WARM History

The University of Wisconsin School of Medicine and Public Health in Madison created a rural medicine program within the MD Program called the Wisconsin Academy for Rural Medicine.

There is a geographic shortage and maldistribution of physicians that affects rural Wisconsin. While 28 percent of Wisconsin citizens live in rural areas, only 11 percent of physicians have rural practices.

This compares unfavorably to national data where 20 percent of the population lives rural and 9 percent of physicians have rural practices. Eighty-three percent (60 of 72) of Wisconsin counties are designated as totally or partially underserved. Of the underserved counties, 77 percent are rural.

This shortage of rural physicians is projected to increase. As current rural physicians retire and as the population ages, there will be a need for more physicians. Further, literature shows that rural citizens are generally sicker, poorer, older and more likely to be uninsured.

These Wisconsin health care work force shortages are documented in two recent reports: "Health Care Wisconsin, a report of the Governor’s Health Care Worker Shortage Committee" (2002), and "Who Will Care for Our Patients? Wisconsin Takes Action to Fight a Growing Physicians Shortage," sponsored by the Wisconsin Hospital Association and the Wisconsin Medical Society (2004).

Resources

Who Will Care for Our Patients? Wisconsin Takes Action to Fight a Growing Physicians Shortage (pdf), sponsored by the Wisconsin Hospital Association and the Wisconsin Medical Society, 2004

What's Different About Rural Health Care? The obstacles faced by rural health care providers and their patients, an article by the National Rural Health Association.

Wisconsin Academy for Rural Medicine Funding

The Wisconsin Academy for Rural Medicine has been fortunate to have the support of the Wisconsin Partnership Program. WARM benefited from a Collaboration Planning Grant in 2004 and was awarded a Strategic Initiatives Grant in 2005. Funding was also awarded to the Wisconsin Academy for Rural Medicine in 2006 and WARM received an implementation grant in 2007. Each of these opportunities has allowed WARM to further its planning and, eventually, its formation within the University of Wisconsin School of Medicine and Public Health.

Making a Difference

Medical educators and policy makers can have the greatest impact on the supply and retention of rural primary care physicians by developing programs to increase the number of medical school matriculants with background and career plans that make them most likely to pursue those career goals.

Curricular experience and other factors can further increase these outcomes, especially by supporting those already likely to become rural primary care physicians." (Rabinowitz et al. "Critical factors for designing programs to increase the supply and retention of rural primary care physicians." JAMA 2001;286:1041-1048.)

"Scientific studies available to health educators and policy makers show there are predictable factors that influence recruitment and retention in rural areas. Policies should be aimed ... both selecting the right students and giving them during their formal training the curriculum and the experiences that are needed to succeed ... in rural settings." (Brooks et al. "The roles of nature and nurture in the recruitment and retention of primary care physicians in rural areas: A review of the literature." Acad Med 2002;77:790-798.)

"Medical schools must continue to make efforts to interest their students in careers as rural practitioners. And they must also try to enroll students for whom the advantages of being rural doctors outweigh the problems and who thus will make long-term commitments to rural care …" (Whitcomb, ME. "The challenge of providing doctors for rural America." Acad Med 2005;80:715-716.)