Albert Lea flap spotlights need to help small hospitals recruit, retain medical providers

The bitter battle over the future of a small southern Minnesota hospital has spotlighted a sensible step state lawmakers can take to fortify other outstate medical centers.

In 2018, the Legislature should move swiftly to boost funding once again for a student loan forgiveness program that helps entice medical providers to practice in rural and other underserved areas. While the 2015 Legislature approved a healthy increase to the program, "there are still more applicants than slots available in all of the eligible professions,'' according to the Minnesota Department of Health (MDH).

The difficulty of recruiting and keeping medical providers in small communities is one of Mayo Clinic's key justifications for the controversial changes it has proposed to the Albert Lea hospital. The Freeborn County city's former Naeve Hospital has been part of Mayo's outstate network since the 1990s.

In June, Mayo abruptly announced plans to consolidate services at its Albert Lea and Austin, Minn., campuses. Intensive care, labor and delivery, and most inpatient services will move to Austin. Behavioral health services and outpatient surgeries will remain in Albert Lea, along with emergency care. The move understandably set off alarms in Albert Lea because citizens will need to drive 22 miles east for important medical needs.

In an interview with an editorial writer, Mayo officials emphasized how challenging it is to attract physicians to work in small medical centers. New medical school graduates may have dozens of job offers, they said. Bigger facilities, with their larger patient volumes, are also thought to provide more opportunities to hone providers' skills.

Recruiting medical providers to rural regions is not a new problem, of course. It will take innovation on the part of health care systems like Mayo to maintain a level of service a community expects. City leaders will also need to step up and find ways they can make their communities attractive to young professionals.

But state lawmakers also have a role in addressing this challenge. That's especially true in Minnesota, where agriculture powers the economy and small towns perched on the prairie and at the edge of the North Woods are a vital part of the state's culture. Boosting funding for the health professional student loan program is one solution.

The program, administered by MDH's Office of Rural Health and Primary Care, currently has 300 enrollees. Data suggest that the state loan forgiveness program works. "About 80 percent of the participants remain for the long term in their original or a similar setting in Minnesota,'' a program spokesman said. The professions the program is open to include doctors, mental health professionals, dentists and public health nurses. The annual "forgiveness awards" are based on 15 percent of the average educational debt of recent graduates in each profession.

The 2015 Legislature gave the program a welcome boost, increasing annual funding from $740,000 to $3.2 million. State Rep. Debra Kiel, R-Crookston, merits praise for her leadership on this.

Kiel has been watching the Albert Lea flap unfold and doesn't mince words about the difficulty of recruiting doctors to rural areas. Minnesota, she said, has a "serious problem." She agrees that more needs to be done and that strengthening the student loan forgiveness program again should be looked at.

Lawmakers, especially those who made campaign vows to prioritize the needs of greater Minnesota, ought to heed Kiel's concerns. They also ought to work to prevent another serious threat to the loan program's future. Dollars for the program come mainly from the state's health care access fund. The medical provider tax generating revenue for this fund is slated to sunset in 2020.

The fate of the tax likely will spur robust debate in coming legislative sessions. That it helps fund a loan forgiveness program vital to small communities' future well-being should be an important part of the discussion.