Rural Hospitals Have A Difficult Time Making It

[MoseyWalker]

especially if that rural area is in an area where there is nothing being generated economically; drilling for oil, uranium, etc.

I found out tonight that the ONE surgeon we have in this rural area is going to be leaving. That means, if they don't find someone to replace him, that the minimal distance to travel to be operated on will then be 120 miles.

If someone has a heart attack or a stroke? 120 miles to get help.

If someone needs emergency appendix or gall bladder surgery? 120 miles to get help.

If someone is shot or stabbed and needs a quick surgical response? 120 miles to get help.

I know that everyone knows intellectually how bad the problems are with this current medical system that is in place, but do people know that people who live away from metropolitan areas are dying in this country because they don't have access to immediate medical care that would potentially, and probably, save their lives?

I have a friend who watched her father die with her in the back of a car on the way to dialysis. The closest place to obtain dialysis is 90 miles away.

Health care.

If one is rural, learn to live with it............or die from it.

[Horse with no Name]

1. Most rural hospitals use rent-a-docs

Chances are that is what they will do.

[Monkeyman]

2. Its only going to get worse

[kineneb]

3. we are sort of in that situation here

there are two small hospitals here with ERs for simple stuff, but serious cases are medivac'ed out on helicopter...all ways out of the area are two lane country roads. The closest "real" hospital is 1.5 hours from us.

There is a medical helicopter service which sells reasonably priced "shares" for people out in the hills. You and your neighbors may want to look into this idea.

[dysfunctional press]

4. what's your solution?

and why would someone with dialysis choose to live 90 miles from a dialysis center if it were that life and death? when my uncle got too sickly to live on the farm, he up and moved to town.

people who choose to live in rural areas do so realizing that there are a lot of trade-offs they have to live with. including being 120 miles away from a surgeon.

obviously there's NO WAY to put a fully-staffed trauma center hospital within a 10 or 15 minute drive of every person in the country.

[MoseyWalker]

6. Well

in answer to your question, and I appreciate your response


"why would someone with dialysis choose to live 90 miles from a dialysis center if it were that life and death"

He was in his late 60's, and lived on the land his entire life that his father and grandfather had homesteaded and developed. He had a wife, and kids who depended upon him, so he hired a few people he could trust to take care of the cattle and the crops when he no longer could. He hired the kids of people he had known his entire life.

Move closer to treatment? I think he was much better off the way things went, but that doesn't change a simple equation.

More health care = give up one's life and livelihood to move closer to a city

[Cleita]

7. That's kind of harsh.

People in remote areas need medical assistance as much as anyone in the city. People who work out in the fields and woods get sick and injured like everyone else. They don't ask for it to happen. As far as dialysis, one can do home dialysis (peritoneal), which requires only a once a month visit to a clinic.

[dysfunctional press]

19. so what do you suggest, that would be less harsh?

:shrug:

[Cleita]

20. Post #15 beneath mine by Liberal Veteran pretty much sums up the situation.

We need single payer universal health care in this country. When that happens all these obstacles will vanish overnight.

Also, suggesting that old people have to live in cities to get health care is really an ignorant thing to say. Cities eat up old people and don't treat them very nicely. So old people move out to small towns and rural areas where they can still get affordable housing, clothing and food, and where they aren't going to get pushed aside and mowed over by the busy, busy younger people going about their busy, busy lives.

Remember you are going to get old one of these days too. So if you can't think about this in terms of compassion. Do think of it in terms of what kind of world you are creating for your future.

[dysfunctional press]

21. i didn't suggest that old people have to live in cities to get health care-

what i was saying is that people in rural areas can't legitimately expect to have convenient access to ALL types of medical care- it's just not feasible, and NO, single-payer health care will not solve that either. building and staffing a fully-equipped trauma center hospital costs a lot of money.

if people want to live in the boondocks, that's their decision- they need to decide which is more important to them- their rural way of life, or ready access to high quality medical care.

[Liberal Veteran]

15. It's not always that cut and dried

In the area I grew up in, the main industry was the textile mills.

Many people made their livelihood on those factories. They paid poorly, but it was steady work, benefits, and little money left over to buy a home or trailer and maybe go out to the movies and buy some clothes at the local shops.

It wasn't the lap of luxury, but it was pretty comfortable.

Then along came companies like Wal-Mart that helped decimate the textile industry in this country because local textile factories couldn't compete with the cheap imported textiles. The businesses that relied on the workers from those mills went out of business shortly thereafter. That took the tax base down dramatically and then a Wal-Mart moved to town further taking out the rest of the town's local business and the tax base that helped provide essential services.

So some guy who only knew how to work in the textile mill and retired there in his home that he finally paid off and is living off Social Security starts out with a little problem here, a little problem there before he finds out his kidneys are shot or his ticker isn't what it should be or has COPD and by that time, what little savings he had is pretty much gone.

He could sell the house, but who the hell has the energy to sell a house (assuming it's in repair enough to sell) and with the depressed economic base, who the hell is going to buy it?

So what's he gonna do?

It's not really as simple as "just move closer to the dialysis center".

