Delaware health facilities receive grant to incentivize rural primary care growth

Two downstate Delaware medical centers have received close to $1 million each to create residency programs in Kent and Sussex counties.

Bayhealth and Beebe are two of 27 health systems nationwide awarded a $750,000 federal grant to grow the physician workforce in rural areas.

There’s no medical school in Delaware, and while there are some training programs, they’re in the northern section of the state.

“Rural communities are more likely to have a shortage of health professionals, especially primary care providers, dental providers, and mental health providers,” said Delaware Division of Public Health Director Dr. Karyl Rattay.

“When individuals get trained, often their training takes place in more metropolitan-like areas — and people tend to stay in or near the geographical area where they are trained,” she added. “So therefore, rural communities tend to have less of these providers.”

The funding, which will be distributed over a three year period, is part of the U.S. Department of Health and Human Services’ Rural Residency Planning and Development Program. The initiative helps residency programs in family medicine, internal medicine and psychiatry address a nationwide shortage of primary care physicians in rural areas. 

A University of Delaware study found between 2008 and 2018, the number of full-time primary care physicians in Delaware dropped from 736 to 662 — or by 10%.

Kent and Sussex Counties have a ratio of more than 2,000 patients per primary care physician.

UD, which has surveyed primary care physician data for the state’s Division of Public Health since the ’90s, also found similar declines in dental and mental health providers. Delaware dentists are aging, and there’s an increased demand for mental health services that’s surpassing supply said Tibor Tóth, who worked on the UD study.

 Tóth, an assistant professor at the Biden School of Public Policy, said it’s difficult to attract primary care physicians to rural medical centers, and in addition, many are leaving private practices for hospital jobs.

Another contribution to the decline is that primary care physicians are aging. In Kent County, 25% of physicians are 65 and older, and many of them plan to retire within the next five years. 

Rattay said the trend is concerning, because those who don’t have access to primary care often neglect their health, or visit emergency departments instead. Primary care physicians provide more guidance for preventing and managing chronic conditions, she said.

Bayhealth President & CEO Terry Murphy said patients also are aging, requiring more medical attention. He said Bayhealth has been affected by the imbalanced supply and demand.

“We are actively always recruiting for medical staff positions and primary care physicians and specialists, and we have a team of individuals that’s their sole responsibility,” Murphy said. “The growth in this part of the state is requiring us to be doing this 24 hours a day in trying to recruit physicians, and I think we’ve been successful,” he added. “The residency program is just another approach to attract and keep physicians as they come through and do their training.”

Bayhealth will launch its residency program with a focus on family and internal medicine, but will eventually expand to emergency medicine and general surgery. The health system will accept six residents per year.

Murphy said he hopes the new residents will remain in Kent and Sussex Counties, making it easier for residents to receive the care they need.

“It’s better to have annual visits with your physicians and to know what’s happening, versus waiting until something gets so bad you’re handling it late — when it can be more preventative rather than reacting,” he said. “We felt it was such an important strategy to become a teaching organization because we think that will help tremendously in … keeping people with their physicians on a regular basis and keeping people healthy as opposed to just taking care of the sick.”