Supporting the Next Generation of Rural Providers
Shelley Irving, MSPAS, PA-C, DFAAPA
2022 William H. Marquardt Community Health Access Fellow

May 30, 2023

Rural communities encounter many barriers to achieving optimal health outcomes. One of these is the lack of access to healthcare services. Workforce shortages and lack of public transportation options needed to travel to healthcare services lead to missed days of school and work and increased cost for rural patients to access care. These barriers often lead to delays in care, deferral of preventative care, and disruptions in chronic disease management. According to the Rural Health Information Hub, 65.6% of Primary Care Health Professional Shortage Areas are located in rural communities.1 The Health Resources and Services Administration (HRSA) published in a recent Rural Health Brief that “20% of Americans live in rural areas, but only 9% of physicians live and practice in these areas.”2

As a practicing PA in Kentucky’s Appalachian region, I have seen first-hand the impact of provider workforce shortages on patient health outcomes. My experiences serving as a volunteer provider for a regional free outpatient internal medicine clinic, sitting on the board of directors for a regional rural hospital, seeking out formal telehealth training, writing grants to promote access to care through telehealth capability and COVID immunization, and leading the rural Appalachian campus location of the University of Kentucky’s PA program have provided unique perspective and opportunities for advocacy. This has been the impetus for seeking sustainable solutions. Encouraging and equipping the next generation of PAs to step into these underserved areas is critical to reducing rural health disparities.

Providers tend to stay and practice in the communities in which they train. Providing opportunities like volunteering with local free clinics, supporting community safety net organizations, engaging with local healthcare leaders, and encountering rural underserved patients throughout their training immerses future providers in the rural Appalachian community. They learn how to network, build resiliency, and connect with mentors to support their future practice goals. Cultivating connections and a sense of trust between these students and their communities is a key step in bridging healthcare delivery gaps and increasing healthcare access in rural areas.

Being awarded the William H. Marquardt Community Health Access Fellowship in 2022 was a humbling honor. This award recognizes a commitment to improving access to care for the underserved. My personal mission is to improve the health and well-being of eastern Kentuckians by increasing access to high quality care through leadership, education, and advocacy. In my educator role, I see that PA students are among the highest utilizers of funding support in the University of Kentucky’s College of Health Sciences. The rigor of the program is often prohibitive of gainful employment as a student, and less funding is available to students at the graduate level.

After much reflection, funding from this award is being used to create an enduring Commitment to Rural Health Award for a rural campus PA student at the University of Kentucky. This annual financial award will support and encourage recipients who demonstrate a passion for improving the health and well-being of rural underserved communities. Through this award and other efforts, we can shape PA leaders who will play a critical role in improving healthcare access and delivery for populations in need.

  2. Training Needs to Prepare the Healthcare Workforce for Rural Practice COGME Rural Health Issue Brief #3
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