Nearly 5,000 recent medical school graduates have so far accepted their share of $1 billion in federal grants to pay off tuition and school loans in exchange for providing care to rural and underserved areas. To help meet the needs of about 45 million Americans who live in these hard-to-recruit regions, the National Health Services Corps hopes to draw another 2,800 students next year, though an estimated 27,000 primary-care physicians will be needed.

Not only has the effort produced a drop in the bucket in terms of meeting demand, but the effect is also temporary, with most contracts lasting three to five years. The Washington Post recently profiled Sarah Carricaburu, a 33-year-old PCP, whose three-year federal contract that provided her with $50,000 to help pay off $200,000 in school-related debt will expire in September 2011.

Raised in the Washington suburbs, Carricaburu is still deciding whether she'll stay on at Southern Albemarle Family Practice in rural Virginia.

"Coming here was like stepping back in time," she told the newspaper. "I would like to stay in a community healthcare setting, but here I didn't feel like I had the resources to do my job. You're cut off."

The resources Carricaburu and many others in her position complain are missing include electronic medical records, reliable Internet service and her iPhone Epocrates app. In addition, she laments her daily commute and lack of local dating potential.

Overall, Carricaburu simply seems convinced she's not cut out for small-town life, at least not permanently. Some of the comments to the Post article and a Wall Street Journal Health Blog post offer suggestions for extending the appeal of rural healthcare: satellite Internet, EMR adoption (which Carricaburu's colleagues resist learning to use), enhanced transportation systems and increased formation of small multispecialty clinics.

To learn more:
- read the article in the Washington Post
- check out the post in the Wall Street Journal Health Blog

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