Even if new general surgeons practice in exurban or smaller cities, that is still preferable to having a glut of physicians practicing in urban centers. "We used towns of 50,000 as the cutoff in our study but there are some who went out to general surgery practice in smaller towns that are between 50,000-100,000," Deveney says. "Those are still closer to where the real need is than in the middle of Portland or Chicago or Seattle."
Deveney readily concedes that the numbers of residents in the Oregon study who gravitated towards rural settings come nowhere near meeting demand. Even so, every little bit helps, and she says the Oregon rural residency rotation could be a model for other states.
"Our program only produces a small number but if you multiplied that by 250 training programs that each produced a couple that would increase the number," she says.
"Increasing the number of trainees entering general surgery practice in rural areas won't take care of the shortage entirely because we don't produce enough general surgeons every year in the entire country—even if all of them went into rural surgery—to do the job. But between our model within a training program and one or two existing programs that have carved out an actual rural track residency program we're mostly saying 'hey if you do this it will work and here is how you do it.'"
"Anything we can do to give greater exposure to the joys of a more generalized practice will have an effect on redistribution."