Staffing Shortages and Rural Healthcare


Between historic attrition rates and increasing demand for healthcare specialists, staff shortages are an enormous challenge for the whole of healthcare. Rural clinics and hospitals are among the hardest hit, and most were already understaffed prior to the pandemic. With rural populations already suffering from disproportionately low access to quality healthcare, the added challenge of protracted wait times to see fewer practitioners is affecting rural patients most significantly.

Astronomical attrition rates

In 2012, the National Rural Health Association (NRHA) published a document entitled Health Care Workforce Distribution and Shortage Issues in Rural America. The brief offered a critical look at the disparity of qualified healthcare professionals serving rural populations and called for ramping up staffing efforts in these areas. Even a decade ago, there simply weren’t enough healthcare professionals available.

In 2022, following the COVID-19 pandemic, the situation has grown far more dire. Practitioner attrition related to the pandemic ranges from 8% to 37% depending on the region, with burnout markedly higher among rural nurses and physicians. Even at the low end of this scale, healthcare professionals are departing the field at a record pace, leaving rural providers to struggle further with provision of care.

Ultimately, it’s rural residents who suffer. Longer wait times, lower quality of care, and lack of resources all contribute to an already stark disparity in healthcare.

Shortages result in sicker populations

What happens when there are only four nurses to fill a shift that demands seven? What do patients do when the only local rheumatologist or gastroenterologist has appointments booked months in advance?

For a growing number of rural residents, the answer is simply to forgo healthcare. It’s a decision with detrimental consequences in both the short and long term. Acute conditions that progress without treatment can become severe or chronic. Quality of life deteriorates, the sick get sicker, and opportunities for preventive care and proactive solutions continue to decrease.

Even those who prioritize their health confront barriers to access as staffing shortages affect the ability of rural providers to meet patient needs in a timely manner. Patients who require specialized care find themselves traveling farther, and wait times — or times between follow-up appointments — increase as fewer staff serve more patients. Meanwhile, the costs of healthcare continue to rise, and even the most persistent patients in rural areas find it increasingly difficult to access consistent, quality care.

Worst of all, attrition tends to replicate. Nurses and other healthcare staff who step away to preserve their own health aren’t replaced, placing burdens on remaining staff — and eventually leading to further attrition.

Hope on the horizon

While staffing is a clear and ongoing concern in rural healthcare today, a 1:1 replacement for providers isn’t the only solution. In many situations, finding ways to streamline healthcare and improve accessibility will go a long way toward alleviating the bottlenecks caused by staffing shortages.

Digital technology, like electronic health records (EHR), for example, enables patients to take a more proactive approach to their health — while also helping physicians treat and manage conditions more effectively. Point-of-care ultrasound (PoCUS) is just one example of low-cost medical technology that’s both reducing the cost of care and improving patient outcomes. Innovations like these and others are bridging the gap between staff shortages and rural healthcare outcomes in ways that benefit both healthcare providers and their patients.

Innovation and the future of rural healthcare

Experts expect staffing shortages to continue, particularly among nurses and other frontline healthcare professionals. While personnel remain hard to find and demand for healthcare continues to rise, more and more providers are turning to medical technology investments for the future. While there’s no substitute for trained medical professionals, digital solutions are making it possible for those burdened by the shortage to maintain a higher standard of patient care.