Medical Practice in Rural Communities
In a theatre of war, there is a term that is known universally to all military personnel. That term is “the golden hour”. Simply it means that the first sixty minutes after a trauma are critical. It means life or death.
People living in cities take it for granted that medical services are readily available. It may mean that an ambulance reaches your door in minutes or emergency room services are accessible quickly.
It is not so in small communities. Sometimes, an adequate emergency room is hours away. The community may have limited medical services. It is not unusual for a small town physician to have a patient base that numbers in the thousands and covers a wide catchment area. For many physicians, it means an unmanageable work load and constant stress.
The simple solution is to have more physicians in small rural communities.
This is a simple solution but it is not easily accomplished. Rural communities have a difficult time attracting graduating medical students. Practice in rural communities just does not have the lure of big city medical practices. The possibility of being overworked in a rural community is not a strong incentive to these graduates. This will continue to be the trend until rural communities become pro-active in selling their communities and taking steps to secure medical services.
One step that small communities can take is to set up financial stipends to help future physicians through medical school. This is not a small investment and, in return for this financial support, the community would be guaranteed a certain number of years of service in that area. It would be a positive situation for both the community and the medical graduate. The community would have the much needed service and an opportunity to “sell” regional practice to the new graduate. For the new graduate, it means going to a community in which services are needed and going into practice without a massive financial debt.
The financial support may mean that medical admissions committees have a more diverse application pool from which to select their students. People for whom medical school is not financial viable could afford to apply, with rural financial support. Small communities need to lobby medical school admission committees to select for people who will return to rural areas to practice. Universities could adjust their fee schedule in return for a commitment to work in a rural practice for a certain number of years.
Some people are hoping that technology will solve this problem. Rural communities can be connected online to medical personnel on a constant basis. That is fine for some problems. However, remember the ‘golden hour’. That means that treatment must begin as soon as possible. This means ‘hands on’ treatment - and an internet connection is only an intermediary solution.
In the end, medical service is still ‘old school’. It means people being available to treat other people. And for rural communities, it means being pro-active. This problem is not even a faint blip on the radar of most politicians. However if, in the future, someone from a rural community needs emergency medical service, this may be a ‘life or death’ issue.
Catherine Forsythe
Tags: doctors, financial aid, golden hour, Internet, Medicine, rural communities, universities
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