Rural PM&R?

[Another Chance]

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Hi. I'm interested in living in a rural area of the country and was wondering if PM&R would be conducive to that plan? Someone told me that to do PM&R, you'd have to live or commute to a big city to practice, but the area I'm looking at settling down is about 2 hours from the closest big city. Would this be a problem in this field?

 

[SportsMed09]

Not too much. As long as you were able to get people to know what you do, you could be a classic jack of all trades inpt/outpt physiatrist and
live well doing it.

 

[PMR 4 MSK]

Feasible in the right situation. Rural is mostly primary care. Specialty care is hard to get a large enough population base. Estimates vary, but you would likely need 25 - 50 K to support 1 Physiatrist. Might have a hsopital with a small rehab floor, but might be used more as SNF. If you want to do classic outpt PM&R - SCI, CVA, TBI, etc, you won't have enough patients rurally. If you want to do more outpt MSK, you could probably do quite well if the community - docs and patients - accept you. Become the local back pain expert and you'll do well. Add in some sports med for high school teams and the town will fall in love with you.

 

[RUOkie]

Feasible in the right situation. Rural is mostly primary care. Specialty care is hard to get a large enough population base. Estimates vary, but you would likely need 25 - 50 K to support 1 Physiatrist. Might have a hsopital with a small rehab floor, but might be used more as SNF. If you want to do classic outpt PM&R - SCI, CVA, TBI, etc, you won't have enough patients rurally. If you want to do more outpt MSK, you could probably do quite well if the community - docs and patients - accept you. Become the local back pain expert and you'll do well. Add in some sports med for high school teams and the town will fall in love with you.

That is exactly right.

OP: There are a lot of rural/semirural community hospitals that want physiatrists. Most of these "jobs" are found through recruiters, although if there is a particular hospital that you are already interested in, you may want to cold-call the CEO of the hospital. THere is a tremendous incentive for hospitals to recruit new physicians (if a doc is brought to a "underserved" area from >50miles away, all relocation expenses and the financial guarantee are 100% written off). Most of these situations are either: 1) come in as a hospital employee-likely as med director of a small rehab unit with a MSK outpt practice. or 2) a 1-2 year income guarantee with a "loan forgiveness program" over the next 48-54months.

This is my exact practice type, although I am no longer the med director of the inpt rehab.

 

[Bombesin]

2) a 1-2 year income guarantee with a "loan forgiveness program" over the next 48-54months.

What exactly does this "loan forgiveness program" entail? I started organizing all my ridiculous student debt over the weekend and the prospect of paying it off is daunting. Is this type of "program" you can negotiate into contracts or is it readily offered as a recruiting tool? Are we talking decent chunks of change or something like 1500-2k per year?

 

[Momentum70]

Im also interested in loan forgiveness, I had thought this was just for the primary care specialties, does anyone have any experience with doing it in underserved areas for PM&R.

 

[RUOkie]

What exactly does this "loan forgiveness program" entail? I started organizing all my ridiculous student debt over the weekend and the prospect of paying it off is daunting. Is this type of "program" you can negotiate into contracts or is it readily offered as a recruiting tool? Are we talking decent chunks of change or something like 1500-2k per year?

Im also interested in loan forgiveness, I had thought this was just for the primary care specialties, does anyone have any experience with doing it in underserved areas for PM&R.

Ok, here is how it works. The hospital lays out upfront money to defray the costs of setting up a practice while guaranteeing a monthly "income" (take home/physician salary). The average is about 200K in the current market (for experienced people). Each month a detailed accounting is done with the comptroler of the hospital. If you collected more (after expenses) than your monthly stipend, you pay the hospital. If you collected less, they pay you the difference to reach your stipend threshold. There is usually a max for monthly expenses (15K/month is about right) that you can claim. Then, at the end of the contract term (usually 12 months) the total "loan" amount is calculated. Then, the loan is "forgiven" over a period of time (usually 1/48 each month for 48months). That forgiven loan IS INCOME for you on your tax return, and the hospital should send you a I-99 each year.

These contracts are very complicated and should be reviewed with an attorney before signing anything. My contract was 25 pages long.

Also, my area was in such need of my services 7 years ago, that at the end of the year, my total loan amount was <50K😀.