One rural doctor decides to close shop: ‘It’s just not sustainable’

[BlueStateSaint]

A sad story.

One rural doctor decides to close shop: ‘It’s just not sustainable’

Posted by Sarah Kliffat 09:30 AM ET, 06/06/2012

A day in the life of Dr. Marc Shiffman can go something like this: Leave home at 7:45 a.m. Drive 40 miles through rural Colorado to Summit Internal Medicine, the clinic he founded in 2007. Start seeing patients at 8:30 a.m. Stop seeing patients at 5:30 p.m. Do paperwork—forms that need to be sent to insurers, bills that need to be looked over—until 9:15 p.m. Make the 40-mile drive back home. Arrive around 10 p.m. Repeat.

Shiffman is the only internist in Summit County, a rural area of Colorado about 72 miles west of Denver. He founded his own clinic in April 2007, after a long career working in large doctor groups and hospitals. At the end of this month, on June 30, Shiffman will close his clinic.

“In a word, I’d say running a solo, primary care practice in rural America is impossible,” Shiffman said. “Rural America is not well-served, and the prospects for the future are gloomier.”

A century ago, half of Americans lived in rural areas, as did 41 percent of their physicians. Since then, Americans have migrated out of rural areas and their doctors have done so at an even quicker pace. Nationally, the United States has 191 physicians for every 100,000 people. In rural areas, that ratio can be as low as 52.3 doctors for 100,000 patients. An American living in a non-Metropolitan area is four times more likely to live in an area with a primary care shortage.

Shiffman has operated a rural clinic, on his own, for five years now. His experience, and decision to shut down business, helps give some insight into the challenges that rural health care faces.

This is something that Obamacare will make worse, as 40% of MDs are leaving medicine, if it's not overturned/repealed.

The link:  http://www.washingtonpost.com/blogs/ezra-klein/post/one-rural-doctor-decides-to-close-shop-its-just-not-sustainable/2012/06/06/gJQALWgWIV_blog.html

[formerlurker]

There are two fields of practice that a local state medical school will pretty much pay the entire tuition for - internal medicine and pediatrics.   No one wants to be a PCP anymore (pediatrician being a child's PCP).    I can't blame them.

[MrsSmith]

Where I grew up, the closest doctor was 23 miles.  When that little clinic gives up and closes, it'll be 40 miles.  If that one closes...90 miles. 

My current hospital actually owns outlying clinics in several small towns around.  We loose millions of dollars every year keeping those little places open.  At some point, we'll have to start closing them...forcing people to drive at least 40 miles farther.   

[longview]

We have a doctor shortage, I suppose.  Compared to what I see and hear from my urban relatives.  But, with our low population density, I don't see how we could get more doctors practicing in the far flung parts of the state.

Wyoming has a residency program tied to general family practice.  Two of the doctors in my town are taking advantage of that.  I don't know if they will stay once they've put in their five years of repayment time.  But, we'll deal with it if they don't.  My youngest is working toward med school.  She wants to do medical mission work.  I tease her that where she lives now is less served than some of the countries that market for our doctors.

[NHSparky]

Hell, good luck finding doctors that take half of the insurance plans out there, let alone Medicare.

If I tried to go to my doctor today, I'd be told, "Sorry, we don't take that insurance."