With support from some hospital corporations, rural medicine is making a comeback in Iowa.
Tired of long hours and little time with his family, Charles Vernon, M.D., last year was on the verge of quitting his job as the only doctor in Anamosa, a town of 5,000 about 20 miles east of Cedar Rapids.
But Integra Health System stepped in, guaranteeing Vernon a salary and taking over much of his paperwork, including dealings with insurers. Four more doctors have come to town, to be joined by another next month.
What has happened in Anamosa is part of what the University of Iowa's Roger Tracy calls a remarkable turnaround in the fortunes of Iowa towns trying to recruit doctors.
"We've really turned the corner," said Tracy, the director of the College of Medicine's Office of Statewide Clinical Education Programs, which helps towns in recruiting.
Although the shortage in rural Iowa is not over, more doctors are considering rural practice as opportunities in larger cities dry up. Ten years ago, there were 334 openings for family doctors. In 1997, there were 152.
Tracy credited physician-hospital organizations for the turnaround.
The organizations are being created by healthcare systems-including Iowa Health System-the state's Catholic hospitals and the 100-physician Mercy Family Care Network.
About 60% of Iowa's primary-care physicians now work in such organizations, Tracy said.
Integra Health is affiliated with Iowa Health System, which includes Des Moines' Iowa Lutheran and Iowa Methodist hospitals.
Integra guarantees salaries and vacation time for doctors and provides administrative and technical support. The investment is returned by referrals to sponsoring hospitals.
"There are almost no physicians nowadays who are interested in bearing the risk of coming into a community and starting on their own," said Joe LeValley, senior vice president for network development at North Iowa Mercy Health Center, Mason City.