bad as big-city gangs... in the big cities, you still have areas of town that aren't "owned" by the gangs. In a small town, if there's a powerful group of ruffians, then there are just places you don't go. There were a few months where the elderly people who would drive to the "big city" an hour away (~50,000 people in the "big" city) would get blocked in by two cars, beat up and mugged in the middle of the day. Why? There's no one around to see it.

Again, there are towns that are just wonderful rural living. You have to be prepared for both kinds of places.

 

[FutureCTDoc]

Okay, you're not really describing rural life so much as you're describing the poorest parts of Appalachia. True - rural areas tend to have a lower per capita income. Also true - cost of living is lower in general. You won't see people driving BMWs around, but you also won't see the boarded windows of the inner city.

Rural poverty is different and variable. A weathered farmhouse appears rustic, the projects dangerous. With Big Ag and the rural flight I'm attempting to paint a realistic picture of rural areas. There is a lower COL in rural areas as well as less intellectual capital. FWIW my father was an attending in a small city of 40,000 of Appalachia. You're sadly mistaken about much of the rural US. Many of these towns were focused on one area of industry i.e. textiles in NC, paper mills in NY and ME and agriculture in large swathes of the midwest. The small family farm is largely dead thanks to big ag and with it large portions of the rural middle class. Young adults tend to leave for college and not return. These areas are experiencing a long term down turn and there doesn't look to be much hope in the immediate future for these areas.

To MLT2MT2DO if you read my statement I said that people weren't interested in rural areas because many people aren't interested in being PCPs period. There was no mention of relative compensation. I stated a major drawback was being a PCP with the attendant poorer pay. In addition to poorer pay in relation to specialties were the notoriously long hours.

 

[Cheshyre]

Rural poverty is different and variable.

Uh-huh. Yet, you continue to focus on the absolute poorest areas.

Believe me, I'm from a rural area. I know about the issues with small farms, and honestly, I'm one of those young adults who is never going to come back home. Also, not all rural areas rely solely on agriculture.

 

[Daedra22]

Uh-huh. Yet, you continue to focus on the absolute poorest areas.

Believe me, I'm from a rural area. I know about the issues with small farms, and honestly, I'm one of those young adults who is never going to come back home. Also, not all rural areas rely solely on agriculture.

To be fair, most people focus on the poorest of areas when they think about "rural" stuff, and that's why a lot of people don't want to go into rural medicine. That is, in fact, the question of this thread. ^.^

 

[FutureCTDoc]

Uh-huh. Yet, you continue to focus on the absolute poorest areas.

Believe me, I'm from a rural area. I know about the issues with small farms, and honestly, I'm one of those young adults who is never going to come back home. Also, not all rural areas rely solely on agriculture.

As I pointed out it isn't farming per se, rather the reliance on one industry. Also economic factors aren't the only issues so are the lack of cultural options and the lack of specialty physicians.

 

[scpod]

One other reason no one wants to go into rural medicine is that it is generally primary care with its attendant poor compensation. Most people really don't relish the thought of 80 hour weeks, awful call schedule and making 120K. Rural areas lack the cultural advantages of a city. There are no plays, limited ethnic cuisine, limited options in terms of houses of worship. Life in a rural town isn't that wonderful. If you have kids and want them to get a high powered high school education prepare to send them to boarding schools as many communities don't offer the APs and IBs that suburban districts do. Be prepared for poverty. In many rural areas the rate of poverty meets or exceeds that of the inner city. I grew up in a semi-rural area. I have contemplated rural practice and have found it to be too confining in terms of the ability to practice a specialty or subspecialty. However if you really love that lifestyle and are willing to put up with the issues of an aging and declining rural population good luck.

