To Save American Medicine, Look to Rural Doctors

If hit television shows like Grey's Anatomy are to be believed, the average American doctor is gorgeous, well-paid, brilliant, and resides in some gorgeous and spacious loft in some gorgeous and spacious city, where she or he spends most days contemplating romance and a perfect wardrobe.

Reality, of course, is very different. In real life, doctors are exhausted, overworked, frequently underpaid, and, sadly, have very little time for life's little idle pleasures. But one part of the stereotype is true: They probably do live in cities.

Slightly over a century ago, more than half of all Americans lived in rural areas, and more than 40 percent of their doctors did as well. Americans have since moved out of the country and into the city -- by the 1960s, two out of every three Americans were residing in urban communities -- and their doctors moved even faster. While states like Massachusetts boast 414 physicians for every 100,000 Americans, in more rural stats that ratio is sometimes as dismal as 176 doctors for every 100,000 residents. This means that unless you live in a big city, your community is 2.5 times more likely to be facing a severe shortage of primary care physicians.

To a certain extent, that's understandable. Doctors, like everyone else, are not immune to business considerations, and from a strictly business standpoint, it seems sensible to want to set up shop where you're likely to attract the greatest possible number of potential clients.

It seems sensible, but, increasingly, it isn't. The future of American medicine, from both an economic and a professional standpoint, isn't in New York or Seattle or Chicago; it's in Vidalia, Reidsville, and Statesboro. And it's not only because rural areas have greater demand, and therefore save young doctors from the cutthroat over-saturation of any large market. It's mainly because the life of a rural doctor, ironically, is much closer to the glamorous ideal you see on TV.

It sounds like a strange statement, but consider the evidence. Down where we are, in southeast Georgia, we live in the communities we care for, and the communities aren't large. This means that we attend church with our patients, see them in the local diner and at the annual charity auction, know them from the PTA and the town's 4th of July picnic. When they end up in our care, then, we never treat them with the same detached manner as an urban doctor who sees hundreds if not thousands of strangers each week.

I'm not suggesting, of course, that physicians in large metropolitan areas give their patients anything but the most excellent care possible. I am suggesting, however, that when the patient sitting in your office isn't just a name and a case history, but a neighbor and a friend the atmosphere is very different.

All these warm, fuzzy feelings, however, have clinical advantages as well:

Because we get to know our clients so intimately, we get to offer them both the kind of diagnosis and the sort of care that is specialized to their own needs. Even when the volume of patients is high -- and it often is -- we don't believe in the industrial approach to patient management. Whether with spinal injuries, joint problems, or physical therapy patients, we do what one does with folks one cherishes: We take the time to listen, comfort, and heal.

And learn: Because advances in medicine often depend on close and careful observation of causes, conditions, and permutations, it pays off to have a clinical environment free of the rush and the hustle of big city life. Peace of mind is essential in our line of work; we have it in spades in our small rural towns, and it gives us rural doctors the luxury of being as slow and thorough as we need to be.

So while downtown Statesboro may not be as cinematic as the sweeping, rain-soaked metropolis you see on Grey's Anatomy, if you're looking for the moving, dramatic, and intimate hospital environment you see on TV, and for the passion and commitment that make doctors such great subjects for hit shows, forget about big cities and their grind, and head down south. We'll treat you not only as a patient, but as a friend.