Showing posts with label rural healthcare. Show all posts
Showing posts with label rural healthcare. Show all posts

Sunday, July 17, 2022

Impacts of rural health care facilities on their communities

Rural America often is portrayed as a pastoral, idyllic landscape where people live a slower, more meaningful life. But there is a darker side to this idealistic portrayal of rural America – healthcare outcomes. Rural residents have higher death rates due to heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke than their urban counterparts. Additionally, cause-specific mortality often is higher in rural counties than urban counties.

According to the Rural Health Information Hub, “Health disparities are differences in health status when compared to the population overall, often characterized by indicators such as higher incidence of disease and/or disability, increased mortality rates, lower life expectancies, and higher rates of pain and suffering. Rural risk factors for health disparities include geographic isolation, lower socioeconomic status, higher rates of health risk behaviors, limited access to healthcare specialists and subspecialists, and limited job opportunities.”

Hospitals are the linchpin in the medical system of rural communities. Rural hospitals offer care to patients that they otherwise wouldn’t be able to access and provide essential services such as emergency care, intensive care and surgical operations. Unfortunately, rural hospitals are closing at alarming rates – according to a study from the Center for Healthcare Quality and Payment Reform (CHQPR), nearly half of all rural hospitals are facing uncertain futures and are at risk of closing due to financial woes.

“Over 500 rural hospitals – more than one-fourth of the rural hospitals in the country – are at immediate risk of closure because of continuing financial losses and lack of financial reserves to sustain operations,” the study said. “Almost every state has at least one rural hospital at immediate risk of closure, and in 21 states, 25% or more of the rural hospitals are at immediate risk.”

The reason rural hospitals are so important is that rural residents face more significant barriers to healthcare, such as:

Lack of providers


According to the National Center for Health Workforce Analysis, fewer than 8% of all physicians and surgeons practice in rural regions. This results in rural populations being severely underserved, resulting in health disparities in rural regions and decreased health equity for rural populations. Rural hospitals have a hard time attracting and retaining enough providers to serve the local population.

Increased risk factors



Rural populations have higher rates of risk factors such as smoking, obesity and physical inactivity, which contribute to the higher mortality rates in rural areas.

Higher rates of underinsured and uninsured patients


Rural residents tend to have lower incomes and fewer folks covered by employer-sponsored healthcare plans, which makes the presence of safety-net hospitals in rural communities even more vital to the overall wellbeing of its residents.

Lack of specialty services


Rural areas typically lack specialty medical practitioners that are more prevalent in urban areas. Additionally, hospitals can provide specialty services that are unavailable elsewhere in the community. Safety net hospitals, which provide services to residents regardless of a patient’s ability to pay, are especially crucial.

Through my work with safety net hospitals, we have brought state-of-the-art medical imaging services to underserved communities, such as providing mobile medical imaging services to the Austin and Jackson Park communities.

“Almost all the rural hospitals that are at immediate or high-risk of closure are in isolated rural communities. Closure of the hospital would mean the community residents have no ability at all to receive emergency or inpatient care without traveling long distances. In many small rural communities, the hospital is the only place where residents can get laboratory tests or imaging studies, and it may be the only or principal source of primary care in the community,” the CHQPR study said.

I believe that multi-system programs will fill a growing need in today’s quality conscious healthcare environment.I am passionate about access to healthcare and making sure that everybody, no matter where they live or their socioeconomic condition, has equal access to high-quality healthcare services.


15% Off Medical Practice Supplies


VIEW ALL



Manual Prescription Pad (Large - Yellow)


Manual Prescription Pad (Large - Pink)

Manual Prescription Pads (Bright Orange)

Manual Prescription Pads (Light Pink)

Manual Prescription Pads (Light Yellow)

Manual Prescription Pad (Large - Blue)

Manual Prescription Pad (Large - White)


VIEW ALL

Tuesday, March 3, 2020

Locum tenens: Rural America’s next provider generation

Small towns and rural communities suffer most from the deficiencies of our system of healthcare delivery. As a result, this segment of our population is the most disproportionate to their urban and suburban counterparts in overall health and in socio-economic factors that define them. This includes suicide rate, poverty level, household income, addiction, access to technology, education, mental health services, chronic illness and maternal mortality.


The physician shortage directly correlates with the severity of these issues among our lesser populated communities. The number of physicians per 10,000 people is 13.1 in rural areas, versus 31.2 in urban communities. The disparity in the number of specialists is even more exacerbated, with only 30 per 100,000 people in rural areas, versus 263 per 100,000 in populations living in urban communities. Therefore, family physicians make up 42 percent of the outpatient physician workforce in rural areas—as opposed to the 15 percent they represent as a whole nationwide—and the population is largely relegated to generalists as it is their only choice for care.


To make matters worse, the shortage of rural providers is compounded by the closure of more than 100 rural hospitals in the last decade. In addition, there are 400 more facilities now risking closure as well. Roughly 60 million people—roughly 1 out of every 5 Americans—live in this stark reality.

How Do We Solve This Issue?



Who are the physicians wanting to work in rural communities and solve this epidemic? We’re learning it’s those who come from rural America. A number of our medical schools are now concentrating on giving more opportunities to this segment of our population to become tomorrow’s physicians and then return home to practice. They’re offering special residency training in underserved areas with additional benefits for staying afterwards in exchange for loan forgiveness not offered to their counterparts practicing in other areas of the country.

