Wyo. partnership expands health care to rural areas

Attracting doctors and health-care professionals to parts of rural Wyoming has been a problem ever since frontier days, but a new public-private partnership is working hard to counter that problem.

The Wyoming Health Resources Network helps communities recruit and retain health-care professionals, and the key to its success is matching the right professional with the right community, said Nancy Caiola, its executive director, and Sharla Allen, its health planner.

Their task is hardly unique to Wyoming, of course. Rural areas throughout the nation often find it difficult to provide a viable economic base, facilities, and cultural amenities to attract and keep health professionals and their spouses.

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But WHRN is showing that it can happen. During the past year, the network has helped 12 Wyoming communities recruit 15 health-care professionals, including doctors, physician assistants and nurse practitioners.

“You have to find people who want to live in rural areas,” Caiola said. “There are people who want to live here. It’s finding them.”

“The smart thing is to find people who want a rural lifestyle, and there are a lot of them, because a lot of people grew up in rural America,” she added. “So once we find those people, recruitment is not as big a problem.”

The Network was formed nearly two years ago in response to an unmet need. It was a key recommendation of the Wyoming Health Reform Commission appointed by then-Gov. Mike Sullivan in 1993, because unlike many rural states, Wyoming had not developed a statewide recruiting program and found itself lagging behind as a result.

WHRN is a unique nonprofit, public-private partnership that reflects an overriding concern by both state officials and private health-care professionals to maintain and enhance health care in the state.

Its $158,000 budget is funded by state and federal money as well as grants from private entities such as the Wyoming Medical Society, the Wyoming Hospital Association and the Wyoming Nurses Association.

With a mission to “improve and enhance rural health services in Wyoming,” the Network has proposed contracting with the Wyoming Department of Health to provide several other components of the state’s Office of Rural Health, including community health planning services and serving as a resource center on rural health issues.

For now, their focus is on helping communities recruit and retain an appropriate mix of health professionals to serve their citizens, both in Health Professional Shortage Areas and areas without shortages.

Caiola and Allen understand how difficult it can be to attract health professionals to small communities.

Problems include lack of backup coverage during weekends and vacations, long hours and lack of spousal employment, and they can be exacerbated in rural Wyoming, where communities not only are small but also often are too remote to make commuting an option.

“But I think there are people who want this lifestyle,” Caiola said. “Our strategy is to not go to Florida or New Jersey, but to recruit here. Our first priority is people who are from Wyoming or who were trained in Wyoming programs.”

They work closely with medical residency programs in Wyoming and surrounding states and are always on the lookout for people who want to adopt the Wyoming lifestyle.

“We ask candidates why are you interested in Wyoming, what’s your previous exposure to the state, what size community would you like to live in,” Allen said, adding that if they answer 100,000 plus, “automatically they go to the bottom of your pile.”

The other key to matching professionals and communities is having what Caiola and Allen call a “recruitable community” because health professionals must be comfortable not only with Wyoming but also with a specific community.

“The vacancies that we fill the easiest are the ones where the need in the community is really clear,” Caiola emphasized. “Those places where there are conflicts in the community or uncertainty about the kind of professional they want … those make it harder.”