Expanding access to health care increases the demand for skilled physicians, and medically underserved areas suffer the most drastic shortages as doctors retire without being replaced. By recruiting more female physicians, rural health facilities can satisfy the surgical needs of aging populations that normally go without care or travel to distant hospitals for specialists. Communities that hope to attract female surgeons should provide a flexible, supportive framework for women managing work and families.
Obstacles to Recruiting Female Surgeons
The Association of American Medical Colleges projects a shortage of 25,200 to 33,200 U.S. surgeons by 2025, while women remain underrepresented in medicine, making up only 33 percent of licensed physicians. One reason for gaps in rural health care is the cap on Medicare reimbursement for graduate medical education, which limits the number of residency positions teaching hospitals can support. Another deterrent is the misogynistic culture many women encounter in surgical residencies.
Niamey Wilson, Director of the Hoffman Breast Health Center, regularly faced sexist, discriminatory attitudes in an environment where maternity leave was treated as a nuisance and families were expected to come second to patient care. Today, she acts as a mentor for students and residents in hopes of grooming female surgeons to become leaders in surgical communities. Wilson identifies poor work-life balance, wage inequality and antagonistic leadership as major reasons women choose not to practice surgery.
Recruiting Women to Medically Underserved Areas
On average, rural health systems have roughly 68 primary care physicians per 100,000 residents, according to Advisory Board. General surgeons are even more scarce, often serving multiple counties and traveling between critical-access hospitals with little or no relief for personal time. Despite offering high salaries, rural health systems have trouble recruiting surgeons because many medical schools don't expose students to rural training, making it difficult to convince them to sacrifice the professional support, convenience and entertainment of larger cities.
To understand the needs of rural physicians, a research team asked 25 female family doctors from 13 states to describe factors that help them foster successful careers. The most important factor was spousal, family and community support, reducing their roles as home caregivers and helping them avoid burnout. In some cases, spouses worked from home or instantly adjusted to accommodate the doctor's call schedule. The physicians also valued flexible work hours, personal boundaries and cooperative practice partners who can step in when conflicting obligations arise.
Rural health facilities should consider similar incentives when recruiting female surgeons, such as customized work schedules and readily available daycare for women who are primary caregivers. Rural surgeons are often isolated from other specialists, making it valuable to create professional networks they can consult for advice and continued training. Many states are also developing support programs that supply covering surgeons when rural surgeons need vacation or personal leave.
Women are more likely to practice in rural areas if they lived or trained in such environments, but they aren't likely to look beyond stereotypes until they see real female surgeons leading balanced, successful lives. Recruitment efforts can be more effective if medical institutions invest in mentorship and training programs that introduce medical students to rural health care while they're forming early opinions about the specialties they want to pursue.
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