Prioritizing rural healthcare by training the next generation of physicians
National Rural Health Day, on Nov. 18, is a chance to raise awareness about the unique healthcare challenges facing rural citizens, including a lack of healthcare providers, increasing rural hospital closures, the needs of an aging population and the un- and under-insured. The day also celebrates the power of rural communities, including our self-reliance, ability to take care of our neighbors, and the innovation skills that come with working with what we have and leveraging the resources of national partners.
Montana is not immune to the challenges facing rural healthcare in America. For every 100,000 people, our state has just 116 primary care physicians, placing us near the bottom at 44th in the nation. We’re also at the forefront of solving some of these challenges through our participation in WWAMI, a decentralized medical school created nearly 50 years ago to help train more rural physicians through a partnership between Montana State University and the University of Washington School of Medicine.
Each year, 30 Treasure State students are accepted into Montana WWAMI’s medical school, accessing public, in-state tuition because of the wise investment of the Montana Legislature. Montana students benefit from access to the number-one primary care program in the country, and the ability to complete all four years of their training in Bozeman, as well as nearly 20 rural clinics across the state, including here in the Flathead, where they learn from physician mentors in a hands-on setting. The return on investment is huge, with every dollar investment yielding $5.14 back to Montana’s economy.
Giving future physicians a taste of rural medicine is key to growing the next generation of doctors who will practice in Montana’s small towns and cities. Physician recruitment can be challenging in all rural places, yet with nearly 20% of Americans living rurally and more than 57 million Americans residing in rural areas, high-quality healthcare should not be reserved solely for those in cities.
Forty-seven percent of Montana is considered “rural” by the U.S. Census, and we are home to almost 50 rural critical access hospitals as well as 61 rural health clinics. Mirroring national statistics, rural Montanans are less likely to have health insurance, more likely to live in poverty or face unemployment, and less likely to have graduated high school than urban Montanans. All of this impacts public health in rural communities.
Montana WWAMI’s mission is to improve the health of all Montanans by making public medical education accessible to residents and to encourage our graduates to choose careers that are needed in Montana especially in primary care medicine and eventually return to practice here. When a physician graduates from medical school, they must complete a residency of 3 to 7 years in their chosen speciality. With limited spots available and many specialties not represented at all in our state, it remains a challenge to connect Montana’s medical school graduates with in-state residency opportunities that provide a launchpad to eventual in-state practice. Even so, about 50% of our Montana residency graduates return to the Big Sky to practice.
As we reflect on rural healthcare in Montana and beyond, WWAMI provides valuable lessons in partnering for excellence, prioritizing the future workforce needs of rural communities, and supporting Montana students in becoming physicians who return to build their careers here.
Dr. Jay Erickson has practiced family medicine in the Flathead for 31 years. He serves as the Assistant Clinical Dean for Montana WWAMI, guiding curriculum, collaborating with the over 500 physician preceptors who teach Montana medical students, and working to advance graduate medical education in Montana. He practices in Whitefish.