From the Editor-in-Chief

THE ROAD LESS TRAVELED

“Two roads diverged in a wood, and I –I took the one less traveled by, And that has made all the difference.” —An excerpt from “The Road Not Taken,” a poem by Robert Frost

It is easy to become set in your ways. I often take the same route to work each day, knowing it is safe and efficient. My wife and I tend to shop at the same grocery store or get takeout from a few restaurants we know have amazing chicken mole or shiro and lamb tibs.

But there is so much more out there. It is worth going outside of your comfort zone and seeking the road less traveled. Often used figuratively, the analogy is certainly apt for physicians who literally take roads less traveled to treat patients in rural clinics and hospitals.

This issue is dedicated to them. We hope to shed some light on the issues facing physicians in rural health, why they choose to live and work outside of larger cities, and steps they’re taking to improve access and quality of care for their patients.

SPOTLIGHT ON RURAL HEALTH

We are very thankful to Holly Rooney, MD, for sharing her perspective of practicing in Globe, Arizona. Dr. Rooney sat down with Managing Editor Edward Araujo to discuss why she is comfortable in rural medicine, the challenges she faces in recruiting physicians to work there, and how greater community integration is a lesson for city dwellers to learn from the rural docs.

For our section What Arizona Docs are Saying, we share a range of answers to why physicians work in rural Arizona, what their biggest frustration is about rural health, what pitch they would use to recruit physicians, and how telehealth improves care in rural Arizona? A common thread among the recruitment pitches is the work-life balance outside of cities.

Guest author Brian Powell, a former reporter now with the Flinn Foundation, writes about his visit to Willcox. He found the town known for ranching and a singing cowboy movie star also has a mix of medical facilities, some of which are partnering with larger health systems to ensure access to specialists.

Maybe the best person to see the full view of rural health in Arizona is Daniel Derksen, M.D., Walter H. Pearce Endowed Chair and Director of the University of Arizona Center for Rural Health. Dr. Derksen shares data on the continued inadequate funding for the rural workforce, disparities between urban and rural health socioeconomic conditions, and urges us to take a “balanced, clear-eyed view of the rural health ecosystem.”

In our section Legal Corner, attorney Miranda Preston presents information about the recent expansion of telehealth. When Governor Doug Ducey signed House Bill 2454 into law, Arizona made permanent exceptions to policy that were temporary during the COVID-19 pandemic. These include audioonly encounters with a patient and allowing physicians licensed out of state to care for patients in Arizona.

Finally, Jeanne Varner Powell describes how federal practice guidelines expand buprenorphine prescribing. A Senior Legal Risk Management Consultant for MICA, Jeanne frames why the opioid partial agonist buprenorphine is an important tool in the fight to decrease deaths from opioid use. It is now easier for doctors to receive an X-waiver and exemption from training often required before prescribing buprenorphine as a part of medicationassisted treatment. The goal is to put this tool in the hands of more doctors, especially those practicing in rural areas where the “per capita overdose rate was nearly 45% higher” than urban counties. Enjoy the magazine.

By John E. McElligott, MPH, CPH