Providers in rural communities are in great demand. Currently, there is a physician shortage in the United States. In fact, according to the Association of American Medical Colleges, the U.S. will experience a shortage of between 40,800 and 104,900 physicians by 2030. The shortage is due to an increased demand for healthcare services, an increasingly aging population. It doesn't help that the cost of healthcare as you age is drastic.

One may think that rural communities would be less affected by the physician shortage as underserved communities tend to have a lower demand for healthcare services. However, physicians usually gravitate to larger urban areas for a broader variety in career choices and better pay and benefits. For this reason, as well as due to the physician shortage, nurse practitioners often serve as primary care providers in rural communities.

The role of the nurse practitioner can be very similar to a physician's role. However, the state in which they practice may place more restrictions on them. Nurse practitioners have a variety of responsibilities including:

  • Taking a patient's history
  • Maintaining a panel of patients
  • Ordering diagnostic tests (imaging, blood tests, etc.)
  • Ordering prescription medications
  • Performing procedures (i.e., suturing, wound care, splinting, excisions, injections, etc.)
  • Admitting and discharging patients from the hospital
  • Providing education to patients and families
  • Following up with chronic conditions and disease management

While the role of the NP in rural settings is the same as in urban areas, they do face a unique set of challenges. For example, those living in rural communities have higher rates of chronic diseases. Rural NPs may have a more difficult time getting a patient's diabetes or hypertension under control as patients are less likely to seek treatment and follow up with care. Additionally, with the Affordable Care Act, there are more patients needing access to care. Because providers are sparse in rural communities, patients may have a harder time getting the care they need in a timely fashion.

Although there are challenges, rural NPs enjoy positive aspects such as more autonomy, the ability to operate their own practice, and getting to develop close relationships with members of the community they serve.

Amanda Bucceri Androus, RN, BSN
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