To me, that's a lot like the people who say "Well, yeah, I know that the jobs all went away when the local factory closed, but why don't those people just move to where the jobs are?" It's really not as simple as that. Many people do, but other people can't always do that because it costs a lot to pick up a family and move. Then there are people who can't bear to leave their elderly mother and father behind when they are the only one able to help them manage?

It's very simple to say, but real life tends to be a lot more complicated than those simple answers.

[dysfunctional press]

18. staffed and equipped trauma centers don't come cheap, either...

it may mean some hefty property tax hikes to get them built, and the rural voters may decide that it's really not worth the cost.

[Cleita]

5. When I was living in Eastern Washington, the nearest

medical centers were in Spokane for hundreds of miles around. The locals had built up a system of clinics in the remoter areas run by nurse practitioners, who could dispense prescription medication as well as visiting doctors, volunteer fire departments with training as emts and a helicopter med-vac system that transported everyone needing additional emergency care and doctors to the large hospitals in Spokane. I know. My husband was one of them after he had suffered a stroke. You guys might look into setting up a similar system.

[kestrel91316]

8. In a real pinch, rural folk could always call on their veterinarian....

Seriously - we have very broad-based skills so if you needed major first aid, a vet would be a lot better than nothing. And we are used to "trench medicine" - most of us would be lost in a truly modern human hospital. But we know how to fix booboos!

[Cleita]

9. Not only that you can administer medications

like penicillin and other prescription type drugs in a pinch.

[kestrel91316]

16. And if you do it in private with no written record, there's that

business of plausible deniability, lol. 'Cause it's actually called practicing medicine without a license.

In a serious SHTF scenario, nobody would be keeping track, however.

I keep Keflex on hand in my clinic for my use (employees know it's there, and I don't keep count of the pills, lol). Saved me a trip to my own doctor on more than one occasion, most recently only a month ago with a serious cat bite to the hand. I don't mess around. I start antibiotics at a high dose within 15 minutes of a bite.

[Horse with no Name]

11. I know a general practitioner

who was a vet first.
He says vet school was harder than medical school...

[kestrel91316]

17. Yeah. I always have to laugh at how medical students whine

about how HAAAARRRRDDDD medical school is. Hell, they only have to learn about the inner workings and ills and treatment of ONE species. We have to learn about ALL THE REST. We could learn a single species in our sleep.

Will Rogers once said something about vets being the best, smartest doctors in the world, because their patients couldn't tell them what was wrong. We just had to "know".

I rather prefer the way somebody compared Ginger Rogers' dancing to Fred Astaire's. Ginger had to do everything Fred did, but backwards and in high heels. That's sort of like us vets. We are seriously handicapped by our patients' inability to speak, clients' lack of funds, our own shortage of trained assistants at our beck and call, and inadequate equipment. Yet our clients have virtually the same expectations of us as they do of their own physicians - sometimes even higher. This isn't helped by the TV mentality, where folks truly believe that it's possible to diagnose and successfully treat a serious medical condition in one to two hours, lol.

My profession surely must attract large numbers of true psychics. How else would we be able to succeed in patient treatment at all???

:crazy:

[nam78_two]

10. That is pretty harsh

Especially, given how many retired people move to somewhat more rural areas for the lower rents and because they just can't afford to live in or near the city.

[Liberal Veteran]

12. It's a symptom of our health care crisis.

Rural hospitals don't get the kind of funding they need to operate because tax dollars for public health are so scarce.

It's really sad.

I just came back from a town in Georgia where the local hospital is shutting down. Granted, they only have a 25 mile drive to nearest hospital, but when you are having a life threatening emergency, a 35 to 40 minute drive is a lifetime.

And sadly rural hospitals tend to be in places where the local economy results an large number of patients unable to pay.

It breaks the backs of the rural hospital already struggling to stay afloat.

It wasn't too long ago that I remember that almost everyone who needed to be in a hospital went to the local hospital, and you knew the person going to the bigger city hospitals was going there for something extraordinary and/or dire.

Now it seems like almost all the rural hospitals are little more than a step above nursing homes for the level of care they provide. They can handle a broken bones, or maybe pneumonia, or a birth, or someone receiving palliative care, but anything much more serious and the hospital neither has the expertise nor the facilities needed to administer.

[MoseyWalker]

14. You win a prize for that observation

the hospital here has become basically a nursing home for people who have nowhere else to go prior to dying. They may stay up to a month or so. It's the only way, in my opinion, that this hospital has managed to stay open with the funding cuts.

btw. The nursing home also closed and moved to a land far, far away.

[sutz12]

13. This is an opportunity....

We should set up a "rural medification" program similar to the rural electrification programs of the '30's.

Start federal funding of medical clinics in rural areas and hospitals in small towns so that medical care is closer to the people who need it. Local funding could be drawn on, but federal and state subsidies will be needed. No insurance companies need apply. Just set up facilities and pay doctors to treat patients.

Set it up so Veterans and Medicare are fully covered, charge small copays to others. Make sure drugs are provided with no "Plan D" bullshit. This could grow into a universal health care program.