A healthcare wake-up call for rural Missourians

I was not privy to the “behind the scenes” culture of medicine prior to my entrance into healthcare. Unlike many of my classmates in medical school, my parents were not doctors, nor were their friends. My family did not attend hospital galas, and they did not dine with the local politicians.

Yes, I admit I was naive. My philosophy was simple. I wanted to provide excellent care to my patients, and I didn’t choose the profession to be rich. I wasn’t interested in the business of medicine. So, imagine my surprise when the blinders were removed from my eyes and I had a chance to see the ugly side of my profession, healthcare and politics.

Our present-day moment is a good example of the ugliness of healthcare and politics. When did scientists, researchers and doctors become villains?  The Centers for Disease Control and Prevention (CDC) was a major part of my medical education and now it is being portrayed by this present administration as incompetent, and it is not being allowed to provide necessary education to the public without its work being scrutinized and redacted in some instances.

What kind of uninformed authoritarian regime is this?

Furthermore, cutting aid to the most vulnerable of our population was an additional outrageous act that was supported by many healthcare providers in the United States Congress. That cowardly act will hurt millions of people, particularly in rural America.

For some reason in this country, poor people are often characterized as living in urban slums.  However, 25% of Missouri’s rural counties have poverty rates above 20%. So, what will Medicaid cuts look like for those citizens?

Rural hospitals were already struggling before cuts to Medicaid. Now, many of those hospitals will close. So, let’s imagine if Grandma Karen had a stroke. To optimize her survival and lessen the chance of morbidity from her stroke, she needs treatment within a few hours.

However, now her local hospital no longer exists, and her family must get her to Kansas City or St. Louis. The likelihood of her having a good outcome is now very low. 

Let’s not stop with the stroke example. Deaths from drug overdose are also a problem in rural Missouri. Looming budget cuts mean that there are fewer programs to assist people with opioid use disorders. 

Per the CDC, in 2019 the rate of drug overdose deaths involving psychostimulants with abuse potential (drugs such as methamphetamine) was 1.4 times higher in rural counties (6.7 per 100,000) than in urban counties.

But let us not forget, however, that the majority of rural Missouri supported this current administration. Oh, the irony of it all!

Keeping the citizens of this country healthy should be a collaborative venture between our healthcare infrastructure, public agencies and a competent, functioning government. As a primary care provider living in this current moment of uncertainty, I must somehow reassure my patients that everything will be OK.

My patients are worried about the next pandemic. Is this country ready? Do we have the right people in charge to help us navigate a crisis? Will our researchers have the funds they need to continue scientific advancements?

The answers to these questions are unknown, but I do hope the past eight months have been a wake-up call to many.

Denise Hooks-Anderson, MD, FAAFP, is the medical accuracy editor for The St. Louis American. She can be reached at [email protected]

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