A Targeted Rx for Rural Health Care

Opinion Editor’s Note: editorial The views of the Star Tribune are represented by the editorial board, which operates independently of the newsroom.

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Few things are more fundamental to the quality of life of Minnesotans than access to medical providers. Which is why it doesn’t take long for alarm bells to ring when we dive into the data collected by the state health department of rural health and primary care.

While the health care workforce across Minnesota is grappling with burnout and looming retirements, the problem is especially acute outside metro areas, where the average age of doctors is a decade older than their urban counterparts — 58 versus 48.

According to a grim 2022 analysis by the Office of Rural Health, “one in three rural doctors is planning to leave their profession within the next five years, exacerbating the current shortage.”

Another data point underscores concerns about the need for more doctors. Per capita, far fewer physicians are already serving rural areas of the state than urban areas. The population-doctors ratio for urban areas is 245. For rural areas, it is 894.

There is no cure for this workforce crisis. But a sensible solution is training more physicians interested in practicing outside the Twin Cities. Fortunately, a new proposal between the University of Minnesota Medical School and CentraCare, a St. Cloud-based health system, aims to achieve just that. Appropriate response: “How can we do that?”

Last week, the two organizations announced they are working to open a new branch of the U of U’s medical school in St. Cloud to recruit doctors interested in practicing in a small town or rural setting. According to a January 16 Star Tribune story, it would be the state’s “first new medical campus in 50 years.” While cost details are still emerging, this is a timely, innovative idea.

There are already three physician training sites in Minnesota. The Mayo Clinic in Rochester has a medical school, and the U of U has two medical school locations—one on the main Twin Cities campus and another in Duluth, the latter opened in 1972.

The Duluth campus is already well regarded for its focus on primary and rural health care. If the new St. Cloud Medical School campus opens, which would require approval by the U of C’s Board of Regents and Centracare’s board, it would have an equally essential focus.

The collaboration will run on the strengths of both the organizations. U trains 70% of doctors practicing within the state. CentraCare’s hospital-and-clinic network will provide valuable hands-on training for students and graduates.

It is hoped that students coming to the new campus will bring an inherent interest in rural or small-town practice. and that they will establish community ties to the area while completing their education and training, making them less likely to leave.

The figures provided by the organization support this view. An impressive 81% of medical school graduates who have passed through CentraCare’s Family Medicine residency program over the past seven years are practicing in Minnesota. Of those, 59% are in rural areas and 73% are outside the seven-county metro area.

63% of Duluth Medical School Branch graduates live in Minnesota, and 44% work in communities with populations of less than 20,000.

CentraCare will house the new campus in a new equipment building that was once used by information technology employees working remotely. The St. Cloud location is also logical. There are designated “health professional shortage areas” for the primary care blanket, which is outside of Minnesota. But there is a troubling concentration of them in central and western Minnesota.

Stearns County, where St. Cloud is located, and the eight counties that border it are either deficient areas, or the entire county is designated as a deficient area. The problem is particularly acute in counties north and west of St. Cloud. It’s smart to have a pipeline of students getting education and training here. The new campus could open by 2025, with 20-24 students in each class.

The initiative is garnering national acclaim. “Challenges accessing care in the country’s most rural communities contribute to health care disparities for patients. Creating new medical school campuses that provide opportunities to train and expand the number of physicians who serve underserved communities This is an important part of addressing and improving rural health disparities,” said Dr. Jonathan Jaffrey said.

The staffing shortage includes more than physicians. Other approaches are needed to bolster the ranks of nurses, pharmacists, mental health providers, and other caregivers. But leaders at the U and CentraCare suggest a targeted, possible solution. It deserves the support of Minnesotans as it moves toward becoming a reality.

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