Kentucky’s primary care provider shortage − and the National Health Service Corps’ possible solution

BY LYNN ANN BISHOP − KENTUCKY PRIMARY CARE ASSOCIATION

FRANKFORT − Rural Kentucky is experiencing a serious shortage of primary care providers. Primary care physicians, nurse practitioners, dentists, dental assistants, social workers, psychologists and others work in outpatient clinics, local health departments and private practices in rural areas across the state. Today, only 28 percent of Kentucky’s primary care physicians work in rural areas, while 43 percent of the state’s population lives in these regions.

This disparity leaves many health care providers overworked and under stress. Aggravating the situation even further is the fact that more than one-third of the rural doctors are either past or approaching retirement age. As primary care providers become more and more stressed because of this situation, the more likely these providers will decide in favor of retirement. And younger health care providers are considering career changes because of the long hours that are expected of them to compensate for the shortage of providers.

Patients, too, are feeling the pinch of the primary care shortage. They are finding it more and more difficult to be seen by primary care providers in their own community and are often forced to drive 30 to 45 minutes to the nearest health care facility. Rising gasoline prices are creating an additional obstacle for people seeking early treatment. Delaying primary health care can lead to more serious illnesses and require more complicated treatments. Hospital emergency rooms are serving as the first place people turn when help is needed. This is leading to unnecessary non-emergency visits to already-overcrowded hospital emergency rooms.

To alleviate this problem, the National Health Service Corps, through the office of the Health Resources and Services Administration, is offering health care providers an incentive to work in underserved areas of Kentucky. The Loan Repayment Program will award a health care provider up to $50,000, tax free, to be used towards outstanding qualifying educational loans. In exchange for this monetary award, the health care provider is required to sign a commitment to work in an approved facility in an underserved area for two years.

NHSC-approved sites include rural health clinics, public health department clinics, hospital-affiliated primary care practices, managed care networks and prisons. To help make the connection between primary care providers and underserved areas, the NHSC’s Web site has a listing of employment vacancies at already-approved facilities across the state.

The NHSC has recently set aside an additional $200 million for this program and streamlined the application process. An easier-to-complete online application form is available on the NHSC Web site and the number of required documents needed to verify the outstanding educational loans has been cut in half.

An applicant will receive notification of acceptance into the program within six to eight weeks. The applicant must be working at or begin working at an approved facility within 30 days of accepting the monetary award. Wages and employee benefits are negotiated as usual, and are not a condition of the contract between the primary care provider and the NHSC.

The objective of the Loan Repayment Program is to increase the number of primary care providers working in areas that have the greatest need. Participants in the National Health Service Corps’ LRP often mention the greatest reward is not the salary they receive for their work. Rather, it’s working in an area where they feel most needed and appreciated by the patients they treat. They understand they are making a difference in the lives of the people they are serving.

Many LRP participants are young people with families who enjoy the advantages of raising a family in smaller, rural communities. When providers work in an underserved area, they become part of the community and are less likely to leave, creating a win/win situation for the health of the community and the lives of the health care provider and their family.

Information about the National Health Service Corps’ Loan Repayment Program can be found on the Web site − nhsc.bhpr.hrsa.gov/about. If you have questions about the LRP, you may contact the author at (502) 564-8966, ext.3241 or This e-mail address is being protected from spambots. You need JavaScript enabled to view it