UNITED STATES
The Doctor is In Applications of telehealth for rural populations
by Nick Sawicki ’23, an Economics and Biology concentrator in the Program in Liberal Medical Education illustration by Katie Fliegel ’21
For most Americans in suburban or urban areas, a trip to the doctor is usually as innocuous as a quick 20-minute car ride. But for 20 percent (60 million) of Americans who live in rural communities, where hospitals and the health care professionals needed to staff them are scarce, accessing basic medical care poses a much greater challenge. The shortage of doctors and closure of hospitals in rural communities can be largely attributed to a generation of rising physicians who are unwilling to practice medicine in sparsely populated communities. A 2019 Merritt Hawkins survey found that only one percent of fourth year medical residents were willing to work in communities with less than 10,000 residents. As a result, 119 hospitals that once served rural communities have closed their doors since 2010, a record-breaking 18 of which closed in 2019 alone. In places such as Wheeler County, Oregon, community members have to travel over 70 miles to their nearest hospital to meet with a physician. Such an inconvenience ultimately means that these Americans often defer visits to the doctor until their medical situation becomes absolutely dire, a practice that leads to higher rates of obesity, cancer, diabetes, infant mortality, and death from preventable disease. When Covid-19 struck in late March, forcing doctor’s offices and hospitals to admit only patients with emergency medical conditions in both rural and urban areas, the medical community was quick to take up a solution that had previously seen only limited use: telehealth. While not previously covered by Medicare or private insurance, virtual visits quickly became the norm as the Centers for Medicare and Medicaid Services temporarily expanded coverage to include 46
FALL 2020 | ISSUE 01
“In places such as Wheeler County, Oregon, community members have to travel over 70 miles to their nearest hospital to meet with a physician.” telehealth appointments, with private insurance plans quickly following suit. Now, total telehealth visits are slated to surpass one billion in number by the end of 2020. Although the adoption of telehealth is only meant to be a temporary solution while social distancing and other public health measures remain in effect, this shift in the healthcare delivery paradigm has incidentally increased healthcare accessibility for many segments of the population. For rural communities in particular, these virtual visits may very well be the key to breaking
