When the doctor is out, where can rural patients turn?

As health care professionals, we are all aware that there is a worrisome trend affecting people who live in rural areas when it comes to access to care. From hospital closures to the shuttering of service lines, such as labor and delivery, we are seeing entire communities become health care deserts. In terms of independent doctors practicing in rural areas, recent research shows that the number has plummeted 43% between 2019 and 2024. 

In these areas where the numbers of health care providers continue to decline, where are patients supposed to go? 

For hospital leaders, these challenges create new opportunities to leverage emerging technology to help patients get access to timely, high-quality care. 

Build with patients in mind 

In my experience, what stands out most is all the reasons patients have trouble getting the care they need. In rural Montana, a snowstorm kept a patient from being transferred to a tertiary care center. In rural Texas, a patient couldn’t be transferred far away because he was responsible for taking care of his elderly parents. The stories are countless. 

For urban health care professionals, it is common and accepted knowledge that it’s hard for patients to make time to get to the doctor between work, family and life’s everyday responsibilities. But in rural America, the challenge for the patient isn’t, “How do I make the time to go to the doctor?” It’s, “Where do I go when there’s no doctor to see?”

Each community across the US is different. In some communities, the strongest need is cardiac care, while in another, it’s diabetes management. That’s why it’s so important that each hospital leader looks at their own unique community to assess the needs and care gaps in order to provide and deliver care that is relevant. 

Leverage hospitalists to inform the right strategy 

Hospital medicine is a unique service that guides hospital strategic decisions. As the nexus/network of the hospital, hospitalists are in a unique position to see the big picture. Which patients can’t get admitted to the hospital? Where is there a shortage of providers or beds? How do those ebb and flow each day, week, month and year? Having this critical insight into a hospital’s operations can help inform the gaps in care – e.g., neurology patients that the hospital can’t treat – in order to identify opportunities to improve access to care.

One takeaway for any hospital leader is that having hospitalists at the table when considering and designing a telehealth strategy can be critical to its success. 

Develop a telehealth strategy 

Rural hospitals around the country are recognizing the role virtual care can play as they address current and future challenges; as a result, they are not considering if they should introduce telemedicine into the organization but are leaning into virtual-first strategies. One example is Piggott Health System. Piggott uses the technology to connect critical acute care patients with doctors in neurology, pulmonology and other specialties. The ability to provide this level of care means patients who need it in the hospital setting – as well as those unable to travel to specialty providers – can connect to them through the health system. 

Make telehealth a communitywide effort 

Having virtual care available within the hospital walls is one thing, but making sure the community knows about it is another. After all, the reason for implementing telemedicine is to get patients access to timely, quality care, so it’s important they know it’s an option. For example, if a patient experiences an acute health issue and doubts their local hospital can provide the right care, they will likely drive to another facility where they’re confident in receiving the necessary treatment. Patients who have lived in a community for decades may be used to not having specific capabilities at their local hospital. The onus is on local leadership to introduce a new mindset – and a new set of capabilities to the community. 

As part of that community outreach, hospital executives can leverage marketing tactics, such as email campaigns and website updates/content; host open houses for the community to meet specialists in person; ensure internal alignment and excitement for the virtual programs; and work with local physicians, such as primary care providers, to ensure they have the information they need to deliver the best continuum of care to their patients. 

A complex challenge

The challenge facing rural communities is real and not going away. With limited resources and infrastructure across the country, the solution is not simple. However, with an understanding of the community and their unique needs, capabilities of the hospital(s) and local health care system, and how the right virtual care strategy could address those needs, patients in rural communities do not have to go without timely, quality care. 

In more than 10 years of practice – and my personal experience growing up in rural Texas – I have never come across anyone who wants to go far away from home for their medical care. Yet every year, 30 million rural Americans drive more than an hour not only for acute health issues, but to receive routine care. Telemedicine is one way to get patients the care they need where they want it – as close to home as possible.

Opinions expressed by SmartBrief contributors are their own.

_______________

Subscribe to SmartBrief for Health Care Leaders, one of our more than 30 health care publications.