How a shortage of doctors impacts medical care in North Carolina’s rural areas

How a shortage of doctors impacts medical care in North Carolina’s rural areas
This kind of data is why WBTV and the company that owns us - Gray Television - is making a commitment to report on efforts to Bridge the Great Health Divide. (Source: WBTV/Gray Television)

CHARLOTTE, N.C. (WBTV) - If you live in Charlotte, when it comes to the visiting the doctor, you may have a few steps. Steps like a phone call to set up an appointment, or a five-to-10-minute car ride to get to the office.

Sounds pretty simple since there are a lot to choose from.

UNC Chapel Hill data from 2019 showed there were 1,051 Primary Care doctors in Mecklenburg County. That’s roughly one doctor for every 1,000 people

But when you get outside of Charlotte - into the foothills and mountains - the options get sparse.

  • Avery County had nine Primary Care doctors, or about one for every 2,004 people.
  • Ashe had 13, but with a few more people that’s one for every 2,141 people.
  • And then there’s Alexander County - nine Primary Care doctors - or about one for every every 4,273 people.

The situation is even more stark -- when you get into some specialties.

Look at OB/GYNs. There are 190 of them in Mecklenburg County.

  • Avery County has one.
  • Alexander and Ashe - none.

This kind of data is why WBTV and the company that owns us - Gray Television - is making a commitment to report on efforts to Bridge the Great Health Divide.

Bridging the great health divide

When’s the last time you scheduled a doctor’s appointment for the next day? It’s probably been awhile.

The latest data explaining why comes from 2017. A Merritt Hawkins survey found that on average, it takes about 24 days just to schedule a first-time appointment with a doctor in America.

The average wait time for an appointment with a family medicine doctor was, on average, about 29 days.

It wasn’t always like this.

That same survey found that new patient wait times jumped 30 percent, between 2014 and 2017 alone. It’s also up from 2004 and 2009.

One of the main reasons for this is there is a shortage of doctors. If you hone in on our smaller towns and more rural counties...the wait could be even longer.

They have even fewer doctors. This is happening in our area, too.

But healthcare doesn’t just come down to doctors. There are far more nurses than doctors in every county according to that same data from UNC Chapel Hill.

How nurses are bridging the Great Health Divide

As we focus on a gap in healthcare in our rural areas - it’s simply put - there are not enough doctors.

It means longer waits to make doctor’s appointments, more time in the waiting room, and overall - it’s just harder access to critical care, when minutes matter.

“I think the biggest challenge from an access perspective is being able to get care when you need it. And in the most appropriate setting. And you know, the emergency department isn’t always the most appropriate setting. And in a lot of rural areas, that’s the only alternative to primary care when there’s access problems. And so I think they would be able to get it, maybe not as timely and in the most appropriate setting,” Brian Yates, CEO of Ashe Memorial Hospital in Ashe County, said.

Yates sees this struggle every day.

Ashe County has been designated an underserved area for primary care, dental care, and mental health care, It means there are just not enough doctors to keep up with the population.

We’re exploring why this is happening. Yates says the big picture is demographics.

“The aging community of referring of retiring physicians, the young community of physicians just hasn’t kept up. So they’re actually aging faster than we’re being able to recruit them,” Yates said.

According to a study by the Association of American Medical Colleges, two out of every five physicians will be 65 or older in the next decade. Retirement age.

And while that happens - demand for healthcare is growing.

Because as our doctors age, so does our overall population. That same study found that the over-65 population is expected to grow by 45 percent in the next 15 years.

It generally requires more health care and attention. But there is also a specific problem our rural counties deal with.

As Yates explains, while their population ages, and their doctors retire - they just can’t recruit younger doctors.

How a shortage of doctors impacts medical care in North Carolina's rural areas

Right now, several initiatives are underway in North Carolina to recruit younger doctors to rural areas.

  • The state has a rural recruitment program in partnership with residency programs across North Carolina.
  • The Mountain Area Health Education Center has partnered with UNC Asheville for a rural fellowship program. They place new physicians in rural counties to work for a year. Two doctors are placed in Ashe right now.
  • And East Carolina University has a scholarship program to train advance practice nursing students and place them in underserved areas for at least two years.

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