A targeted Rx for rural health care

Opinion editor's note: Editorials represent the opinions of the Star Tribune Editorial Board, which operates independently from the newsroom.

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Few things are more fundamental to Minnesotans' quality of life than access to medical providers. That's why it doesn't take long for alarm bells to sound during a dive into the data collected by the state Department of Health's Office of Rural Health and Primary Care.

While the health care workforce across Minnesota is struggling with burnout and looming retirements, the problem is especially acute outside metro areas, where doctors' median age is a decade higher than their urban counterparts — 58 vs. 48.

"One out of every three rural physicians reports planning to leave their profession within the next five years, exacerbating existing shortages," according to the rural health office's sobering 2022 analysis.

Another data point underscores concerns about the need for more doctors. Per capita, far fewer physicians are already serving the state's rural areas than its urban areas. The population-to-physicians ratio for urban areas is 245. For rural areas, it's 894.

There isn't a cure-all for this workforce crisis. But one sensible solution is training more physicians interested in practicing outside the Twin Cities. Fortunately, a new proposal between the University of Minnesota Medical School and CentraCare, a St. Cloud-based health system, aims to achieve that. The appropriate reaction: "How can we make this happen?"

Last week, the two organizations announced they are working to open a new branch of the U's medical school in St. Cloud to recruit doctors interested in practicing in a small town or rural setting. As a Jan. 16 Star Tribune story noted, it would be the state's "first new medical campus in 50 years." While cost details are still emerging, this is a timely, innovative idea.

Minnesota already has three physician training sites. There's a medical school at Rochester's Mayo Clinic, and the U's medical school has two locations — one at the flagship Twin Cities campus and another in Duluth, with the latter opening in 1972.

The Duluth campus is already well regarded for its focus on primary and rural health care. If the new St. Cloud medical school campus opens, which would require approval by the U's Board of Regents and CentraCare's board, it would have a similar much-needed focus.

The collaboration would play on both organizations' strengths. The U trains 70% of the doctors practicing within the state. CentraCare's hospital-and-clinic network would provide valuable hands-on training for students and graduates.

The hope is that students drawn to the new campus would bring a built-in interest in a rural or small-town practice. And that they would establish community ties to the area while completing their education and training, making them less likely to leave.

Stats provided by the organization support this approach. An impressive 81% of medical school graduates who went through CentraCare's family medicine residency program in the last seven years are practicing in Minnesota. Of those, 59% are in rural areas and 73% outside the seven-county metro area.

Among graduates from the Duluth medical school branch, 63% stay in Minnesota, and 44% work in communities with a population of less than 20,000.

CentraCare would house the new campus in a retooled building once used by information technology workers now working remotely. The St. Cloud location is also logical. Designated "health professional shortage areas" for primary care blanket much of outstate Minnesota. But there's a troubling concentration of them in central and western Minnesota.

Stearns County, where St. Cloud is located, and eight of the counties touching its borders either have shortage areas within them, or the entire county is designated as a shortage area. The problem is particularly acute in counties north and west of St. Cloud. Creating a pipeline of students getting their education and training here is smart. The new campus could open as soon as 2025, with 20-24 students in each entering class.

The initiative is garnering national praise. "Challenges with accessing care in the nation's most rural communities contributes to health care inequities for patients. Creating new medical school campuses that provide opportunities to train and expand the number of physicians who can treat patients in underserved communities is a critical piece of addressing and improving rural health disparities," said Dr. Jonathan Jaffery, the chief health care officer for the Association of American Medical Colleges.

The workforce shortage encompasses more than physicians. Other approaches are needed to bolster the ranks of nurses, pharmacists, mental health providers and other caregivers. But U and CentraCare leaders have prescribed a targeted, doable remedy. It merits Minnesotans' support as it moves toward becoming a reality.