How can we care for rural America?

December 13, 2012 —

For a future issue of DMU Magazine, I plan to explore the joys and challenges of rural medicine. Numerous studies, including those published in the Journal of the American Medical Association and conducted by the U.S. Department of Health and Human Services, show that rural America is underserved: While about 20 percent of the nation’s population live in rural areas, rural physicians make up only about 10 percent of the total number of working physicians in the country.

Rural life can be tranquil – until you need emergency health care.

Des Moines University and Iowa’s Area Health Education Centers (AHEC) are working to tackle this issue, which will likely only get worse as our nation ages and demand for health care services rises. In addition to working with AHEC to nurture interest in science and medicine among youth, promote health care careers, and provide training, DMU’s rural pathways program provides scholarships to select osteopathic and podiatric medical students and physician assistant students who will commit to practicing a specific number of years in rural Iowa after residency.

My interest in rural medicine is why a recent article on The Atlantic Monthly’s website caught my eye: It described a Sioux Falls, South Dakota, hospital that has no patients, and the 70 rural communities in four states where patients struck by urgent health issues “are rushed to an E.R. where there are no doctors.” Or there may be just one doctor or other care provider, not trained in emergency care, who can connect by technology to the emergency room doctors in that Sioux Falls hospital.

This long-distance critical care center of Avera Health Network, the article notes, is believed to be the only one in the U.S. and “possibly the world.”

“Based at Avera Mckennan Hospital, the nonprofit provides a range of ‘telemedical’ services that take advantage of technology – including high-definition two-way video consulting – to make it possible for experts to be available 24/7 in locations throughout South Dakota, North Dakota, Minnesota, Iowa, Wyoming, and Nebraska,” the article states.

I believe innovations like this are hugely beneficial to rural residents, who can get the emergency care they need without traveling long distances. In addition to saving lives, such “e-care” has been shown to reduce ambulance and helicopter transfers to major hospitals, saving money and keeping rural patients’ health care dollars in their communities.

If you are part of a health care practice or organization in a rural area, what are your biggest challenges? What do you think can be done to improve patient care there?


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