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A Shortage Of Rural Doctors In Colorado Inspires Action

Bente Birkeland
Dr. Jeffery Bacon works at the Sterling Family Care Clinic.

Access to something as simple as a doctor can be near impossible in the more rural parts of Colorado. The issue is especially pronounced along the Eastern Plains, leading state officials to embark on a new training program. The objective is to recruit and train more family practice physicians in places like Sterling, a city of about 15,000 people that’s 130 miles northeast of Denver.

Dr. Jeffrey Bacon has made his career in that city, including the past 16 years at Sterling Family Care Clinic.

“It’s difficult to get people to come out and stay and retain here,” he said of doctors and other medical workers. “The critical piece, as well, is if you can bring them back and see that they can have their passion in a small town, and do what they want to do in a small town, it makes a huge difference.”

The issue isn’t unique to Sterling. The number of family doctors across the country is in decline, according to Wanda Filer, the president of the American Academy of Family Physicians.

“The data I’ve seen from our own work suggests Colorado is going to need 49 percent more family physicians by 2030,” she said. “So there should be a strong state interest here to make sure family residency programs get what they need to expand and medical schools accept those students who are most likely to choose family care.”

State leaders have commissioned a study to see what can be done about the shortage. The group released 14 recommendations, such as funding a new program to provide loan repayment assistance for medical students who decide to practice in rural parts after residency.

“It’s probably a bit more challenging to get people to work in a rural areas than it has been in the past,” said Amy Downs, vice president of the Colorado Health Institute, a non-partisan healthcare think tank in Denver.

“You have more females going into the primary care workforce and they’re less likely to select rural areas,” she said. “You also have the issue of primary care clinicians very often being married to a professional spouse who sometimes might have a challenge finding a position in a rural area.”

Colorado’s Eastern Plains, for instance, would need a 133 percent increase in doctors just to keep up with the industry benchmark of one physician per 1,900 Medicaid patients. She said Tele-medicine can help – but that doesn’t take the place of an in-person physician.

“It takes a special person to do this out here because you’re on your own,” said Adam Mackintosh.

He’s lived in Sterling for 10 years, but grew up in California, outside of San Francisco. He admits that it took time to get used to practicing medicine in rural Colorado.

Credit Bente Birkeland / KUNC
Residents Natalie Krier and Pete Banchuin work as interns at North Colorado Family Medicine in Greeley.

  “I don’t have a big hospital 15 minutes away down the road,” he said. “If we have a baby that is sick we have to hold them and keep them safe until we can get the guys out of Denver, that could be two hours or if there’s a snow storm which seems like there always is when it’s the worst, it can be 24 hours.”

A new state law aims to address the shortage. It creates an income tax credit for people who teach and train medical students who want to do family medicine.

The state commission could build on that if some ideas gain support. There’s talk of a tax credit for physicians who practice in rural areas, as well as more thoughts about student loan forgiveness.

Pete Banchuin is an intern at Greeley’s North Colorado Medical Center and one of two residents that will soon spend the next two years working in Sterling. It’s part of a new track that gives residents more time to understand rural life and what it means to practice there.

Banchuin didn’t need convincing to go: “You get a chance to do things and train in things that I would not otherwise get to do.”

Paying doctors more is another way to attract those who are otherwise driven to more lucrative specialties. To that end, Filer said there is some good news: salaries for family physicians have gone up 17 percent over the last year.  

Bente Birkeland has been reporting on state legislative issues for KUNC and Rocky Mountain Community Radio since 2006. Originally, from Minnesota, Bente likes to hike and ski in her spare time. She keeps track of state politics throughout the year but is especially busy during the annual legislative session from January through early May.
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