Americans living in rural areas of the United States have historically suffered from a lack of adequate health care. As the focus of this study, the Cortland County area of central upstate New York State is a rural community of 74,000 that has been served for the last 118 years by Cortland Regional Medical Center (CRMC). CRMC is the federally designated "sole community hospital" which means that there are no other hospitals within 45 minutes of the medical center ("Department of Health and Human Services," 2009). Its HSPA designation indicates that on average, each primary care physician must allocate services to more than 1,500 residents. As a result of its high doctor to patient ratio, Cortland County is also recognized by New York State as a Regents-designated Physician Shortage Area.
Truck, Jennifer E., "Caring for the Country: Physician Retention at Cortland Regional Medical Center" (2009). MPA Capstone Projects 2006 - 2015. 39.