This overview of rural health care today shows the role that internal medicine can and should play in delivering primary care to rural populations.The American College of Physicians recommends changes to improve access to and delivery of primary care in rural areas. There are six specific recommendations.
1.Implementing universal health care coverage through a system that makes primary care equally affordable to rural populations.
2.Increasing the supply of primary care providers in rural areas by lessening specialty and geographic differentials in physician income.
3.Increasing the supply of primary care providers in rural areas by changing medical education to emphasize training enough rural physicians.
4.Decreasing professional isolation in rural areas through accessible continuing medical education and through telecommunications technology.
5.Identifying tertiary care needs at the community level and using state and federal funds to assist rural hospitals where access to care would be threatened by hospital closure.
6.Using innovative delivery systems that emphasize coordination and cooperation among providers, institutions, and communities.
*This paper, authored by Janet Weiner, MPH, was developed by the Rural Advisory Group (see the Appendix for members of this group) for the 1993-1994 Health and Public Policy Committee: Gerald E. Thomson, MD, Chair; Whitney Addington, MD; Robert A. Berenson, MD; Christine K. Cassel, MD; Nancy E. Gary, MD; Sheldon Greenfield, MD; David J. Gullen, MD; Charles E. Harrison Jr., MD; L. Julian Haywood, MD; Ana Maria Lopez, MD; Ernest L. Mazzaferri, MD; Mack V. Traynor, MD; and James R. Webster Jr., MD. This paper was approved by the Board of Regents on 21 November 1993.