2022 Undergraduate Research Symposium: Taha Kader Family physicians are crucial to providing appropriate medical care in rural areas. Family physicians tackle various roles such as maternity and emergency care in these areas. However, there aren't nearly enough family physicians in these areas, and something needs to be done.

1. The Importance of Family Physicians in
Rural Areas
By: Taha Kader

2. Medical Care in
Rural Areas
• Rabinowitz et al. (1999) mentions how
even though rural areas make up for more
than 20% of the total U.S population, they
“contain one of the largest medically
underserved populations in the country,”
having more Health Professional Shortage
Areas than other areas (Section 1).
• Rosenblatt and Hart (2000) discovered that
“the growth of specialization is a major
contributor to the geographic
maldistribution of physicians,” more highly
specialized physicians are less likely to
settle in rural areas (Section 2).

3. Diversity of Rural
Family Physicians
• A study from Deutchman et al. (2021) found that
in rural areas, family physicians often play a
significant role or are the main providers of
maternity care, performing “vaginal delivery,
cesarean delivery, and VBAC” (Section 4). Family
physicians were delivering newborns and
providing maternity care at 124 of the 185 rural
hospitals in this study. Furthermore, at 50 of these
124 hospitals they were the only physicians
providing maternity care (Deutchman et al., 2021,
Section 4).
• In a study conducted by Bennet et al. (2021), they
discovered 4345 emergency physicians that either
had family physician training or were family
physician board certified, and 21% worked in rural
areas while the rest were in urban areas (Section
3). However, even though the population of rural
family medicine emergency physicians(EP) is
smaller than the population in urban areas, “the
rural proportions presented here are higher than
those of the overall EP population” (Bennet et al.,
2021, Section 4).

4. Decreasing Amount
of Family Physicians
• The rural family physician population
remains to be quite minimal compared to
the rest of the nation as “only 9% of the
nation's physicians practice in rural
communities” while over 50 million
individuals live in these communities
(Rosenblatt & Hart, 2000, Paragraph 2).
• Additionally, according to a report by
Phillips et al. (2019) from the American
Academy of Family Physicians(AAFP), the
US can expect a deficit of around 52,000
family physicians by the year 2025
(Paragraph 2).

5. What has been
Done?
• To tackle this shortage in the rural areas in Pennsylvania, JMC
established the PSAP. According to Rabinowitz et al. (1999),
the PSAP broadened JMC’s admissions criteria to choose
those based on their rural background and commitment to
practice family medicine in rural areas, the program then
trained these individuals to work in rural areas (Section 1).
• The results of this program led to PSAP graduates
representing 21% of all rural family physicians in
Pennsylvania in 1997 while only representing 1% of all
graduates from 7 different allopathic medical schools in
Pennsylvania (Section 1)
• A more recent article regarding PSAP supports its
effectiveness at increasing the number of family physicians in
rural areas. Garrison-Jakel (2010) discusses how PSAP
graduates are 4 times more likely to practice family medicine
than their peers and how 79% of these graduates remained
in rural practices for over a decade after they had graduated
(Paragraph 6)
• Garrison-Jakel (2010) mentions how the Council on Graduate
Medical Education(COGME) has told medical institutions to
“pursue their social obligation to develop an adequate
workforce”

6. What needs to be
done?
• Garrison-Jakel (2010) mentions how the
Council on Graduate Medical
Education(COGME) has told medical
institutions to “pursue their social
obligation to develop an adequate
workforce”
• Medical Schools need to be incentivized
into tackling the rural family physician
deficit.
• A letter from the American Academy of
Family Physicians to the Senate Finance
Committee led to the Pathways to Practice
Program, which aimed to broaden the
physician workforce in rural communities.

7. References
• AAFP. (2019, November 10). Strengthening the Workforce. AAFP Advocacy: Recent Family
Medicine Wins. Retrieved March 27, 2022, from https://www.aafp.org/advocacy/wins.html
• Bennet, C. L., Gerard, A. W., Cullen, J. S., Espinola, J. A., Sullivan, A. F., Clay, C. E., Camargo,
C. A. (2021). National Study on the Contribution of Family Physicians to the US Emergency
Physician Workforce in 2020. Journal of the American Board of Family Medicine : JABFM,
34(6), 1221–1228. https://doi.org/10.3122/jabfm.2021.06.210166
• Deutchman M, Macaluso F, Bray E, Evans D, Boulger J, Quinn K, Pierce C, Onello E, Porter J,
Warren W, Erickson JS, Bright P, Maness P, Luke S, James KA. (2021). The Impact of Family
Physicians in Rural Maternity Care. Birth. https://doi-
org.proxy.lib.wayne.edu/10.1111/birt.12591
• Garrison-Jakel, J. (2011). Patching the rural workforce pipeline--why don’t we do more?
The Journal of Rural Health : Official Journal of the American Rural Health Association and
12 the National Rural Health Care Association, 27(2), 239–240.
https://doi.org/10.1111/j.1748-0361.2010.00341.x
• Phillips JP, Wendling A, Bentley A, Marsee R, Morley CP. Trends in US Medical School
Contributions to the Family Physician Workforce: 2018 Update From the American
Academy of Family Physicians. Fam Med. 2019;51(3):241-250.
https://doi.org/10.22454/FamMed.2019.395617
• Rabinowitz, H. K., Diamond, J. J., Markham, F. W., & Hazelwood, C. E. (1999). A program to
increase the number of family physicians in rural and underserved areas: impact after 22
years. JAMA, 281(3), 255–260. https://doi.org/10.1001/jama.281.3.255
• Rosenblatt R. A. & Hart G. L. (2000). Culture and medicine: physicians and rural America.
The Western journal of medicine (0093-0415), 173 (5), p. 348. https://www-ncbi-nlm-nih-
gov.proxy.lib.wayne.edu/pmc/articles/PMC1071163/