{"database": "press", "table": "releases", "rows": [["http://adriansmith.house.gov/doctor-shortage-hurts-rural-nebraska", "Doctor Shortage Hurts Rural Nebraska", "2013-12-13", "2013", "2013-12", "Republican", "House", "NE", "Adrian Smith", "S001172", "adriansmith.house.gov", null, null, "legacy", "There is a significant shortage of physicians, particularly primary care physicians, in rural areas which hurts communities in places like Nebraska\u2019s Third District.\u00a0 There are three or fewer primary care physicians in 45 of the 75 counties in our district.\u00a0 Eighteen of these counties have no primary care physician at all.\u00a0 With so few physicians, rural Nebraskans may have to travel farther to see a doctor which can limit access to care.\u00a0\nPart of the reason for this doctor shortage is the challenge of recruiting physicians to rural areas.\u00a0 Many times, rural health care facilities simply do not have the resources to pay doctors salaries comparable to those at larger hospitals or more populated areas.\u00a0 While physician assistants, nurse practitioners, and other providers can provide some of the same services as doctors, many of the challenges of drawing physicians to rural areas apply to these professionals as well.\nI recently visited one of the more than fifty Critical Access Hospitals in the Third District.\u00a0 These hospitals are designated as small, remote facilities providing 24-hour care.\u00a0 This hospital employs only one doctor who is ready to retire, but after more than a year of searching a replacement has not been found. \u00a0\nThe hospital administrator estimates it will cost about $200,000 a year to hire a new doctor.\u00a0 This salary is increasingly unaffordable for the hospital because of costs related to implementing the Affordable Care Act, also known as Obamacare.\u00a0 Compliance with the medical records mandate included in the health care law alone will cost this hospital about $1.3 million.\u00a0 Numerous other mandates in the law will burden the hospital with costs, time, and lost productivity.\nThese mandates further discourage doctors from working in rural areas.\u00a0 With fewer physicians and administrative staff, regulations disproportionately affect providers in rural areas more than in larger facilities with more resources and personnel to dedicate to compliance.\u00a0 Given the choice, it is not difficult to understand why a doctor would prefer to spend more time treating patients and less time filling out paperwork.\u00a0\nAnother mandate which could further discourage physicians from taking rural positions are physician supervision regulations.\u00a0 These rules require a physician\u2019s presence and supervision over nearly all routine procedures administered in hospitals.\u00a0 While this requirement is less of a challenge for large hospitals, it can be very problematic in areas with few doctors.\nThe Centers for Medicare and Medicaid Services (CMS) previously delayed enforcement of this rule for Critical Access Hospitals, however, last month the agency announced it would begin to enforce the rule at all hospitals.\u00a0 This week, I introduced legislation to delay this harmful rule for at least one year for Critical Access Hospitals, and until CMS completes an analysis of the impacts of this regulation.\u00a0 Physicians, nurses, and ancillary staff in rural facilities are highly experienced in determining the appropriate level of patient care.\u00a0 They must be given the flexibility to provide affordable and efficient health care.\nRural providers face many challenges without the heavy hand of government.\u00a0 The more government gets involved in health care, it is more difficult for doctors to do their jobs.\u00a0 To maintain access to quality care for rural Americans, we must do more to get the federal government out of the way of providers, and find ways to encourage more doctors to seek positions in smaller communities.", 1, "2026-03-30T12:14:52Z", "2026-03-30T12:14:52Z"]], "columns": ["url", "title", "date", "year", "month", "party", "chamber", "state", "member_name", "bioguide_id", "domain", "scraper", "source", "date_source", "text", "has_text", "collected_at", "updated_at"], "primary_keys": ["url"], "primary_key_values": ["http://adriansmith.house.gov/doctor-shortage-hurts-rural-nebraska"], "units": {}, "query_ms": 0.813137274235487, "source": "dwillis/congress-press", "source_url": "https://github.com/dwillis/congress-press", "license": "MIT", "license_url": "https://github.com/dwillis/congress-press/blob/main/LICENSE"}