13 Nebraska counties have no primary care doctor. Here’s what UNMC is doing to reach rural areas

LINCOLN — Rural Nebraskans escape human hordes and traffic jams, but when they’re ill, many have a long way to go to see a doctor.

University of Nebraska Medical Center officials told the NU Board of Regents on Friday that they are finding ways to serve rural places and are recognizing what it takes to place a young doctor in a small town. They also are making progress through video technology and mobile training strategies.

UNMC has been working at this for years. The problem is sure to persist as urban America grows in population and rural America shrinks. In 1910, 54.4 percent of the United States’ population lived in rural areas. As of 2010, that had plummeted to 19.3 percent.

A report Friday said 13 of Nebraska’s 93 counties have no primary care doctor. Dr. Bradley Britigan, dean of UNMC’s College of Medicine, told the regents that the challenge of serving rural Nebraska continues.

All counties other than Douglas and Lancaster have been designated by the state as shortage areas for at least one kind of primary care. Those include family doctors, pediatricians, internal medicine doctors and obstetrician-gynecologists.

“There is clearly a workforce shortage in Nebraska, particularly rural Nebraska,” Britigan told the regents.

Statistics indicate that UNMC College of Medicine values rural students. In the college’s class of 2022 (those who entered last fall), 40 of 81 rural applicants won acceptance, while 79 of 198 applicants from the Omaha and Lincoln areas were accepted. Not all of those who were accepted enrolled at UNMC.

Eighty-eight percent of the class is made up of Nebraskans, Britigan said. In all, UNMC had 1,865 applicants for a class of 132.

More than half of the physicians practicing in Nebraska attended medical school, did their residency or had a fellowship at UNMC, the report said.

UNMC and other organizations have found that experience in rural Nebraska and having family there increase the likelihood that a young doctor will choose to practice in rural Nebraska.

“If you’re from a rural area, you’re much more likely to practice there,” he said. UNMC places medical students for six to eight weeks into rural family medicine clinics to expose them to working in small communities.

UNMC has had success with its Rural Health Opportunities Program and Kearney Health Opportunities Program. These initiatives give promising high school graduates scholarships to certain colleges. If they meet performance standards, they are then guaranteed admission to the UNMC medical school.

Over more than 20 years, 45 percent of the graduates of those programs have chosen to practice in rural Nebraska, Britigan said.

UNMC also has found success through telehealth, in which a UNMC doctor counsels a rural patient or health provider through video technology.

Dr. Paul Paulman, an associate dean in the College of Medicine, said UNMC also has taken advantage of a $5.5 million grant from the Helmsley Charitable Trust. UNMC has acquired four trucks that carry simulation equipment and other training aids around the state.

The mobile training program enables UNMC at no charge to teach and train emergency providers in towns and staff in small hospitals.

The 44-foot-long trucks visit small communities all over Nebraska. UNMC personnel can demonstrate how to handle difficult deliveries of babies, head injuries (the town’s coaches and trainers often participate) and trauma situations.

Paulman said the program started in Nebraska in 2017 and the grant money expires this year. Annual operating costs are about $1.1 million, Paulman said. The program, called SIM-NE, most likely will count on private money after the $5.5 million is gone.

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