"Helping urologists establish practices in rural areas and incentivizing those practices is so important," says Kevin Koo, MD, MPH.
In this video, Kevin Koo, MD, MPH, discusses the Specialty Physicians Advancing Rural Care (SPARC) Act, one of the key legislative priorities of the 2023 AUA Summit, which took place in Washington DC. Koo is a urologist at Mayo Clinic in Rochester, Minnesota and on the Board of Directors for the American Urological Association Political Action Committee (AUAPAC).
We know that our patients live in diverse geographic areas. Sometimes they're urban, sometimes they're suburban, and sometimes they're rural. Here at Mayo Clinic, our patients live across Minnesota and the surrounding states. Some of them are living in the cities and others are farming in some of our more rural areas. Regardless of where patients live, we want to be able to do the best we can for them as urologists and take care of their urological needs. But the urology work force is a bit maldistributed, which means that more urologists live in urban and suburban areas than rural areas and this creates some potential disparities in access to care, which is so important for us to address.
Telehealth is one option that can help us to bridge that divide, but we know that care is easiest for patients and most efficient and effective when that care is close to home. That's why helping urologists establish practices in rural areas and incentivizing those practices is so important. One of the pieces of legislation that has been supported by the AUA and by the urology community for many years, and it was first introduced in the last Congress, is the SPARC Act, which stands for the Specialty Physicians Advancing Rural Care Act. This is a bill that establishes a new loan forgiveness program for specialty physicians, including urologists who establish their practices in rural areas.
Specifically, it provides up to $250,000 of educational loan repayment for up to 6 years of service in those areas. Every year, about 1/6 of the total loan burden, up to $250,000, would be repaid every year for up to 6 years of service. This is really important because we're not going to solve the rural access to care issue with a single piece of legislation or a single policy intervention. We know that we need to address this issue from a number of fronts, including work force, including telehealth, including making rural communities a safe and affordable place to practice.
What we do know from the AUA census is that urology trainees, residents, and fellows have reported that one of the most effective strategies to helping new graduates from urology training establish practice in those much needed underserved rural areas is to include some form of loan repayment. That helps our new urologists to set down roots, to start practicing in those communities, and to make it affordable to set up practices when it can often be financially infeasible to do so.
This type of loan repayment program already exists for many primary care specialties. We know that primary care is important, but specialty care, just like urology, is also important. The SPARC Act, which is soon going to be reintroduced in the current Congress is a really important piece of legislation that we can all get behind—urologists, specialty physicians, and medicine at large—to help address rural access to care issues to help our new graduates and urologists who want to practice in rural areas do so and to make sure that this is one among several different policy interventions we can use to help our rural patients get the urological care they need and deserve.