You guys seem to have equated "rural" with the wilderness. I did a rotation in a "rural" clinic and had a blast. It's 45 to 50 minutes from Orlando. Everything you ever really need is within 30 minutes or so. "Rural" isn't necessarily in the middle of nowhere. There are many, many small towns within an hour or so of major cities that qualify as "rural." Because of this they also qualify for state and federal aid in addition to what private insurance, Medicare or Medicaid will pay. They also may qualify for student loan repayment. There is often a lot of unusual pathology as well due to the infrequency with which patients seek medical treatment as well as consanguinity leading to often rare diagnoses. Your income can be very good there-- much better than you would get in an urban setting.

 

[Bacchus]

Don't speak sense to the premeds, scpod.

 

[FutureCTDoc]

I recognize that rural is a by definition thing. However the poster was not referring to HPSA. Instead they referred to rural as commonly conceived not by the government definition. While some areas that are "rural" may be within reasonable distance of a decent size city and this is especially true on the east and west coast; many are not. Areas like Appalachia, where my father practiced, the midwest, great plains, deep south and the rocky mountain west have poorer access to these larger cities. Kansas has 5 cities with a population of 100,000; Arkansas 1; West Virginia none; Mississippi one; Alabama 4. These areas certainly have poor access to major metropolitan areas. The reference to a site an hour away from a major city is abnormal and not necessarily representative of the average rural area.

 

[MedStudentWanna]

One other reason no one wants to go into rural medicine is that it is generally primary care with its attendant poor compensation. Most people really don't relish the thought of 80 hour weeks, awful call schedule and making 120K. Rural areas lack the cultural advantages of a city. There are no plays, limited ethnic cuisine, limited options in terms of houses of worship. Life in a rural town isn't that wonderful. If you have kids and want them to get a high powered high school education prepare to send them to boarding schools as many communities don't offer the APs and IBs that suburban districts do. Be prepared for poverty. In many rural areas the rate of poverty meets or exceeds that of the inner city. I grew up in a semi-rural area. I have contemplated rural practice and have found it to be too confining in terms of the ability to practice a specialty or subspecialty. However if you really love that lifestyle and are willing to put up with the issues of an aging and declining rural population good luck.

http://www.camdenme.org/

http://www.castine.me.us/pages/AboutPages/about.html

 

[billw]

I grew up rural. I still live in a very rural location when not at school. I want to keep living in a rural place. So, I would like to practice rural medicine. The sort of lifestyle one wants to have is part of the consideration in choosing any specialty.

So, the question might as well be, "Why does everyone hate living in rural places?" Clearly, everyone does not, although people may be more predisposed to want to practice medicine in the environment they are most familiar with and comfortable in.

It is also not unusual for people who grew up rural to want to escape at about college age. The desire to return tends to come later in life. So, it may be hard to attract young people to rural primary care, but that does not mean that primary care docs won't find themselves looking to make a move 10-20 years down the road.

 

[MLT2MT2DO]

To MLT2MT2DO if you read my statement I said that people weren't interested in rural areas because many people aren't interested in being PCPs period. There was no mention of relative compensation. I stated a major drawback was being a PCP with the attendant poorer pay. In addition to poorer pay in relation to specialties were the notoriously long hours.

Normally long hours aren't synonymous with being an everyday PCP (at least not 80 hours as previously quoted).

When reading the post I also had the same understanding as you about "rural"....I was considering a good 2 hour drive 20k pop city, not NHSC scholarship definition.

 

[katwaa]

There is often a lot of unusual pathology as well due to the infrequency with which patients seek medical treatment as well as consanguinity leading to often rare diagnoses.

I live in the upper peninsula of Michigan and while we are very rural, I definitely do not think there are rare diagnoses up here due to consanguinity. I don't know if anyone else caught this remark but I thought it was rather rude. You act as if it is commonplace for rural people to be inbreed. Sure people make jokes about it, I could be naive, but I just don't think it is something that is prevalent just in rural areas.

 

[MN premed]

What I think is an equally appalling questions is - Why does everybody love big cities?! Yuck, everyone is crammed in there, lots of traffic, oftentimes superficial priorities, oftentimes higher crime. I will not be returning when I'm done with all my schooling.
Not for me. 😛

It's all a matter of what your priorities are and what you're used to.