Models from Other Communities: Hope for Health Care
What does a successful effort to improve access to health care in an isolated rural region like ours look like?
The good news is that examples exist of best practices that worked elsewhere to create a better healthcare future.
It’s not just recruiting medical professionals. Recruitment is just the preface to our book on a healthier Humboldt County. After recruitment comes retention — once they come here, what will make medical professionals stay?
As the 2005-2026 Humboldt physician data show (page 3), our region churns through more physicians than is healthy. This is a death spiral. The fewer physicians we have, the more difficult it is to attract new ones. As numbers of doctors dwindle, the burdens on those remaining grow. Across the country, research shows, physicians say in exit interviews that the job is impossibly hard and professionally isolating, which makes retaining current providers and attracting new medical personnel even harder.
The good news is that similar small towns and rural areas — Visalia, California, rural Nebraska and eastern Washington state — have found ways to build their healthcare provider corps. They made their communities more “sticky” to retain newcomers. Sticky communities are welcoming, where new providers and their families feel greeted and appreciated by the larger community, not just the hospitals and clinics that hire them.
What does that look like? What follows may seem like common sense, but requires a functional “village” for success. High pay may get a doctor to a rural town, but social and professional integration is what determines whether they stay beyond two years.
Research shows that physician hiring must shift from a “transactional HR task” to a “community-wide integration project.” One American Medical Association study found that the newcomer’s own background makes a difference. “Physicians who felt socially prepared for small-town life were twice as likely to stay at least six years compared to those who only felt medically prepared,” the study said.
Many studies — including from the National Institutes of Health and the National Rural Health Association — conclude that finding a comfortable, welcoming home is more important than money in retaining new physicians. Successful employers focused beyond the individual recruit: if the spouse and family do not find work, good school matches or connections, the doctor will leave regardless of paycheck, research shows.
“Loan repayment and teaching opportunities ranked significantly lower than community integration and family happiness,” researchers said. The “wishes of significant others” — i.e., partners and children — were the single more important factor in long-term doctor retention.
Professional isolation is another leading cause of turnover, and social ties act against that isolation. One North Carolina study concluded, “By integrating residents into local non-profits, school boards, and community events during training, they achieved a retention rate near 90%.”
In these studies, physicians who stay 10-plus years usually had at least two of these:
• 36% of successful rural MDs grew up in a rural area, or
• They completed a “rural immersion” program or residency, and
• Areas near outdoor recreation have naturally higher retention rates for younger MDs seeking work-life balance.
Communities that successfully attract and hold onto healthcare professionals are proactive and creative, taking a more holistic approach and making them feel welcome. Humboldt County should be able to do that.
If we want Humboldt County to enjoy the advantages of a village, it is time for us to act like one. Let’s dust off our creative community hats and figure this out!
Peter Pennekamp is a longtime community-builder who lives in Eureka.
