So practicing medicine in rural areas pays better, but what is "rural" ?

[Putkernerinthehall]

Are smaller / mid-size towns in the Midwest considered rural ?

Cedar Rapids, Sioux Falls, Dayton, Green Bay, Fargo, Springfield Mo, Springfield IL, Lansing, Evansville, Rockford IL for example ?

Or places in the South like Little Rock, Huntsville AL, Savannah, Athens GA, Jackson MS, Wilmington NC, Charleston SC, Chattanooga, Amarillo, for example ?

Or when we talk about "rural" in the sense of higher compensation, are we taking about truly rural ? Dozens of miles between towns and/or couple hours from nearest small city ?

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[voxveritatisetlucis]

If you have to ask, it’s not rural

 

[voxveritatisetlucis]

But I’m sure all of the above would still pay much better than NYC, SF, LA etc:

 

[KnightDoc]

Are smaller / mid-size towns in the Midwest considered rural ?

Cedar Rapids, Sioux Falls, Dayton, Green Bay, Fargo, Springfield Mo, Springfield IL, Lansing, Evansville, Rockford IL for example ?

Or places in the South like Little Rock, Huntsville AL, Savannah, Athens GA, Jackson MS, Wilmington NC, Charleston SC, Chattanooga, Amarillo, for example ?

Or when we talk about "rural" in the sense of higher compensation, are we taking about truly rural ? Dozens of miles between towns and/or couple hours from nearest small city ?

In general, the market is based on supply and demand, like most things in life. You can Google it and get the definition as set by the Census Bureau, but that's not really going to answer your question.

The answer you are looking for is that higher pay is going to be consistent with practicing in places where it is difficult to attract physicians. This will primarily be because all physicians make enough that they don't have to chase every last dollar, so they tend to want proximity to friends and family, infrastructure, and common amenities consistent with urban and suburban living (culture, sports, entertainment, restaurants, transportation, etc., etc., etc.).

So, it's not strictly about distance between population centers, or even the size of the population. It will be more about lifestyle. If you like being in the middle of nowhere with few modern amenities and conveniences, you can clean up and provide a needed service. Otherwise, you probably won't want to make the sacrifice, as most people don't, which is what creates the very market imbalance you are asking about possibly exploiting.

 

[operaman]

Truly rural places may not be that lucrative simply because demand isn’t there. The cities you list are the types that tend to have enough people to support specialty practices. I wouldn’t think of any of them as rural. Some of them are fairly saturated already.

I think you’d find better pay in cities somewhat adjacent to those you mentioned. Charleston is rather saturated, but Summerville, Myrtle beach, Conway, etc would likely offer higher salaries to recruit new docs.

 

[deleted1065184]

For the actual definition of rural, first think of a city. Now think about how suburbs are not in the city but have quick access to its amenities (including hospitals/clinics, airports, etc). Rural areas exist outside of this. They have very small populations, tend to have agriculturally-based economies, and do not afford you access to the amenities of a mid- to large-sized city.

None of the cities you named are rural. In fact, if the name of the city is recognizable to a large number of people, it's probably not rural. I grew up in an unincorporated community that was so small that even the people in nearby rural towns and cities didn't know it existed lol

Regardless of rural vs suburban vs urban location, the South and Midwest tend to pay physicians much better than the Mid-Atlantic, Northeast, and West Coast. But the more rural, the higher the pay tends to be.

 

[lumya]

I'm from the midwest and we have so much land that generally a 20 min drive out even from decently sized cities can be considered rural. I would not consider any of the cities you listed as rural, but probably 10-20 miles out, you would end up in a more rural community.

Compensation would really depend on if there's a need for that field you're going into. Primary care is well-compensated in more rural areas in part due to the need, but also the expanded services that those physicians offer when the nearest specialty hospital might be a 30+ minute drive out (I've seen rural family med docs deliver babies, do colonoscopies, and perform procedures that would've been referred out in urban settings). Specialists are not going to hit it big in rural settings unless it's very specific to the population there.

 

[voxveritatisetlucis]

From my understanding, wRVU rates vary relatively little between urban and rural areas. There is a slight uptick in rural areas, however it’s not enough to justify the premium that rural docs get paid. Most rural docs are thus subsidized to the extent that health care systems need coverage to bill for more expensive services (ie hospital stay).

