Lack of Health Care Access in Rural America

October 16th, 2019 - By Chris Ferguson

The US government has declared almost 80% of rural America to be “medically underserved.” In many places throughout the rural parts of the country, residents within an 11,000-square-mile range have but a single doctor to serve all their medical needs. Despite rural America being home to 20% of the nation’s citizens, it is home to only 10% of the nation’s physicians. As doctors know best, however, for every crisis, there are solutions. Before the health care crisis in rural America gets any worse, there are decisive actions that can be taken today to start making it better.

Rural America’s Health Care Crisis

Worse than the current lack of health care in rural America are the indications that the problem is only going to get worse. A phenomenon health industry experts have named “the gray wave” forebodes an even more significant disparity between the number of doctors and patients on the near horizon. Already, doctors in rural America are an average of three years older than doctors in urban America, with more than half of rural doctors over 50 years old and more than 25% over 60. Given this, the number of doctors in the rural parts of the country is poised to drop another 23% over the next ten years, compared to the number of urban doctors, which is expected to remain the same.

Consider the State of Texas as just one case in point. Out of its 254 counties:

  • 30 have just one doctor
  • 35 have no physicians whatsoever
  • 121 have no medical specialists
  • 159 have no general surgeons

Numbers like these are reflected in states and counties throughout rural America. Emergency room visits in the approximately 2,000 hospitals in rural America have shot up over 60% in the last ten years alone. At the same time, those very hospitals are experiencing dramatic shortages of physicians and operating with dangerously low margins. Compared with hospitals in urban communities, rural hospitals treat patients who are an average of six years older, yet 40% poorer. This compounds two problems into one: specifically, a greater risk of more severe health problems and, consequently, greater medical costs with less ability to cover those costs.

Another unfortunate consequence of this disparity is that government cuts. Reimbursement rates for Medicare and Medicaid have disproportionately impacted these very same rural communities that rely on those protections the most. Rural doctors and hospitals are left to treat an increasingly large number of patients uninsured and unable to pay their bills. This leaves rural medical services with mounting piles of unpaid debt. Nearly half of all rural hospitals lost money in the last year alone — hundreds of rural hospitals slashing services or handing over ownership to third-party organizations as necessary stopgaps. The results – over 400 rural hospitals, or one-fifth, to be at nearly imminent risk of failure.

How the Lack of Healthcare in Rural America Affects Patients

This relative shortage of doctors in rural America causes patients all across the country to be subjected to a multitude of problems. Seeing the doctor and long wait times once they get there, often only to be transferred or transported to a nearby city anyway for the proper health care they need. In many cases, the travel time alone is enough to discourage rural residents from even seeing a doctor for a regular checkup once or twice a year. This, in turn, exacerbates health risks for those residents, further perpetuating the vicious cycle.

How the Lack of Healthcare in Rural America Affects Doctors

Not only does this dangerous gap between rural patients and doctors place patients at incredible health risk, but the burden this imposes on physicians is crisis-level as well. Consider the typical modern rural doctor to realistically juggle as a general practitioner, specialist, surgeon, rural clinic health director, local hospital chief of staff, county medical director, and so on. Rural doctors may be forced to see dozens of patients per day and work multiple shifts and excessive hours without sufficient rest breaks. Medically underserved rural communities do rural doctors as much a disservice as rural residents. Burnout is a danger all-too-common for doctors serving rural America.

This vicious cycle of increasing disparity between the supply of rural doctors and the demand for quality rural health care seems set to only continue spiraling worse. Decisive action needs to be taken to correct this dire situation and set rural health care back on course.

Solutions to Rural America’s Healthcare Crisis

Several actions can be taken—by governments, communities, doctors, and patients—to improve the availability and quality of health care in rural America. One of the most practical and cost-effective of these actions is telemedicine.

Telemedicine makes use of modern communication technology to provide health care services to patients remotely. Doctors and patients communicate by videoconference. That way, they can see each other face to face and, if a doctor needs to examine a patient visually, she can. Health data can be exchanged securely using EHR (electronic health records), and prescriptions ordered and filled using e-prescriptions. Important documents can even be signed remotely using HIPAA-compliant e-signature software. Any tests that are needed, the doctor can order, and the patient can have done at a lab. In some cases, a nurse or nurse practitioner on staff at a telemedicine facility can provide many of the same services for the physician. The patient would be provided with the same service as at any regular, in-person appointment (such as checking height, weight, blood pressure, and pulse.)

Tele-medicine helps to solve the problem of insufficient numbers of doctors serving a particular area by allowing doctors outside the area to help serve those residents. Eliminating the need for doctors or patients to travel exorbitant distances or for doctors to maintain practices in areas with insufficient populations to support them makes health care both more readily available and affordable for rural residents.

Learn more about how PrognocCIS EHR can help doctors connect remotely with patients anytime, anywhere. To further improve your reach and your patients’ access to health care request a demo or call1-877-693-6748 today.

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