Finding and parsing rural health data, tracking COVID-19’s curve in rural regions, the promise and limitations of telemedicine for rural health consumers, and reopening rural hospitals were among the topics tackled at AHCJ’s Rural Health Workshop 2022. (Check out full panel recordings.)
During the first in-person Rural Health Workshop since 2019 in Denver, expert panelists also cited ongoing gaps in care for rural patients and shared innovations for filling some of those voids.
The one-day workshop was hosted by the University of Tennessee School of Medicine Chattanooga; the University of Tennessee Health Science Center College of Nursing; Cempa Community Care and Erlanger Health System. Sponsors were The Commonwealth Fund; the Helmsley Charitable Trust; and the Robert Wood Johnson Foundation.
Stories about health in far-flung, medically underserved places are fodder for journalists and essential to improving rural health care, said Rob Headrick, M.D., CHI Memorial Rees Skillern Cancer Institute’s chief of thoracic surgery.
“The challenge for us is how to combine your skills and mine … ” Headrick said during the panel “Bringing health care to the people: mobile screening and other routes to prevention.”
Headrick is among clinicians regularly traveling to rural communities to provide care and boost health literacy so health consumers refine their self-care and treat illnesses early on. “Health care is local, meaning people search for solutions locally,” said Headrick, whose presentation spotlighted mobile lung screening.
“When we get out to the rural communities, there’s at least a perception that they can’t understand or don’t want to understand that I think is completely false … For so long we had this perception that lung cancer was just part of our culture, particularly in the South — that it’s smoking-induced and somehow you deserve [it]. Yet it’s impacting our health care dollars. It’s making us less stable as a family [and] making us less stable as a county or a state.”
When found early, the cure rates for lung cancer — with death rates higher than opioid overdoses, a more often-told news story — are relatively high, Headrick said. But the lack of symptoms for lung cancer and stigma have prevented many who contract cancer from being diagnosed early.
His institute’s mobile unit puts more rural patients in the pool for whom there is 90% cure rate versus the 18% cure rate among those whose lung cancer isn’t detected early.
Making connections and spreading hope
Blake Farmer, a reporter for NPR’s Nashville affiliate and for Kaiser Health News, was among the 60 people who attended the six panels and heard luncheon keynote speaker Stephanie Boynton, vice president and CEO for critical access facilities Erlanger Western Carolina Hospital and in Tennessee, Erlanger Bledsoe Hospital.
“This state has lost more hospitals than any state, except for Texas,” Farmer said at the end of the workshop. “That story is kind of old. What we heard about today was backfilling. How do you get the doctors, the staffing?”
“I came looking for ideas beneath the surface of the headlines I’ve written for years. I’ve just made a list of six or seven stories,” Farmer said. “And I made connections here. I’m logging out of here with a pretty concrete list of stories I’d like to do in the next couple of months.”
Medical student Amanda Lemus, a volunteer organizer at Migrant Equity Southeast, lent her expertise to “Few and far between: How sparse resources shaped the COVID-19 curve in rural communities.” In her fourth year at Medical College of Georgia, she is considering setting up a rural practice.
“My school and my upbringing have led me to want to do this. I’ve seen the need and grown up in it,” said Lemus, a Savannah native whose parents immigrated from Honduras.
“The Latino community is where I’ve seen the most need, especially in Savannah,” she said. “But, also, … in my [medical] rotation, I’ve gone to Vidalia and Claxson, very small towns. I’ve seen the need. I’ve seen how many health care providers there are for the patient population.”
Lemus said she’s encouraged by student-loan debt forgiveness programs for physicians who move to rural areas. “I feel like, once they get an idea of these areas, they’ll actually want to stay there and practice.”
That’s the hope of Leslie Griffin, M.D., family medicine residency director at the University of Tennessee College of Medicine’s Chattanooga campus. As it works to dispatch more newly minted family medicine doctors to rural communities, it’s also expanding their skills in areas of medicine usually associated with physicians with niche specialties.
“Family physicians are the way to go in the rural health track,” said Griffin of that track in her medical school.
Those doctors, she added, “do a lot more than a lot of the communities realize. Yes, we do the adult care, we do the geriatrics. But we also take care of kids. I still deliver babies. We do the g-y-n … We do sports medicine and non-operative orthopedics … pain management, mental health. We have to. There’s no one else to do it.”