Rural Health Care

This article appears in the Healthbolt Carnival at Healthbolt.net.

I often mention that I live in a very remote, very rural town in West Texas. Today I got to experience one of the negative aspects of that arrangement. I spent a good part of my day taking one of my close friends back and forth to the hospital. She called again late this evening and asked me to take her back. She was experiencing severe pain and none of the drugs I had stood in line at the drug store to get for her this afternoon were doing the trick. After spending an hour or two in the emergency room, they decided to admit her. Evidently she has a very large kidney stone, which she will be unable to pass. They are going to keep her overnight for pain management. Tomorrow I will probably be leaving early in the morning to make the six or seven hour drive with her to Austin so she can see her urologist and have it dealt with. What a miserable trip that will be for her. Hopefully they’ll give her some good pain meds.

I love living in a small town and don’t mind being 200 miles from the nearest mall, multiplex, traffic jam and high-rise. There is always a trade-off though and tomorrow my poor friend will be paying that price as we bounce along the Interstate. It is very difficult for rural communities to hire and retain doctors. We usually have a couple of GPs but specialists are few and far between. They just can’t make a living out here. Although we have a nice, relatively new hospital, once our residents develop chronic medical conditions they invariably move away because we don’t have the medical staff to support it. There is no way to know how many people choose not to move here at all because of our lack of good medical care. I had to move to El Paso for my summer of cancer several years ago because I could not get treatment locally. It’s a conundrum that some small communities have tackled by paying for medical school for students who are willing to come back and spend a few years serving their area. Our town has not yet made that choice.

Rural health care is a big issue with no easy answer. According to the Agency for Healthcare Research and Quality “one-fourth of America's population lives in rural areas. Compared with urban Americans, rural residents have higher poverty rates, a larger percentage of elderly, tend to be in poorer health, have fewer doctors, hospitals, and other health resources and face more difficulty getting to health services”. Along with all the other issues facing our country, access to good health care for people in rural areas is a big problem and we’re going to have to think of a resolution. I’m afraid though, we’re pretty far down the list!