When it comes to health care there seems to be at least one thing people across the country can agree on — They want a better system. But while Republicans and Democrats try to sort out their vision for a long-term solution, they can’t afford to ignore the fact that health services in rural counties need urgent care. The rural health crisis facing patients and communities in North Dakota and across rural America has reached a tipping point. Federal lawmakers need to turn their focus to the growing problem they can treat now.

Since 2010, more than 100 rural hospitals nationwide have closed their doors for good and another 430 are at risk of closure, putting rural communities in harm’s way. When rural hospitals and emergency rooms close, patients face longer travel times, diminished access, increased costs, and poorer health care outcomes. A big part of this problem is that it’s getting harder and harder to even find a doctor.


Nationwide, demand for physicians continues to outpace supply. So much so that, according to new projections by the Association of American Medical Colleges, the U.S. could see a shortage of up to 122,000 physicians by 2032. The unmet doctor demand that threatens the lives and well-being of countless Americans and communities has been caused by a number of factors. They include overall population growth, an increase in the number of seniors with a higher need for health care services, increased rates of physician retirements, and vacant primary care positions. As such, there is no single cause for our nation’s physician shortage, nor is there a single solution.

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While the impending scarcity of health care professionals should raise red flags for everyone, those living in rural communities will feel the impact far more acutely. As it is, patients in rural communities are five times as likely to be living in a county experiencing a physician shortage than those living in urban or suburban communities. While only comprising 15% of the U.S. outpatient physician workforce, family physicians provide 42% of all care in rural areas. As fewer and fewer medical school graduates choose to enter these positions, their absence is being felt by the patients with the greatest need, including those with higher rates of diabetes and heart disease.

And, aside from the primary care drought, there is a persistent and growing lack of access to emergency medical services in rural communities. In fact, the problem has gotten so bad in North Dakota that many communities must rely on volunteer emergency medical services, and even these services are dwindling, with seven North Dakota ambulance services closing in the last 10 years. Neighbors pitching in to help each other out is part of what makes rural towns great, but specialists in emergency medicine should not be volunteers. Further, some smaller, rural towns and counties across the state not only don’t have hospitals in the immediate area but also don’t have access to ambulatory services.

Across the U.S., the continued closure of ambulatory services puts roughly 60 million Americans at risk of being stranded during a medical emergency. This is not how the greatest, most prosperous nation in the world should be treating any of its citizens. Let’s say an ambulance is even able to reach a rural North Dakota community, they then might have to drive 50 miles or more to the nearest emergency room or hospital. When time is of the essence, every minute counts. It is simply unconscionable for anyone to have to wait that long to get any kind of medical care, least of all in an emergency situation.

Whether a routine checkup or emergency situation, rural health care is in crisis, and this status quo should be unacceptable for our state and national leaders.

There may not be an easy solution to end this nightmare overnight, but there are practical measures and policies that we can implement to stem the tide and help begin to address the lack of rural health care access and our nation’s growing physician shortage. North Dakota, for example, has begun to increase residency programs in the past several years in an effort to attract and retain talented physicians to practice in our state. Continuing to expand Medicaid in the states that have yet to do so would also help address diminishing rural health care access and affordability.

While there is no silver bullet, Washington needs to wake up to the very serious needs facing rural communities when it comes to the growing physician shortage and its impact on rural health access and affordability. Lives are on the line – this is no time to sit idly by and watch as our health care system continues to deteriorate. It’s time for real action.