Decline of rural doctors may leave parts of Ohio in a bind
Dr. Dhriti Sooryakumar gets to know her patients in a way many physicians won’t ever have the chance to.
When Sooryakumar clocks in every morning at the hospital, one of the first things she does is look to see if she knows any of the patients she’ll be treating in the emergency department.
It’s one of the benefits that Sooryakumar, a Dublin native and Ohio State University graduate, gets from completing her residency at Mercy Health’s St. Rita’s Medical Center in Lima — a smaller hospital in a city of nearly 36,000 residents in northwestern Ohio.
“Medicine for me is really service, so whatever I end up doing, I’m really planning to use it as a way to reach the most-underserved people,” she said.
But Sooryakumar may be the exception, as few medical students plan to seek opportunities to practice in smaller or more-rural communities.
Just 1% of medical students in their final year of study in 2019 said they wanted to practice in a rural area, according to a survey from the physician recruiting firm Merritt Hawkins. The survey showed that 2% wanted to practice in a town of 25,000 people or less.
The trend is a reflection of a larger one that could result in too few doctors to meet patient demand in Ohio. By 2025, the U.S. Department of Health and Human services estimates, Ohio will fall 1,200 primary care doctors short of the number needed to treat patients throughout the Buckeye state.
The shortage of rural physicians is a longstanding issue that stems from a decline in the number of independent medical practices, said Todd Baker, chief executive officer of the Ohio State Medical Association, an organization that advocates for physicians and health policy reform.
In recent years, it’s gotten more difficult for someone to become that “quintessential small-town doctor” without the backing of a larger health care system, Baker said. That’s due to the fact that solo practice doctors are often also in charge of their own human resources, billing and more, he said.
On top of that, Baker said rural doctors are forced to work long hours to treat all the patients who need them.
“You’re never off the clock,” Baker said. “If you run into a patient at the grocery store, all of a sudden you’re performing an appointment in the cereal aisle. That certainly is a challenge.”
While Baker said there’s no one solution to the shortage of rural doctors, technology may offer a short-term fix.
COVID-19 forced doctors to get creative, conducting some patient appointments remotely. That form of telemedicine made popular by the pandemic could help doctors in big cities more easily reach patients in Ohio’s small towns, Baker said.
But long-term, he said, something or someone needs to help move more doctors into rural areas. A forthcoming program at Ohio State may be the best answer, Baker said.
In August, Ohio State announced that it would launch a program in partnership with Bon Secours Mercy Health designed to attract future physicians to underserved and rural communities.
The program, which will begin enrolling students in 2024, will offer a community medicine track for medical students.
The program will require students to work alongside clinicians and students of pharmacy, nursing, therapy, social work and behavioral health. The approach will allow students to gain a more-holistic perspective of health care and how to better treat patients as part of a team, according to the university.
Students will spend their first two years on Ohio State’s main campus in Columbus and then their third and fourth years in Lima, where the university has a branch campus. One point of the program is to give students who are specifically interested in working in a rural community the opportunity to test it out and train in one, said Dr. Carol Bradford, dean of Ohio State’s College of Medicine.
“We and others are very aware of the growing physician shortage in Ohio, especially in our rural and underserved communities,” Bradford said. “We have an obligation, a duty and a responsibility to serve all members of our state . ... We want to do our part.”
While Sooryakumar isn’t sure what she’ll do after her residency ends, she hopes to be in a job that would still allow her to treat people in places like Lima or other underserved parts of the world.
Before Sooryakumar started her residency in Lima, she traveled to rural Honduras in central America
to treat people in need. She gained a sense there of how grateful people are to have a doctor willing to care for them.
In Lima, she said that “honest warmth” of gratitude is ever present too.
Around 20% of adult Ohioans didn’t have a personal doctor or health care provider as of 2019, according to the Kaiser Family Foundation, a nonprofit group focused on health care and health policy in the United States.
That statistic really shows in Lima, Sooryakumar said. Despite working in an emergency department, Sooryakumar and her colleagues essentially become the primary care doctors of some patients they treat.
Those repeat visits mean they develop longstanding, close relationships.
One time, a woman who recently gave birth brought her new baby to meet an emergency department physician, Sooryakumar said. The doctor was one of the woman’s first stops because that’s what she meant to the woman, she said.
It’s moments like those that make working in a smaller community worth it, she said.
“There’s so many stories like that. I’ve only been here a few months, but that rapport and that kind of relationship is something you develop here because it’s a smaller community,” she said. “That kind of true caring and empathy, that’s almost already built in.”