Rural Health Research Gateway

Roger Rosenblatt, MD, MPH

WWAMI Rural Health Research Center

Phone: 206.685.1361
Fax: 206.616.4768
E-mail: rosenb@u.washington.edu

WWAMI Rural Health Research Center
University of Washington
Department of Family Medicine
Box 354696
Seattle, WA 98195-5304

Current Projects

Contribution of J-1 Visa International Medical Graduates to the Rural Physician Workforce
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: International Medical Graduates (IMGs), J-1 Visa Waiver, Workforce
This study is determining the contribution of J-1 visa waiver International Medical Graduates to the rural physician workforce using American Medical Association data for 2005, and comparing the numbers and percentages of J-1s to those of U.S. medical graduates and non J-1 visa waiver IMGs.

Completed Projects

Is Rural Residency Training of Family Physicians an Endangered Species? An Interim Follow-up to the 1999 National BBA Study, Lead researcher
Research center: WWAMI Rural Health Research Center
Funder: Office of Rural Health Policy (ORHP)
Topics: International Medical Graduates (IMGs), Physicians, Workforce
This study examined the proportion of rural-based family medicine residencies that have ceased operations since 2000, the residency-match experiences of the surviving programs, the proportion of U.S. medical school graduates and international medical graduates, major issues confronting these rural residencies, and likely impacts of these changes on the preparation of future family physicians for rural America.

Publications

  • Access to Maternity Care in Rural Washington: Its Effect on Neonatal Outcomes and Resource Use
    Author(s): Thomas S. Nesbitt, Eric H. Larson Roger A. Rosenblatt, L Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Children, Health services, Maternal and child health
    Citation: American Journal of Public Health, 87(1), 85-90
    Date: 01 / 1997
    Compares birth outcomes for areas with poor health care access to those with adequate health care access in rural Washington state.
  • Family Medicine Residency Training in Rural Areas: How Much is Taking Place, and Is It Enough to Prepare a Future Generation of Rural Family Physicians?
    Author(s): Roger A Rosenblatt, R Schneeweiss, L Gary Hart, S Casey, C Holly Andrilla, Fredercik M Chen
    Research center: WWAMI Rural Health Research Center
    Topics: Physicians, Workforce
    Report Number: No. 69
    Date: 03 / 2002
    Determines how much rural family practice training is taking place in the United States. Among the results are that only 33 family medicine residency programs (7.4 percent) are located in rural areas and most of the training sponsored by these programs occurs in rural areas. On the other hand, while more than one-third of the urban programs listed rural training as an important part of their mission, only 2.3 percent of the training they supported took place in rural areas. For the nation as a whole, only 7.5 percent of family medicine residency training occurred in rural areas despite the fact that 22.3 percent of the U.S. population lives in rural places. The report concludes that to the extent that there is a link between the place of training and future practice, the lack of rural training contributes to the shortage of rural physicians. Furthermore, unless significant efforts are made to increase rural residency training, rural physician shortages are likely to persist.
  • Impact of U.S. Medical Students' Debt On Their Choice of Primary Care Careers: An Analysis of Data from the 2002 Medical School Graduation Questionnaire
    Author(s): Roger A. Rosenblatt, C. Holly A. Andrilla
    Research center: WWAMI Rural Health Research Center
    Topics: Physicians, Workforce
    Citation: Academic Medicine, 80(9), 815-819
    Date: 2005
    The authors used results from questions on the Association of American Medical Colleges' 2002 Medical School Graduation Questionnaire that focused on students' debt and career choices to examine the hypothesis that medical students' rising total educational debt is one of the factors that explains the recent decline in students' interest in family medicine and primary care. Students reported that higher levels of debt influenced their future career choices, and there was an inverse relationship between the level of total educational debt and the intention to enter primary care, with the most marked effect noted for students owing more than $150,000 at graduation. Total debt was associated with a lower likelihood of choosing a primary care career, but factors such as gender and race appeared to have more explanatory power. Female students were much more interested in primary care-and especially pediatrics-than were male students; African American students were more interested in inner-city practice than was any other identified racial or ethnic group.
  • Improving the Quality of Outpatient Care for Older Patients with Diabetes: Lessons from a Comparison of Rural and Urban Communities
    Author(s): Roger A. Rosenblatt, Laura-Mae Baldwin, Leighton Chan, Meredith A. Fordyce, Irl B. Hirsch, Jerry P. Palmer, George E. Wright, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Aging, Chronic diseases and conditions, Quality
    Citation: Journal of Family Practice, 50(8), 676-680
    Date: 08 / 2001
    Compares the quality of diabetic care received by patients in rural and urban communities in Washington State. Among the findings: Generalists provided most diabetic care in all locations. Patients living in small rural towns received almost half their outpatient care in larger communities. Patients living in large rural towns remote from metropolitan areas were more likely to have received the recommended tests than patients in all other groups. Patients who saw an endocrinologist at least once during the year were more likely to have received the recommended tests. Concludes that large rural towns may provide the best conditions for high-quality care-growing communities that serve as regional referral centers and have an adequate, but not excessive, supply of generalist and specialist physicians.
  • Pathways to Rural Practice: A Chartbook of Family Medicine Residency Training Locations and Characteristics
    Author(s): L. Gary Hart, Denise M. Lishner, Eric H. Larson, Frederick M. Chen, C. Holly A. Andrilla, Thomas E. Norris, Ronald Schneeweiss, Tim M. Henderson, Roger A. Rosenblatt
    Research center: WWAMI Rural Health Research Center
    Topics: Physicians, Workforce
    Citation: Seattle, WA: WWAMI Rural Health Research Center, University of Washington.
    Date: 08 / 2005
    Discusses characteristics and geographic locations of family medicine residency programs' rural locations, types of rural family medicine training by location, and rural mission of family medicine residencies.
  • Shortages of Medical Personnel At Community Health Centers: Implications for Planned Expansion
    Author(s): Roger A. Rosenblatt; C. Holly A. Andrilla; Thomas Curtin; L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topics: Federally Qualified Health Centers (FQHCs), Physicians, Workforce
    Citation: JAMA, 295(9), 1042-1049
    Date: 2006
    To examine the status of workforce shortages that may limit Community Health Center (CHC) expansion, the authors surveyed all 846 federally funded US CHCs that directly provide clinical services and are within the 50 states and the District of Columbia. Analysis of the results showed that CHCs face substantial challenges in recruitment of clinical staff, particularly in rural areas. The largest numbers of unfilled positions were for family physicians at a time of declining interest in family medicine among graduating US medical students.
  • State of the Health Workforce in Rural America: Profiles and Comparisons
    Author(s): Eric H. Larson, Karin E. Johnson, Thomas E. Norris, Denis M. Lishner, Roger A. Rosenblatt, L. Gary Hart
    Research center: WWAMI Rural Health Research Center
    Topic: Workforce
    Date: 08 / 2003
    Overview of rural health care workforce issues. National and state-by-state data on the health care workforce, with rural-urban comparisons and interstate comparisons. Also includes data on rural health care facilities. To request a copy, call (206) 685-0402 or email: rowe@u.washington.edu

This web site includes content provided by and adapted from the Maine Rural Health Research Center, University of Southern Maine under a Cooperative Agreement with the University of North Dakota.