23 MARTINDALE CENTER FOR THE STUDY OF PRIVATE ENTERPRISE generally ranging between 2 and 3 years in the US, while still providing the qualifications to prescribe medications and perform procedures. PAs’ and NPs’ skill sets span physician practice and nursing, allowing them to be multifaceted. PA and NP professions may be appealing to students who do not want to commit to the time and workload of becoming a medical doctor. Nonetheless, implementing PA and NP roles poses challenges. Supervising multiple NPs and PAs may initially place heavier demands on general practitioners, and formal PA and NP programs would have to be established within major teaching hospitals. Expanding rural medical education To reduce the gap in rural medical education, medical and nursing schools and rural clinics should provide training tailored to low-income, geriatric, rural populations. For instance, medical and nursing schools could increase the number of students attending residency and clinical programs in rural communities. James Cook University in Australia places students in their final year of medical school in rural clerkships for 20 weeks. A study found a significant association between medical students’ intentions in working in rural areas and their participation in the rural clinical clerkship (Mackie et al., 2025). Students also expressed they felt more confident in their clinical preparation regarding serving the rural community. Medical and nursing schools integrating rural health rotations could increase the number of students willing to practice in nonurban areas after graduation. For physicians and nurses already working in rural areas, the Ministry of Health could provide continuing education in the form of online asynchronous classes focused on geriatric care, chronic disease management, home-based care, and telehealth. In conjunction, Croatian medical schools could establish international partnerships with medical schools located in the US and EU that have expertise in geriatrics and rural medicine to help train Croatian medical personnel. Connections with leading geriatrics programs internationally would allow medical personnel to share knowledge and experience working with the geriatric population in rural environments and strengthen the global network of medical personnel. The breadth of knowledge and techniques from international health-care professionals could instill confidence among newly graduated physicians and nurses and encourage them to use their skill set to practice in rural communities while providing exceptional care. Greater access in rural areas Strengthening the telehealth infrastructure would ameliorate inaccessibility. Older people in rural areas could then access specialist consultations and follow-up care as well as monitor chronic conditions without traveling. Currently, Croatia utilizes online health services the least among EU countries (European Commission, 2025). Though in-person appointments are sometimes necessary, telehealth appointments often can address patient concerns and manage care when a physical exam is not required. There are limitations to this solution—most of the elderly population in rural areas live in poverty and therefore may not have the necessary technology for telehealth appointments. Local governments should use funds allocated to public health expenditures to provide the necessary equipment for patients in rural areas to be able to participate in telehealth visits. As of April 2025, Croatia plans to establish mobile clinics and mobile pharmacies to cover 80% of Croatia’s rural, remote islands and areas. The project is valued at €5.3 million and 33 vehicles will be purchased to be distributed across rural counties (Croatia Expands Healthcare Access…, 2025). By prioritizing mobile care, doctors and nurses will be able to administer physical exams, prescribe medications, and make home visits to patients. With a larger workforce, hospital systems in the urban communities can establish urgent care centers in rural areas. If such centers are easily accessible and well staffed, rural residents would be incentivized to check in with a medical professional for acute medical conditions, which in turn would help with their overall health. In Aotearoa, New Zealand, the urgent care model was instituted with NP-led care in rural and urban areas. With a growing demand for primary care and a healthcare workforce, urgent care allows for patients with acute needs or nonurgent health concerns to be seen without having to wait to get an appointment with a general practitioner (James-Scotter et al., 2025). In Croatia, greater numbers of NPs in rural urgent care centers could decrease the demand for physicians, while allowing more patients to be seen. A limitation of this model, as seen in Aotearoa, is that the role of NPs is not widely understood; therefore, trust between communities and NPs must be established in rural areas. This approach is only a partial solution; patients would continue to rely on general practitioners for LTC and serious conditions.
RkJQdWJsaXNoZXIy MTA0OTQ5OA==