Rural Healthcare Providers in Georgia
Healthcare in rural Georgia is in desperate need of a change because due to limited access. 89 Georgia counties have been identified as Primary Care Health Professional Shortage Areas.[1] More specifically, as of 2020, 9 counties had no physicians; 82 counties had no OB/GYN physicians; 65 counties had no pediatric physicians; and 90 counties had no psychiatry physicians.[2] Lack of access to general physicians and to different types of specialists causes health disparities for rural residents in Georgia.
Recognizing a need to understand this issue, the Georgia Senate Committee passed Senate Resolution 371 to create the Senate Study Committee on Rural Medical Personnel Recruitment during the 2023-2024 Regular Session.[3] The resolution cited that rural hospitals face unique challenges in providing services to larger areas of coverage and also in recruiting surgical personnel, specifically.[Ibid] The committee, composed of five senators, held its two hearings and was abolished on December 15, 2023.[4]
The committee’s second hearing was held at Augusta University in late October, where senators serving on the committee had the opportunity to visit the school’s Interdisciplinary Simulation Center to learn about Certified Registered Nurse Anesthetist (CRNA) training.[5] Additionally, the committee heard presentations and recommendations from the Medical College of Georgia, the Georgia Society of Anesthesiologists, the Georgia Association of Nurse Anesthetists, and Augusta University.[6]
As the only public medical school in Georgia, the Medical College of Georgia (MCG) at Augusta University plays an important role in training the future healthcare providers of Georgia residents.[7] Dr. David Hess, who is the current dean at the Medical College of Georgia, explains that “… it’s important for state leaders and policymakers to understand what we are all doing here to help alleviate the shortage of health care professionals in the most underserved areas of Georgia. I view it as MCG’s responsibility and a critical part of our mission to help alleviate these shortages.”[Ibid]
In their presentation, MCG highlighted what they are already doing to train their students to enter the rural healthcare workforce. MCG 3+ programs give medical students the opportunity to complete their degree in three years and then use their fourth year of school to begin residency, complete a dual degree, or conduct more specific research.[8] The Peach State Scholars Program covers tuition for a small group of medical students who complete their degree through MCG 3+ and choose to enter a primary care residency in an underserved area of Georgia.[Ibid]
A recommendation that stands out from the Georgia Society of Anesthesiologists is to enhance the currently existing Georgia Physician Loan Repayment Program to incentivize more healthcare providers to practice in rural areas.[9] Under current program guidelines, only certain medical specialties and rural areas with populations of 50,000 or less are eligible for the loan repayment program.[10] Expanding the program to include more specialties and to any underserved area (both rural and urban) with a population of 50,000 or less would encourage and incentivize more providers to practice in underserved areas across Georgia.[11]
The Georgia Association of Nurse Anesthetists recommended that the General Assembly move to pass and adopt SB 102 and HB 445, which were introduced during the 2023-2024 Regular Session.[12] These pieces of legislation would allow CRNAs to practice without the supervision of a physician, therefore removing a barrier for CRNAs to practice.[Ibid] Allowing CRNAs to practice without supervision will increase the number of providers available to assist with services for surgical procedures.[Ibid] So far, 22 other states have chosen to allow CRNAs to practice without physician supervision, and CMS is able to reimburse states for the services that CNRAs provide.[Ibid]
The Georgia General Assembly should consider these recommendations from the associations that represent the healthcare providers of our state, as they are experts in understanding the gaps in access to care that disproportionately impact rural Georgians.