Physician Shortage in Rural Georgia
by Emily Kopp
Flipping through the morning paper, you may come across this ad - Wanted: Doctors. With a booming population and aging workforce, Georgia is facing a critical physician shortage. Nowhere is it more visible than in rural areas. But some young doctors are bucking the trend.
The state government gave Heather Naggar a scholarship to the Medical College of Georgia. In return, the Atlanta native is working far from home, in the manufacturing town of Wrens. She opened her practice here just a few months ago. She's still getting to know the locals. On this morning, a couple has brought their feverish granddaughter, who's wary of strangers.
"Hey, Mary Joyce! How are you, sweetheart?" Naggar tries to soothe the toddler, but without success. She has more success in setting the grandparents at ease. She explains everything she does. They seem to listen. Naggar says patients' satisfaction isn't the problem - it's getting them through the front door.
"People really want everyone else to try you out first," Naggar says. "One of my patients works in a hair salon and she says 'People ask me about you all the time and they want to know if you're okay.' I think things are slower to start up here than they would be in a larger area."
But Naggar is optimistic. After all, she's the only full-time pediatrician in town. Pediatricians are especially rare in rural Georgia. Naggar says she almost didn't come here because the state board that awards country doctor scholarships doubted a city girl could make it in a two-stoplight town.
"My response was, 'I've lived in Atlanta my whole life because that's where my parents lived,'" Naggar says, "'but these are the reasons why I think living in a small town would be great.' And I talked about family life and I talked about getting to know my patients."
Naggar says she loves Wrens, but studies have shown that most doctors who succeed in rural areas have grown up there, like Anthony Davis. He graduated from schools in Atlanta and Macon, but Davis says he's always wanted to return home to Swainsboro.
"I enjoy easy access to hunting, fishing," says Davis. Now Davis is raising his children here, and working in nearby Twin City, population 1,777. His wife, Brandy, admits she misses Thai food, upscale coffee shops, and supermarkets.
"It's definitely been an adjustment just going from being able to go to Publix or Harris Teeter-- huge grocery stores--just around the corner to having only two stores to choose from," she says.
Brandy isn't impressed with the job opportunities in Twin City, so she's trying to start her own home-based gift shop. Anthony Davis says the lack of options in tiny towns may be deterring other doctors. "By the time you get done with your training, you've been away 12 to 15 years and you make roots in other places," he says. He knows several physicians who grew up here, but none of them have returned. "Most time, they're either married or almost married and they have to consider what their spouse wants as well."
It's not just the lifestyle that can be tough. The work can be relentless. "Being the only physician in a particular county, you don't have the back up," says Dr. Joel Bray, who runs the health clinic in Soperton, near onion country. "If I need help from a nephrologists or a gastroenterologist, I can't call down the hall and ask a partner, 'Hey, can you come down here and take a look at this?' I've got to find help in far-off places."
People come to Bray with all sorts of problems. On this afternoon, he sees a smoker with allergies and swollen legs, a 500-pound man who had a bad reaction to blood thinners, and 82-year-old Miss Ollie Kate. Her arthritis is so bad, she can barely walk. She points to her left knee. "The first time this one gave out on me, I fell outside. I was going to the mailbox," she says. "The pain hit so hard, I fell on the concrete."
Bray gives Ollie Kate two shots in the knees to ease her pain. He also asks about her family, and offers advice on a personal issue with her grandson. Ollie Kate says Bray is "very nice." Before this clinic opened, she saw a doctor 24 miles away in Dublin. "I wouldn't go if it was further away because I have to get someone to bring me," she says.
Stories like Doc Hollywood, about a country doctor, inspired Joel Bray to seek out a rural practice. He knows he misses out on some things urban physicians receive. "I could make a lot more money working in Augusta, Savannah or Atlanta, but the rewards of being in a community like this and being comfortable, and knowing my family is comfortable, that's what matters," he says. "Knowing I'm providing a resource to these people that otherwise they wouldn't have, that's the rewarding part."
Georgia officials hope other young doctors follow suit. Most of the state's physicians are baby-boomers. But numbers from state medical schools don't look good.
"This state hasn't seen a real increase in graduation rates for medical school in a couple of decades," says Ben Robinson, executive director of the State Medical Education Board. He says a recently-opened medical school will help. But will it be enough? Georgia is the ninth most populous state in the nation and it's growing quickly. But it lags behind two-thirds of the country when it comes to recruiting doctors.