Tuesday, August 24, 2010

Wednesday Roundup: Rural Health

Scouring the web for news and opinion of interest to the denizens of the Rural Republic, I realized there were enough stories this week dealing with health care in rural areas to produce something of a "theme day." If you like this idea and would like to see other similar collections of articles in the future (or, conversely, if you never want us to do this again), please let us know. For now, at least, here is the rural health news of the day for your enjoyment and edification.

The Hill reports on Monday's announcement by Health and Human Services Secretary (and former Kansas governor) Kathleen Sebelius that $32 million has been released to help fund seven programs designed to improve rural health. About two-thirds of this funding will go to support the Critical Access Hospital program (more information available here).

One of the other programs receiving funding is geared toward the recruitment and retention of healthcare professionals in rural areas. The issue of doctor shortages was taken up this week in TIME, which predicts the growing wage gap between family practitioners and specialists could "produce a national doctor crisis in just a few years," and in The Denver Post's profile of a Brighton, Colorado clinic being described as a model for the "doctor's office of the future." The primary difference: doctors there see patients much less than in a typical practice, instead "more often act[ing] like supervisors, overseeing larger staffs of nurse practitioners and physicians' assistants."

Also included in the Sebelius announcement was a program promoting telemedicine through such technologies as videoconferencing. Coincidentally, a heretofore unimagined (by me, at least) "dark side" to telemedicine was highlighted in The Des Moines Register this week, which reported that a "coalition of anti-abortion groups vowed Friday to oppose Planned Parenthood's use of telemedicine to dispense abortion pills in Iowa." The initiative of Planned Parenthood of the Heartland, which more than 1,500 women have received abortion drugs through during the last two years, involves a physician in Des Moines communicating via computer with patients in more remote clinics. Once the doctor is satisfied that a woman meets a set of criteria, he or she can remotely unlock a drawer containing abortion drugs in front of the patient - who then must consume the first dose in front of the monitor.

Finally, Sebelius announced nearly a million dollars of funding for a program "designed to find innovative ways to provide mental health services" to rural military veterans. This may be wise, considering Dr. James Werth of Radford University told the Convention of the American Psychological Association last week that "Country by country, state by state, the top areas in terms of suicide are rural." According to Ivanhoe.com, Werth said rural residents may be at greater risk of suicide because they "are usually more isolated, less willing to ask for help, or to travel to get help, and they typically have more access to lethal means like guns and poisons." However, he also suggested that rural areas may have more means to address this problem, such as building upon "strong relationships with families and religion."

With that being said, take care of one another, people. I hope you have enjoyed this (slightly extended) installment of our daily roundup, and that you have a happy Wednesday.


  1. I like the occasional theme roundup, and this one in particular. I've heard of a few rural hospitals that give scholarships to local kids who are interested in medicine, in hopes they come back home to practice. They don't require it, though, because bringing back a doctor who doesn't want to be there doesn't do anyone any good.

    Home-grown "professional" talent returning seems like the most viable solution to the continued vitality of rural communities, whether you're talking about teachers or doctors or even police officers. Clearly, there are potential disadvantages, but I think someone who has grown up in a rural community and wants to return is more likely to be a positive than someone from a different background who wants to try it out.

  2. I've actually got a post beginning to percolate on pretty much the exact topic of young people leaving (or returning to) rural communities, so I won't go into it too much here. Hopefully I can knock the one in front of it in line down and actually start writing it sometime.

    One thing I would say about teachers coming back to the same school they attended is that Lori and I found out during college (at a time when she was considering the pursuit of becoming a professor herself) that many institutions of higher education are very reluctant to hire their own ex-students for teaching positions because of the idea of "intellectual inbreeding." I think there is a valid concern there, in that while strengths of the past instructors are passed on to another generation, "blind spots" or even prejudices can be, too. At the very least, fewer new ideas are coming in to the mix. Not that I would necessarily have a blanket ban on hiring alumni... just food for thought.