The traditional approach of recruitment and retention is getting more difficult. Relocating a new physician and their family to these regions is a tall order. Competitiveness between facilities is at an all-time high. Compensation alone is often not enough to attract providers and avoid the costs incurred from being short-staffed during a permanent search, which has no guarantee of success.

The Role of Locum Tenens


A combination of addressing the needs of current staff while infusing it with locum tenens is the way to address the shortage of rural healthcare providers. Focus on offsetting the major worries of today’s doctors such as burnout, help decrease student debt, emphasize autonomy, and support flexible schedules and time off with supplement coverage that ensures the continuity of your practice.


Remember that locum tenens was born out of the physician shortage of rural America and our need to relieve the full-time doctors who practiced in these same areas. An increasing amount of today’s physicians are choosing locums to supplement their income by taking assignments in smaller communities considered underserved populations. Here, they’re able to practice medicine without the bureaucracy they find within large healthcare organizations, while focusing on treating patients, exercising more autonomy, paying off debt, trying new settings and enjoying the travel aspect of being a temporary physician.

It’s also important to note that many of our retiring physicians aren’t fully retiring from practicing medicine altogether. Instead, they practice locums part-time by continuing to meet demand, whether that of their fellow baby boomers or the next generation. Addressing the shortage of rural healthcare providers begins with providing opportunities for individuals from these areas to be successful in medicine, while at the same time tapping into the locum tenens workforce.

15% Off Medical Practice Supplies


VIEW ALL



Manual Prescription Pad (Large - Yellow)


Manual Prescription Pad (Large - Pink)

Manual Prescription Pads (Bright Orange)

Manual Prescription Pads (Light Pink)

Manual Prescription Pads (Light Yellow)

Manual Prescription Pad (Large - Blue)

Manual Prescription Pad (Large - White)

VIEW ALL

Tuesday, March 12, 2019

Physician assistants improve healthcare in rural areas

I have been concerned with the maldistribution of rural health provider assets for decades. The situation is dire. The sad reality is that the number of physicians practicing in rural and medically underserved areas has been declining for decades. The reasons for this are complex. Practice in these areas is challenging from financial and quality of life perspectives. Many clinicians I know choose to work in metropolitan areas to find a “better life,” more opportunities, and more professional support.


The PAs I know who practice in rural and medically underserved areas tell me how much they love their work and their patients. They also express concerns about the isolation and the fatigue that comes with being the only provider in a small community with little professional support. It takes a special kind of clinician to work in this environment.


In a recent policy brief, the National Rural Health Association (NRHA) recognized the substantial resource that PAs represent in solving the crisis of rural healthcare and outlined steps to better utilize PAs to do so.


Approximately 15 percent of PAs practicing in 2017 (17,280 out of 115,200 total) practiced in rural or frontier counties, as opposed to 11 percent of practicing physicians. The NRHA also found that at least in Iowa, Texas, California, and Washington state, PAs practiced in rural areas in higher percentages than other providers.


PAs are uniquely qualified to fill an expanded healthcare role in rural and medically underserved areas due to their broad generalist education and a 50-year track record demonstrating competence and skill. One issue that stands in the way of PAs practicing at the top of their experience and training is overly restrictive state laws and regulations governing PA practice. The NRHA recommends, in addition to changing state laws, that scope of practice for PAs be determined at the practice level by the teams they work with.

The NRHA policy brief supports the tenets found in the American Academy of PAs’ Optimal Team Practice (OTP) policy, which are:


Emphasize PAs’ commitment to team practice;

Authorize PAs to practice without an agreement with a specific physician—enabling practice-level decisions about collaboration;

Create separate majority-PA boards to regulate PAs, or give that authority to healing arts or medical boards that have as members both PAs and physicians who practice with PAs; and

Authorize PAs to be paid directly by all public and private insurers.

The simple fact of the matter is that physicians who work in rural areas need PAs to practice to the full extent of their training and experience. It is a quality of life issue, and PAs have shown over their long history to be competent, safe, and efficient providers in rural and all other areas of medicine and surgery. PAs have also shown since the inception of the PA profession to be part of solution and not part of the problem when it comes to healthcare delivery.

I have lived in a lot of rural areas in my life, and I have practiced in medically underserved areas. Some of the reasons that physicians and PAs choose rural practice are obvious—the outdoors, clean air, simple living, low crime, low traffic, and other characteristics of rural areas appeal to folks looking for a better, simpler life. The reasons that some folks choose not to live in more isolated areas are a lack of professional support, a lack of resources, fewer opportunities for relationships, and fewer cultural amenities, among other barriers.

I have thought a lot about this problem from a policy standpoint. If we want clinicians to consider rural practice, we have to reduce some of the barriers and incentivize people to work there. It would also be helpful to remove some of rules and regulations that get in the way of team practice of medicine and the practice of medicine in general.I’ve already mentioned OTP, which would help PAs in rural practice, but things like easier implementation of telemedicine would make rural practice much more appealing by increasing providers access to specialty care in remote areas. Tax credits and loan forgiveness for physicians and PAs who commit to rural practice are other possible incentives.

This is a massive problem that will only get worse as the rural population ages and the ratio of rural patients to physicians and PAs gets more upside down. Reversing this trend will require a comprehensive policy solution that includes PAs front and center in ensuring that rural Americans have access to quality, affordable healthcare.

Medical Office Supplies

15% Off All Products