TERRE HAUTE — The growth of technology in the health-care industry seems to move at the speed of light.

From laser surgeries to MRIs to robotics and implants, the procedures and treatments of today might seem like science fiction compared to the industry 20 years ago.

The changes anticipated in the next 20 years of health care in the Wabash Valley are expected to outstrip the advances from the past two decades.

But one major part of the health-care puzzle probably will remain unchanged — the shortage of health-care professionals available to provide care to the mostly rural population that thrives in the Wabash Valley.

“It’s well-recognized that we have a health-care worker shortage,” said Dr. Jim Turner, medical director of the Lugar Center for Rural Health on the campus of Union Hospital.

The shortage spans the industry from physicians to nurses, respiratory and physical therapists, mental health specialists, medical technology, to lab technicians, nursing home caregivers and others.

“We’re not going to have enough trained people to fill future need,” Turner said of the coming years in the Wabash Valley. “We already don’t.”

Vigo County alone has 306 companies whose primary occupation is health care and social assistance, providing more than 8,100 jobs, according to the Indiana Department of Workforce Development. The only county industry providing more jobs is manufacturing, with just more than 8,400 jobs in 132 companies.

The Union Hospital Health Group is the largest employer in the county with 2,300 employees, according to the Terre Haute Economic Development Corp. Also in the top 25 employers by number of employees are Terre Haute Regional Hospital with 831 health-care employees, Associated Physicians and Surgeons with 503, and Providence Medical Center with 270.

Health care in the Wabash Valley covers a two-state, 12-county area. As such, Terre Haute has the largest medical services network between Indianapolis and St. Louis.

That network serves a largely rural populace. And that rural aspect can be a challenge when attracting physicians to set up a long-term practice.

Television has many shows that make emergency rooms and specialty medicine the appealing choice for a health-care career. Gone are the days of “Marcus Welby M.D.,” the family doctor who took care of all medical needs from birth to death and every strep throat in between.

In reality, the number of U.S. medical school students going into primary care has dropped more than 51 percent since 1997, according to the American Academy of Family Physicians.

Part of that can be attributed to the higher pay, prestige and shorter work days that a specialist puts into health care. Rural health care is a less “TV-sexy,” more community-driven choice, and the Lugar Center’s Dr. Turner advocates it for the medical students who enter the 11-year educational pipeline on their way to becoming health-care providers.

A rural physician himself, Turner knows the best way to attract physicians, nurses and other health professionals to a community is to grow your own.

“It’s very rare to find an urban-trained doctor who likes rural medicine,” said Turner, who still practices in Marshall, Ill., in addition to his duties training young physicians.

What makes rural health care different, he said, is the people factor.

“It’s all about people. It’s about understanding their lives — how they grew up, where they work, their mom and dad,” Turner said.

“It’s a special relationship, and it’s not easy.”

While the bygone days of making house calls is a legend of health care, rural physicians and their staffs are still important parts of their community.

Especially as an economic impact for a community.

Each primary care physician injects about $2 million annually into a hospital, Turner said, through not only direct medical care, but also by ordering testing. lab work, therapy and other services.

Each primary care physician also is associated with an average of 24 jobs and about $1 million injected into a local economy. That comes through medical staff and office workers, caregivers, nursing homes, hospice, technicians, pharmacy services and other associated jobs.

In Clark County, Ill., for example, Turner said there are about 400 health-care jobs, making that industry the second-largest employer in the county.

“So, there are many advantages for a community to attract a physician due to the economic impact,” Turner said.

It is a proven fact as well that the availability of medical care attracts companies and industries, thereby providing economic benefit to a community.

“It’s not just about the altruistic idea of taking care of hometown folk,” Turner said of being a rural physician. “There’s also the economic impact that affects everyone.”

It is anticipated that in 10 years, America will be short 40,000 physicians, Turner said, citing information from the American Academy of Family Physicians.

“So what we’re trying to do at Union Hospital and the Lugar Center is improve that rural workforce through our new program,” he said.

Medicine still is attracting the best and brightest students out of high schools and colleges. With an 11-year educational commitment ahead, however, medical students must placate themselves with the delayed gratification of entering their field well-trained.

“We tell them it’s a marathon, not a sprint,” Turner said.

The Lugar Center program accepts 24 new medical students each year into its Rural Health Program, trained through the collaborative effort of Indiana State University and the Indiana University School of Medicine.

With the first group of graduate students entering the program in the fall of 2008, and the second class now under way, 48 medical students are now on campus.

Turner said the buzzword today in medical education is “interdisciplinary” studies. One example of how that works at the Lugar Center is by having the athletic training students at ISU explain to the medical students how to examine knees and shoulders, and then having the athletic training students going to the anatomy labs with the medical students to see how the human body is put together.

That kind of team effort in training carries over into the team effort of providing health care, since physicians often make referrals to specialists in areas such as physician therapy or sports medicine to help a patient recover.

“We approach this as a team in real life,” Turner said, “so why not learn together as a team?”

The growth of the Union Hospital Health Group in recent years has played into the formation of the Rural Health Innovation Collaborative, or RHIC, which partners ISU and IU with Ivy Tech Community College, the Lugar Center, the City of Terre Haute and the Terre Haute Economic Development Corp. A health care “corridor” linking the Union Hospital campus to the ISU campus to the south, and at some point including Regional Hospital, is one example of how health care can positively influence not only the economic health of a community, but also its environmental growth through building projects and neighborhood improvements.

At Indiana State, academic changes are in the works to feed more students into the Lugar Center program.

Richard “Biff” Williams, professor and dean of the College of Nursing, Health and Human Services, said ISU is working to create a master’s degree in physician assistants, and doctoral programs in physical therapy and nursing practitioner.

After reviewing the programs that could be grown and expanded at ISU, Williams said, those are the three areas that are moving ahead. But there is also interest in establishing pharmacy and health information technology programs.

One of the unfortunate problems with setting up the programs is finding staff that is qualified to teach them.

“We can’t find enough nurse educators,” Williams said. “Teaching is difficult. You really have to be gifted in teaching.” Simply having on-the-job experience is not enough in a medical education program.

“Our nursing faculty are very talented people who can take complex theories and principles and teach it to students who really don’t understand it yet,” he said.

And that is one reason ISU hopes to offer a doctorate in nursing practice, to help create nursing educators.

Another growth area that Williams sees on the educational horizon is in health information technology. The program would teach IT students how to go into clinics and hospitals and set up technology systems that communicate with each other in the specialized needs of a medical community.

“It takes a year to educate a good technology person on how to do electronic medical records and health IT,” Williams said.

And then there is the telemedicine aspect of technology that allows distance consultation and diagnosis by doctors.

Distance medicine is the electronic wave of the future, Williams said, and ISU is developing a program to meet that need.

“The physician shortage will require this kind of distance consultation,” he said.

And he added that he does not see the shortage among health-care workers ever going away. “This profession is not recession-proof,” Williams said, “but it’s pretty darn close.”

Lisa Trigg can be reached at (812) 231-4254 or lisa.trigg@tribstar.com.