SYRACUSE, Kan. -

After college, most people migrate to the big cities - urban areas with shopping, fine dining and a night life.

Although Kansas has a few metropolitan areas, most of the state is composed of rural towns - surrounded by farmland, lucky to have a stoplight, and desperate for doctors. Nearly the whole state needs more general practitioners.

James Kallail, Associate Chair of Research at the KU School of Medicine, said 101 of the 105 Kansas counties are either partially or fully designated as shortage areas for primary care.

"It's a huge shortage," he said. "It's been around for years and the federal government projects the shortages won't go away in the next 50 years."

Syracuse, Kan., has the only hospital in Hamilton County. It even has an emergency room. However, it has gone eight years without a doctor on staff to treat life or death situations.

That worries residents like Carol Roberts, who is concerned not only for the town's elderly population but for her two grandsons that live in Syracuse.

It also worries Bryan Coffey, CEO at Hamilton County Hospital.

"What is life like when you have an emergency and you don't have a town physician?" he said. "Well, it's stabilize and ship. You have your EMS crews bring you to the local hospital, where they stabilize you and make arrangements to send you out to a larger facility."

The hospital hired a physician's assistant, Wade Buckley. But some emergencies are just too big.

"If it was something we couldn't deal with," Buckley said, "we would put them in an ambulance and make sure they got the help they needed."

A few doctors from bigger towns ran clinics at Hamilton County Hospital a couple days a week. Bu that was a temporary fix.

"It's mighty inconvenient," said Wayne Westblade. "My wife broke her hip and we were going to call the ambulance. But they would've delivered her up to this hospital, and the doctor wasn't there."

So most people who live there now travel miles for primary care. Carol Roberts said she just returned from a trip to Amarillo, Texas, which is three and a half hours from Syracuse, for health reasons.

"When you're facing emergency room care, by definition it's an emergency," Coffey said. "You need immediate treatment of some sort. So the longer it takes to get treatment, the more potential damage can happen to your body long term."

Not to mention damage to your pocketbook.

"Gas is not cheap," Roberts said. "If you're there any length of time you're also looking at hotel rooms, food. So that is a hardship financially."    

There is also the cost of paying the hospital that can't help you on site.

"Anytime you have to be life-flighted out, flown out, or even an ambulance ride 30 miles to the next town, that's all very expensive," Coffey said.

Expensive for the patient - and eventually crippling for the hospital.

"Funny thing about health care - if you don't have doctors, you don't really have billing," Coffey said. "If you don't have billing, you don't have revenue or cash coming in, so it put the hospital in dire straights."

It's a a reality mirrored in numerous towns across Kansas, that stands to get worse before it gets better. Tuesday night, we'll focus on what the state and the University of Kansas are doing to help the problem. Wednesday night, we'll look into how they're using technology to get around it.