Medicine
Thanks to Dr. Fitzhugh Mullan and colleagues at the Medical Education Futures Study for letting me know about a terrific 4-part series of articles by Emily Ramshaw of the Texas Tribune. In "No Country for Health Care," Ramshaw documents the severe difficulties that residents of rural Texas have in accessing primary and specialty care services. While most of the national health reform debate has revolved around providing insurance coverage to more people, this series illustrates the profound challenges of obtaining medical care in these and other similar regions of the U.S., insured or not:
Many Texans live more than an hour from basic medical care. Some border communities have so little health care that U.S. citizens cross over into Mexico to get it. ... 63 Texas counties have no hospital. 27 counties have no primary care physicians, and 16 have only one.
Conventional solutions to this shortage of rural health providers - offering scholarships and loan repayment incentives to doctors who choose to practice in underserved areas and changing medical school curricula to increase exposure to rural medicine - have proved woefully inadequate to the task. As the urban population has increased relative to that in rural counties, fewer legislators are able to advocate for rural health needs, and recruitment of new doctors has become nearly impossible. (Cities, in contrast, usually have a glut of doctors - the District of Columbia, for example, has more nonfederal physicians per capita than any state in the U.S.)
Despite a recent infusion of federal stimulus funds, the National Health Service Corps is not, and probably never will, be enough to compensate for the tendency for physicians (and other types of clinicians) to gravitate toward urban and suburban lifestyles. Health care reformers need to come up with more creative solutions. Telemedicine may be part of the answer; old-fashioned house call practices might be another. No strategy can possibly succeed, however, in the absence of a coordinated and determined effort to train more family physicians.
- Training Rural Family Doctors
. In a recent report from the University of Washington’s WWAMI Rural Research Center, “Family Medicine Residency Training in Rural Locations”,[1] Chen et. al. repeat their 2000 study of rural training in the US. They note that this is very important...
- Caring For The Underserved: The National Health Service Corps
Forty years ago, Eric Redman's classic book The Dance of Legislation provided a compelling "insider's account" of how the U.S. Senate worked by following the winding path of Public Law 91-623 (The Emergency Health Personnel Act of 1970), which...
- Primary Care Remains A Prominent Topic
Recently, several articles in high-profile medical journals have discussed the upcoming shortage of primary care physicians in the U.S.: 1) The New England Journal of Medicine published a thoughtful commentary by Representative (and psychiatrist) Jim...
- Primary Care In Developing Countries
While this blog focuses on health and the dysfunctional health care system in the U.S., it's worth noting that many other countries have problems providing their citizens with good primary care. Last year, the World Health Organization released a...
- New Salina Med School Campus Unique In U.s.
The following is an excerpt (posted with permission) of an article by Dave Ranney from the Kansas Health Institute News Service that was originally posted on July 5, 2011 on the KHI website. Dave Ranney graciously gave permission for this reposting....
Medicine
No country for health care: rural medicine in America
Thanks to Dr. Fitzhugh Mullan and colleagues at the Medical Education Futures Study for letting me know about a terrific 4-part series of articles by Emily Ramshaw of the Texas Tribune. In "No Country for Health Care," Ramshaw documents the severe difficulties that residents of rural Texas have in accessing primary and specialty care services. While most of the national health reform debate has revolved around providing insurance coverage to more people, this series illustrates the profound challenges of obtaining medical care in these and other similar regions of the U.S., insured or not:
Many Texans live more than an hour from basic medical care. Some border communities have so little health care that U.S. citizens cross over into Mexico to get it. ... 63 Texas counties have no hospital. 27 counties have no primary care physicians, and 16 have only one.
Conventional solutions to this shortage of rural health providers - offering scholarships and loan repayment incentives to doctors who choose to practice in underserved areas and changing medical school curricula to increase exposure to rural medicine - have proved woefully inadequate to the task. As the urban population has increased relative to that in rural counties, fewer legislators are able to advocate for rural health needs, and recruitment of new doctors has become nearly impossible. (Cities, in contrast, usually have a glut of doctors - the District of Columbia, for example, has more nonfederal physicians per capita than any state in the U.S.)
Despite a recent infusion of federal stimulus funds, the National Health Service Corps is not, and probably never will, be enough to compensate for the tendency for physicians (and other types of clinicians) to gravitate toward urban and suburban lifestyles. Health care reformers need to come up with more creative solutions. Telemedicine may be part of the answer; old-fashioned house call practices might be another. No strategy can possibly succeed, however, in the absence of a coordinated and determined effort to train more family physicians.
- Training Rural Family Doctors
. In a recent report from the University of Washington’s WWAMI Rural Research Center, “Family Medicine Residency Training in Rural Locations”,[1] Chen et. al. repeat their 2000 study of rural training in the US. They note that this is very important...
- Caring For The Underserved: The National Health Service Corps
Forty years ago, Eric Redman's classic book The Dance of Legislation provided a compelling "insider's account" of how the U.S. Senate worked by following the winding path of Public Law 91-623 (The Emergency Health Personnel Act of 1970), which...
- Primary Care Remains A Prominent Topic
Recently, several articles in high-profile medical journals have discussed the upcoming shortage of primary care physicians in the U.S.: 1) The New England Journal of Medicine published a thoughtful commentary by Representative (and psychiatrist) Jim...
- Primary Care In Developing Countries
While this blog focuses on health and the dysfunctional health care system in the U.S., it's worth noting that many other countries have problems providing their citizens with good primary care. Last year, the World Health Organization released a...
- New Salina Med School Campus Unique In U.s.
The following is an excerpt (posted with permission) of an article by Dave Ranney from the Kansas Health Institute News Service that was originally posted on July 5, 2011 on the KHI website. Dave Ranney graciously gave permission for this reposting....