In rural areas, doctors are like a revolving door, rarely staying in one place for long. There are disparities in healthcare access in rural America, but technology may be a solution to increasing healthcare access.
Authored by Nan Sloan
I never would have thought that access to healthcare providers and services in 2019 would be so limited. I’ve always lived in large cities and had easy access to providers and facilities. But last year, my husband and I moved to an area best described as rural Virginia.
Tappahannock, Virginia, is an hour from Richmond and—on a good day—at least an hour and a half from Washington, D.C. We moved here to provide oversight management for my very active 92-year-old mother-in-law. She works four days a week, plays bridge two or three times a week, drives (a topic for another day) and was a Virginia state gold medalist in ping pong. However, at 92, she has developed health issues.
She is nine years post-stroke,11 years post-double hip replacement and seven years post-shoulder surgery. She’s also facing a combination of other age-related health issues. The reality of her declining health is compounded by the challenge of making sure she has access to a doctor.
The U.S. Census Bureau reports that 20% of the U.S. population is rural, but only 12% of primary care physicians are working in rural areas—and that number is declining. We’ve seen this on a first-hand basis—it’s like a revolving door keeping up with my mother-in-law’s doctors.
At her last visit, we learned her doctor was leaving the area in two weeks. She’d been with this doctor for only seven months; the one before that was six months; and the one before that was with her barely a year. You get the picture. My husband and I tried to find a local doctor, but we were told that no one was taking new patients. They asked us to check back in September 2019. So much for access to healthcare. I even inquired about doctors in Richmond—but no doctors in Richmond are in-network. The closest in-network provider was 117 miles away in Maryland. I was shocked to say the least.
Fortunately, I found a husband-and-wife physician team who wanted to give back to the community in which they grew up, so they set up a nearby practice in their hometown. Even though they were out-of-network, they were only 20 miles away and were accepting new patients. Mission accomplished! Now the task at hand was to convince my mother-in-law to drive 20 miles to a doctor. It didn’t matter that my husband or I would do the driving—to her, driving 20 miles is like driving from Virginia to North Carolina. Needless to say, it took a lot of convincing.
I share this story because I know and understand that many people in rural communities have no one to help them find healthcare services, let alone provide transportation to appointments or to pick up prescriptions. In my small town, there is no bus, no Uber or Lyft drivers, and not even a cab. A recent issue brief from the Altarum Institute found that travel and wait times are longer for healthcare consumers than they are for consumers in other industries—and this is compounded for those living in rural areas. This poses a real threat to access to care.
Because of my experience with my mother-in-law and through my volunteer work, I am becoming more aware of the disparities in healthcare access in rural America. We talk about access to healthcare for all. But what about the rural communities? How do we get doctors to stay and provide services? How do we address transportation, food and social support issues?
The conversation about the rural-urban healthcare divide is critical, and those of us in the healthcare industry need to continue pushing for ideas and solutions. If we can come up with creative ways to target our healthcare resources and retain rural physicians, we can impact the health of rural Americans in a real and meaningful way.
I believe that technology can and should be a key component of increasing healthcare access in rural communities, as digital health holds the promise of collaborating and sharing through solutions such as social/mobile platforms, telehealth and home medication delivery. Technology has the power to connect us in the goal of achieving better health, regardless of where we live. I will continue to advocate for my small community, as will my fellow volunteers, in order to make a difference on a local scale. Even if local means a 20-mile drive.