Bill sponsored by Rep. Perry Buck, Sen. John Cooke aims to bring more doctors to rural Colorado
March 25, 2016
With parts of Colorado facing a drastic shortage of medical professionals willing to practice in the lower-population areas, two northern Colorado lawmakers are trying, for the second year in a row, to do something about it.
"There's a huge shortage in the rural areas," Rep. Perry Buck, R-Windsor, said. "It's frightening."
That's why Buck and Sen. John Cooke, R-Greeley, co-sponsored House Bill 1142, which aimed to provide income tax incentives to some doctors who practice in rural areas. The bill was postpoed indefinitely with a 13-0 vote.
"The intent is obviously to help rural Colorado," Cooke said. "It helps with a little bit of a tax incentive so that doctors practicing out there will stay out there, and they'll be able to recruit new doctors."
“If there’s not some sort of other incentive then it’s that much harder to get them to do it. ... This is hugely important. People don’t go out into rural practice to get rich. Anything you can do to help them out, recognize them and incentivize them is very much appreciated.”
— Dr. Marc Ringel, medical director of Hospice of Northern Colorado and rural physician
Rural areas of the state tend to pay doctors less, and practicing medicine in these areas poses challenges that physicians in more populated areas don't have to face, such as equipment shortages and a higher percentage of patients on Medicare and Medicaid as the younger population move to the cities, said Dr. Marc Ringel, medical director of Hospice of Northern Colorado and an experienced rural physician.
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"It's hard to get good, qualified people," Cooke said.
To help get some of those qualified professionals into rural areas, the bill — which passed the House Public Health Care and Human Services 10-2 on Feb. 16 and was referred to the House Agriculture, Livestock and Natural Resources Committee — would offer a $1,000 tax credit to health care professionals who provide a minimum 4-week mentoring experience where a doctor provides personal instruction, training and supervision to an eligible graduate student.
Buck and Cooke proposed a similar bill last session that died because of resistance against the amount of the tax credit. The votes against it in its first committee test sprouted from similar concerns about increasing tax incentives while the state's finances struggle, Buck said.
"If this helps to get rural doctors out there, I think we need to do that," she said.
Up to 300 doctors can claim the incentive per year, which is credited against their income tax due and not issued as a refund.
So far, Buck expects that only about 160 doctors in the state will be eligible for the incentive.
These doctors typically face problems that can be difficult to address because of facility and staff limitations, Buck said.
Rural doctors have to be at least proficient in a wider variety of medicine out of necessity than those physicians who practice in metropolitan facilities with in-house specialists. The old adage that rural hospitals are where those with less talent or less training go simply isn't true, Ringel said.
Instead, they act as the front line of defense for health problems in these rural areas. Whereas city-based doctors can immediately refer to an in-house specialist, rural doctors have to make the decision of whether they can send a patient home, should keep an eye on them or fly them out to a larger hospital.
"If anything it's harder and you have to know more stuff," he said. "You're the first person that has to address so many problems."
Culturally and psychologically, attracting doctors to rural area poses a challenge, Ringel said. Broken down into two groups, there are people that enjoy lots of stimulus and change in their day-to-day lives and those that do not.
Rural healthcare is a mix of the two things: work life that is very active and stimulating and a lifestyle that a lower stimulus level.
This means that doctors coming into the area do not feel fulfilled and can be frustrated by the juxtaposition. By incentivizing doctor's in these areas to bring in new professionals, the bill helps mitigate the problems by developing an external network.
"Being involved in education is one of the best ways to stay connected," Ringel said.
It also helps expose medical students to rural practices and lay the foundation for later work.
"If you can get people exposed earlier in their career to rural practice and rural areas then they're much more likely to do that," he said.
The incentive helps to encourage rural doctors to focus more on the educational aspect when trying to balance their busy schedules.
"If there's not some sort of other incentive then it's that much harder to get them to do it," he said.
The bill also symbolically reflects much-needed attention at the state level of the plight of rural doctors, Ringel said.
"This is hugely important," he said. "People don't go out into rural practice to get rich. Anything you can do to help them out, recognize them and incentivize them is very much appreciated." ❖