Before starting physician associate (PA) school at the Keck Graduate Institute in Claremont, California, Sydney Kasner worked as an x-ray technician in a small town in rural Oregon.
“I’m not originally from the rural community, but after living there with my husband for 8 years, it quickly became my home,” she told Medscape Medical News.
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Working in a hospital in a community of about 10,000 residents, Kasner learned firsthand how challenging it can be to provide healthcare to the people who had become her friends and neighbors.
“We had constant provider changeover. My patients would get a letter in the mail saying, ‘This provider left, and you have a new provider now.’ Then it would happen again just a few months later,” she said. “So, what would end up happening is people would fall through the cracks. We weren’t able to provide the highest quality healthcare, not because of the local people or the hospital system, but because we just couldn’t keep providers.”
The Centers for Disease Control and Prevention has sounded the alarm that people who live in rural counties run a higher risk of dying early from chronic (and often preventable) disease than those who live in more populated areas. With limited numbers of healthcare professionals willing to work in underserved areas, organizations like the National Rural Health Association have called on PAs to help fill those gaps.
Kasey Puckett, a research analyst at the National Commission on Certification of Physician Assistants (NCCPA), said their research has shown that the lion’s share of PAs works in urban areas, with less than 7% practicing in rural settings. Moreover, their surveys have also highlighted some of the characteristics of people who tend to work in these areas.
She said that 14% identified as being from backgrounds that are underrepresented in medicine. “Other research has shown that growing up in a rural area is among the strongest predictors of rural practice among PAs, as well as physicians and nurse practitioners.”
To inspire PAs who may not have roots in rural communities to consider practicing there, Kasner hosted a webinar, Rural Medicine Panel for PA and Pre-PA Students, this past March. She included multiple speakers to highlight the benefits, incentives, challenges, and opportunities of working in rural areas, including Dorothy Bratton, PA-C, a deputy chief medical officer, to walk webinar attendees through a day in the life of a rural PA.
“The idea is to provide PAs with a real picture of what working in a rural area looks like,” Kasner said. “And why it’s really worth it to look into this as a career opportunity.”
More than 200 people signed up to learn about these opportunities — and Kasner said she hopes people realize that working in a rural area doesn’t necessarily mean you are “living somewhere in the middle of the desert.”
“There are many rural opportunities that are actually quite close to metropolitan areas — those rural pockets and underserved areas are within commutable distances.”
Kasner developed the webinar as part of her capstone project within a PA Education Association project. She said she wanted to “think outside the box” and find ways to share opportunities in rural medicine because so many PAs have preconceived notions about working in “huge need, high-demand, and high turnover areas.” She, herself, plans to return to Oregon as soon as she finishes her PA degree.
There’s a lot of good things about being part of a rural community, being in a place where you are valued and appreciated for the work you do, and Kasner wanted to talk about those benefits. “Also, you can sometimes get 70% of your school loans repaid for working there for a few years — or, if you are interested in a specialty, it’s often easier to do that kind of specialized work in these places [rurally]. The benefits shouldn’t be overlooked.”
Puckett said that the NCCPA’s work in surveying the PA workforce provides a better understanding of current practice trends that can inform more precise workforce planning and projections, especially in Health Professional Shortage Areas and Medically Underserved Areas.
“Developing strategies to recruit more PAs in large rural, small rural, and isolated settings is crucial to expanding access to care,” Puckett said.
And Kasner’s webinar is a strategy that she specifically designed so others can build upon. She is currently analyzing data from surveys given to attendees before and after the webinar and hopes to see that more PAs and aspiring PAs will consider a move to the country — and that more PAs and organizations will consider hosting similar events in the future.
“This is very reproducible,” she said. “And, if just one PA says that they are interested in this now, that they have increased knowledge of the opportunities and incentives [rurally], I’ll feel like it’s a success.”
Kayt Sukel is a healthcare and science writer based outside Houston.
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