George Gongora/Caller-Times Physician’s assistant Frank Rinaldi examines patient Megan Landrum’s ear as Megan’s mother, Teresa Vidal, holds her. Rinaldi’s patients are sent to Alice Regional Hospital for surgery and X-rays.

Big personal, financial benefits pull doctors to small practices

Rural doctors can work one-on-one with more patients, are eligible for grants to pay off medical school loans

February 1, 2003
By Quincy C. Collins
Caller-Times

For 21 years, Dr. Nirupama Patel, an Alice pediatrician educated in India, has kept a watchful eye over expectant mothers and sick children while watching Alice’s health care needs grow.

Patel moved her practice from Corpus Christi 21 years ago after completing research at the Baylor College of Medicine in Houston and her residency at Driscoll Children’s Hospital.

Patel said she chose to open her clinic in Alice because Corpus Christi was saturated with pediatricians at that time.

Alice’s proximity to Corpus Christi allows Patel to work with specialists and transfer patients easily. Yet her clinic is far enough away from Corpus Christi to allow her to work at her clinic as well as in emergency medicine at Alice’s two hospitals, she said.

"For a physician, the ideal place to live is a small town near a big city," Patel said. "You have to work hard, but it’s worthwhile."

According to the U.S. Bureau of Labor, annual salaries for physicians in general practice in Corpus Christi average more than $140,000, while doctors with a general practice in nearby cities have an annual salary of about $130,000.

Some doctors in rural South Texas may not receive huge salaries and bonuses to move their practices from larger cities, but many have found the ability to practice in under-served areas rewarding in other ways.

Benefits of rural practice
But the need for doctors and other health care workers still exists in rural areas, and there are various programs to attract doctors to rural communities in South Texas.

At the state level, the Texas State Office of Rural Health has maintained the Texas Health Services Core Program that offers primary care physicians up to $15,000 annually for each year a doctor in his or her residency agrees to work in an under-served community. Robin Wright, program administrator for the rural health office, said physicians usually receive $45,000 for three years of service.

According to the U.S. Department of Health, rural counties such as Aransas, Bee, Brooks, Duval, Kenedy, Live Oak and Refugio are designated as having a shortage of health care professionals.

Small communities that are designated as medically under-served areas can sponsor foreign doctors for citizenship in exchange for establishing medical services, according to Chuck Brazell, a recruiting director for Texas Recruiters, based in Tyler.

Brazell said incentives for doctors to establish practices in counties that are designated under-served include federal or state grant money that can be used to repay educational loans.

Doctors in areas designated as facing a shortage of health care professionals can qualify for benefits such as specialized loan repayment plans, 10 percent Medicare payments and cost reimbursements. In addition, community scholarships are available for medical students in their third or fourth year.

Seeing more patients
For Frank Rinaldi, a physician’s assistant at the San Diego Outreach Clinic, the opportunity to be a primary healthcare provider and to serve a community with limited access to medical care was an incentive he could not pass up.

Rinaldi, a physician’s assistant who retired from the Army in 1981 and practiced in a Portland doctor’s office for almost 10 years, was eager to work in an environment where he had more contact with more patients. Physician’s assistants are certified to provide basic medical services under the supervision of a physician. Rinaldi’s patients are sent to Alice Regional Hospital for medical procedures such as X-rays or surgery.

Though seeing patients similar to Rinaldi’s, Dr. Amina Ahmed is a kidney specialist with a medical degree. But she practices mostly internal medicine at her San Diego office and nephrology at Alice hospitals.

Ahmed, who was educated in Pakistan, completed a fellowship at the University of Southern California in Los Angeles before establishing her San Diego practice.

She does not receive state or federal grants to keep her practice in the traditionally under-served area, she said.

Ahmed said the transition from Los Angeles to a small community in Texas was difficult at first, but said after four years in San Diego, she has found advantages to working in a rural area.

"The patients always give us positive feedback," Ahmed said. "I feel we have made a little difference."

Contact Quincy C. Collins at 886-3792 or collinsq@caller.com