The National Rural Health Association provided the best rural sessions and networking again this year, better than STFM’s Boston meeting and AAFP at New Orleans. NRHA also has advanced plans to work with STFM regarding membership and rural health issues. The past predoc meeting in Austin and most program director’s meetings have done better than most, but there is far to go and a dedicated rural staff person could do much.

AAFP has most of the political muscle and staff resources, but rural coordination is often crowded out by legislative and practice issues. Rural workforce issues, rural medical education, and rural student interest groups are just a few areas where AAFP could really have an impact on rural health, national workforce policy, and influencing trainees toward rural practice. Students are now more interested in this area. Will AAFP respond? At stake are better rural health presentations at the Annual Meeting and other meetings, improved workforce reports, and meeting the needs of various types of rural physicians. These include young physicians 2-3 years into practice in need of support to keep going, those wanted specific help regarding rural managed care, and others interested in varied topics such as rural medical education.

I have had a chance to meet, talk, and work with all of the past AAFP Staff people assigned to the Rural Committee. They are super folks, just very busy with other areas, especially areas where immediacy (legislative) is more important than long range efforts. I realize the AAFP employs a lot of people and has many important functions, but rural health will never get the response it deserves unless there is a staff person that is 50+% rural. I have had multiple jobs that split time between rural and teaching and clinical duties. Only in jobs where 50% of my time is rural have I been able to publish, develop, write grants, etc.

Having a staff person or coordinator who is primarily involved in rural health is a priority for rural faculty and it should also be a priority for departments who hope to have rural impact as well as AAFP. Rural physicians in practice, those who need future colleagues, and students and residents who will choose rural practice need consistent coordination and leadership in the AAFP in the area of rural health. A staff person could work with the AAFP Rural Committee, the Division of Education, student interest groups, meeting planners, international efforts, STFM, and NRHA?

With most of the current trends pointing away from rural practice, we can ill afford to wait to act. Federal programs and state efforts have been lost and other efforts may fade with time. Family medicine must pay attention and continue its efforts to produce rural physicians or else suffer the consequences.