The Big Five: Healthcare Workforce Deficits


Welcome back to TeleQuality’s blog series on the top five issues putting healthcare providers into financial crisis. Today we will unpack the second issue of our series: Healthcare Workforce Deficits. The healthcare system is facing a serious workforce shortage. From physicians and nurses to health IT workers, these shortages are being felt deeply across the country every day. As with most challenges in the industry, the shortage is exacerbated in rural areas. There is both a limited supply of medical professionals to cover the needs of our population, but also a limited number of skilled IT workers to manage and support the complex IT environments relied upon heavily by healthcare organizations of all sizes.

According to the National Rural Health Association, almost 60,000,000 people live in rural areas of the country making up about 19% of the U.S. population, while only 10% of physicians practice in rural areas.  In 2014, the Association of American Medical Colleges projected a shortage of 45,000 primary care doctors and 46,000 specialists by 2020 in the U.S. In addition, a 2014 Health Resources and Services Administration (HRSA) study showed:

  • Nearly 20% of Americans live in areas with an insufficient number of primary care doctors;
  • 16% live in areas with too few dentists;
  • 30% are in areas that are short of mental health providers.

HRSA also found in a majority of rural counties 1 practitioner serves 3,500 patients, when it’s considered adequate for 1 practitioner to serve 2,000 patients.


The workforce shortage reality is even worse for physician specialists. On average, there are 54 specialists for every 100,000 patients in rural areas, especially:

  • General surgeons;
  • Cardiologists;
  • Neurologists;
  • Rheumatologists;
  • Pediatricians;
  • Obstetricians/gynecologists;
  • Psychiatrists;
  • Internists.

So, how is this happening and why? There are numerous factors that contribute to the workforce shortages but the main hurdle all of our rural healthcare provider customers cite is recruitment. Simply put, most physicians are looking for the cultural amenities afforded in urban or metropolitan areas as opposed to rural America. Rural healthcare providers also can’t compete with urban providers in terms of salary and pay for physicians due to their low-income patient base and limited financial resources. In addition, rural healthcare organizations don’t have as big of a network for reaching new medical school graduates as their metropolitan counterparts. This scenario puts rural healthcare providers at a disadvantage from the very beginning.


In terms of a skilled IT workforce, our direct experience with customers has proven there is a consistent demand for IT technicians but a general supply shortage in rural America. Those individuals that get an IT education typically stick to higher paying jobs in metropolitan areas rather than returning to their rural roots and working locally. This adds another element to the struggle rural healthcare providers are having to keep up with the technology demands of today’s healthcare delivery system.

The physician shortage creates a healthcare access problem, from primary care to specialties. It is less expensive to care for patients by managing their health proactively in a clinic setting, but with so little access to such care, patients end up in the Emergency Room with more acute cases. Or, Emergency Rooms are used in place of a primary care provider forcing what should be a routine office visit into a high cost care setting.

Regulatory requirements, like mandatory direct physician supervision of therapeutic services, increases the burden on rural hospitals. The physicians that are in place are stretched thin to meet regulatory demands, taking more time away from patients in the community.

Although it was hoped that changes to the Medicare Graduate Medical Education residency slots via the Accountable Care Act would help, the lack of rural teaching hospitals stifled a positive impact for rural communities. What funding is there assists physicians at the beginning of their careers, but offers no assistance for retention.



So what can we do to solve this shortage?

Fortunately, the stunning advancements in health technology over the past decades leave telemedicine as one of the obvious solutions to mitigate the patient access problems generated by the physician workforce deficit. With a variety of telemedicine tools and practices available for nearly every healthcare facility, telemedicine provides the perfect solution that increases access and quality care for rural communities while decreasing costs and taking advantage of existing urban physicians.

From telepsychiatry and telestroke to remote patient monitoring and store-and-forward technologies, telemedicine can be tailored to your organization’s specific needs that can help alleviate the workforce shortage.

Of course, implementation of telemedicine is not without hurdles. Some of the challenges experienced include:

  • Costs associated with implementing a new telemedicine program.
  • Lack of awareness of funding opportunities to assist in implementation costs.
  • Necessary bandwidth and local IT infrastructure needs to be in place to successfully implement.
  • Inter-state licensing, especially for those areas that border nearby states.
  • Varying reimbursement by state and payer

However, after successfully navigating these challenges, access to physicians, both primary care and specialists, becomes much easier to work through! It allows physicians wanting to work and live in metropolitan areas to stay there while extending their reach to patients in rural areas that otherwise have difficulty traveling to whatever nearby area those physicians are located.

One of the most successful telemedicine cases is Project ECHO at the University of New Mexico’s School of Medicine. Using virtual consultations through telemedicine, this project enables primary care providers to treat patients that normally require a specialist. The project uses case-based learning to enable treatment of complex, common diseases which provides:

  • Local access for treatment to the patients
  • Continuing medical education to providers, at no cost
  • Access to consultations with specialists
  • Increased professional satisfaction for the providers

There’s no question that telemedicine is a leading solution to the healthcare workforce deficit, so what are you waiting for? Start your telemedicine journey today!

Is your healthcare organization facing workforce deficits? Have you found relief through telemedicine or another solution? Let us know in the comments below or email us at!

Interested in expanding your organization’s services to include telemedicine? The first step to any successful telemedicine program is a fast and interconnected telecommunications network. Contact us today for a free evaluation of your network and how we can help you get equipped with the bandwidth you need for a future telemedicine program!

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