Rural health care can thrive if innovative tactics are used. Four principles can influence health care services: (1) an integrative approach is needed; (2) recognition that competition is a dominant mode; (3) cultural and professional ethnocentricity are counterproductive; and (4) the possibilities are limitless. (Author/MSE)

Seven common myths about rural America are debunked, and three characteristics of the rural environment (diversity, sparse population, and interdependency with broader social and economic forces) are examined in relation to health care delivery and medical education. Health care contributions to rural economic needs are discussed. (Author/MSE)

Successful rural health delivery factors include group practice, retention of the same health providers for three years, community-oriented focus, integration of non-M.D. providers, and commitment to education within the practice. Academic medical centers with and without area health education centers should expand to serve rural communities…

The discussion consists of a national overview of state legislative activity and summaries of state legislation addressing aspects of physician distribution in rural areas and other rural health care issues during the period 1984-89. Legislative summaries are organized by state. (MSE)

The annotated and indexed bibliography contains over 120 citations of research and program reports from multiple health disciplines concerning rural health care delivery. Citations cover the period of January 1980 through July 1990, and are organized by state in which the program or research occurs. (MSE)

Options outlined for improving health care to rural areas include selective recruitment into medical and other health occupations education, early professional socialization, curriculum reform, and the kinds of technical assistance that academic centers can provide to rural practitioners and caregiver institutions. (Author/MSE)

A solution to the rural health crisis will require not only changes in student selection, curriculum, and training location but also strengthening of the rural economy, improved reimbursement to rural hospitals and primary care physicians, and increased sensitivity among leaders of the medical profession to rural community and practitioner needs.…

With the support of outreach library services and visits by university-based faculty, area health education centers improve a rural community's ability to recruit, retain, and keep up-to-date primary care physicians and other health manpower. North Carolina is an example of this enhanced professional environment. (Author/MSE)

Steady urbanization and decreasing availability of health services for an aging rural population are occurring in Saskatchewan. Saskatchewan medical graduates find rural practice unattractive, and medical careers are not attracting rural youth. A comprehensive strategy of recruitment and reorganization of health care is needed. (MSE)

A study of Dalhousie University (Nova Scotia) medical school primary care residency graduates (n=200) and other specialty graduates (n=371) suggests that the institution's policy of requiring first-year residencies in small community health services may cause more graduates, both primary care and specialists, to choose rural practice locations.…

Many recent changes affecting the general and rural health care system are reviewed. The American Association of Medical Colleges' recommends a task force on rural health and medical education be established to begin active dialogue on how medical education can effectively respond to the challenges of rural health. (Author/MSE)

It is proposed that medical schools recruit students from rural areas, have them choose family practice, and train them in rural settings. Specific recommendations for improving content and context of rural medical care education are made, including merging internal medicine, family practice, and pediatrics as a single primary care specialty.…

A collaborative summer program by the University of Washington medical school, a professional association, and regional and state agencies provides students with an early introduction to community medicine in rural and urban underserved areas. Students (n=74) have been extremely satisfied. Suggestions are made for identifying potential program…