Therefore, a rural neuro hospitalist may actually get paid a bit more than wRVUs that he/she generates because if the hospital didn’t have a neuro hospitalist, it would be more difficult to admit neuro patients, causing them to lose associated revenue with the stay

This could be wrong, but i heard that this is one reason for the difference

 

[DOVinciRobot]

To some people Kansas City is rural. But I wouldn’t classify any of those cities you mentioned as truly rural. But in healthcare “rural” can mean a lot of things. When it comes to pay even practicing in a city of 50-150k will often come with a significant pay increase compared to a large metropolis.

 

[CantFindMeNowAdcoms]

I'm from a town of 2.3k people that was 30 minutes from metro of 1m people--community hospital IM primary care physician made 400k+ (public record). I wouldn't consider that rural, but some would. His salary was definitely higher than the same role within the metro itself.

 

[deleted1065184]

I'm from a town of 2.3k people that was 30 minutes from metro of 1m people--community hospital IM primary care physician made 400k+ (public record). I wouldn't consider that rural, but some would. His salary was definitely higher than the same role within the metro itself.

Does the population in this town mostly work in the major city? If so, it's suburban. If the community is mostly self-sutained by agriculture, factory work, etc., then it's rural. The size of the city matters, but citizen occupations and reasons for living in the particular city matters just as much.

If it's a city created by white flight (due to the Great Migration) where the bulk of people still work in the city, for instance, then it's not rural no matter how small it is.

 

[deleted1065184]

To some people Kansas City is rural. But I wouldn’t classify any of those cities you mentioned as truly rural. But in healthcare “rural” can mean a lot of things. When it comes to pay even practicing in a city of 50-150k will often come with a significant pay increase compared to a large metropolis.

The people who believe Kansas City is rural are just wrong, lol. The term has a little bit of flexibility of use, but there are still general definitions that must be met. "This city is of 500k people is smaller than my home city of Chicago" doesn't make it rural. They're just wrong haha.

 

[DOVinciRobot]

The people who believe Kansas City is rural are just wrong, lol. The term has a little bit of flexibility of use, but there are still general definitions that must be met. "This city is of 500k people is smaller than my home city of Chicago" doesn't make it rural. They're just wrong haha.

Well yes. That was said tongue in cheek lol

 

[mvenus929]

I imagine the definition of 'rural' for compensation purposes will vary based on specialty. I'm a subspecialist, so I need a decent sized population to support my practice. I absolutely get offers for better than average in places like Springfield, MO, Great Bend, IN, Sioux Falls, SD. I work in a small city about an hour outside a larger city, and the people here generally expect to be paid more than in the big city because it's not a great place to live.

But, family medicine docs truly working low resource areas in rural communities may get subsidized to work there because there is a need in the community. I would not be able to get the same offer because there isn't a large enough population to support me.

 

[Tenk]

You are trying to oversimplify something that is so incredibly complex it cannot be oversimplified.

For instance, I have friends in EM that take home $500,000 a year in cities because they are part of their own group.

I also have friends that make $200,000-$300,000 in cities because they are part of CMGs.

I’ve seen rural jobs that pay $350/hr and I’ve seen rural jobs that pay $90/hr.

It has to do with payer mix, RVUs, location, specialty, and the staffing method.

You can make high and low amounts anywhere, you just have to find the right job.

 

[Putkernerinthehall]

I imagine the definition of 'rural' for compensation purposes will vary based on specialty. I'm a subspecialist, so I need a decent sized population to support my practice. I absolutely get offers for better than average in places like Springfield, MO, Great Bend, IN, Sioux Falls, SD. I work in a small city about an hour outside a larger city, and the people here generally expect to be paid more than in the big city because it's not a great place to live.

But, family medicine docs truly working low resource areas in rural communities may get subsidized to work there because there is a need in the community. I would not be able to get the same offer because there isn't a large enough population to support me.

Interesting. So for you as a sub specialist, the sweet spot is in the middle ---- a smallish-size city but not too far outside a larger city. Not enough patients in truly rural areas and too much competition in major urban areas. This is the insight I was looking for, especially as it pertains to subspecialties.

 

[mvenus929]

Interesting. So for you as a sub specialist, the sweet spot is in the middle ---- a smallish-size city but not too far outside a larger city. Not enough patients in truly rural areas and too much competition in major urban areas. This is the insight I was looking for, especially as it pertains to subspecialties.

Basically 🙂

 

[MDMechEngr]

what is "rural" ?​

Rural tends to be places where you will find a larger percentage of DO and IMG practicing.