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A Profile of Colorado’s Rural Physicians

Findings based on a survey of Colorado’s rural physicians provides a snapshot of these important health care providers, including why they practice in rural Colorado, what keeps them working in their communities and the demands placed on their practices.
March 10, 2023

CHI’s survey of Colorado’s rural physicians provides a snapshot of these crucial health care providers, including why they practice in rural Colorado, what keeps them working in their communities and the demands placed on their practices. Attracting and retaining physicians for Colorado’s rural areas can be challenging, illustrated by the fact that these rural areas are home to one sixth of the state’s population, but just one tenth of the state’s physicians.  As Colorado leaders work to devise the best strategies to maintain and improve health care access among rural residents, insights from this survey can serve as a resource.

These findings are from a Colorado Health Institute (CHI) survey of Colorado’s rural physicians taken in 2009. Particular attention is paid to factors associated with the supply of Colorado’s rural physician workforce.

Key findings from the survey include:

  • Forty-four percent of Colorado’s rural physicians practice primary care.
  • Thirty-nine percent grew up in a rural area.
  • Nearly two-thirds (61 percent) completed a rotation in a rural setting during their medical school training.
  • One-third said they were likely to leave their practice in the twelve months following the survey. Among this group, one-third listed retirement as an important reason.
  • Opportunities exist for improved classroom instruction and residency training in telemedicine, occupational health and interdisciplinary practice. Training in these topic areas was most likely to be rated inadequate by rural physicians.
  • Rural physicians rated a variety of lifestyle factors as important determinants in their choice of, and satisfaction with, living and working in a rural area. They most commonly cited were recreational and leisure activities (70 percent); suitability for raising children (55 percent); and professional independence (44 percent). The physicians had the highest satisfaction levels with:  the community (84 percent); their ability to provide quality care (84 percent); and work-life balance (60 percent).
  • Common areas of dissatisfaction with living and working in a rural area related to the overhead costs (56 percent) and administrative burden of maintaining a practice (49 percent). Spousal dissatisfaction was listed as an important factor by about one quarter (26 percent) of physicians who had plans to leave their practice in the next year. These responses suggest that rural physicians may benefit from additional professional and spousal support.
  • Rural physicians were likely to accept public forms of insurance, such as Medicare (89 percent), Medicaid (79 percent for children, 76 percent for adults) and Children’s Health Plan Plus (CHP+) (82 percent). For physicians who did not accept Medicaid, low reimbursement rates (98 percent) and time-consuming paperwork (72 percent) were the most common obstacles. 
  • Rural physicians were likely to accept public forms of insurance, such as Medicare (89 percent), Medicaid (79 percent for children, 76 percent for adults) and Children’s Health Plan Plus (CHP+) (82 percent). For physicians who did not accept Medicaid, low reimbursement rates (98 percent) and time-consuming paperwork (72 percent) were the most common obstacles.