Efficiency, medical homes can ease rural healthcare strains

Roughly 16 percent to 20 percent of the U.S. population lives in rural areas, but only 9 percent of physicians practice there, noted a recent article from American Medical News.

As we've previously reported, while a small-town lifestyle may be just right for some physicians, rural doctors face significant challenges in doing many of the tasks physicians in more metropolitan areas may take for granted.

For example, doctors like Neil Nelson, the only general internist and pediatrician for the 3,407 people living in Gibson City, Ill., have no one to share call coverage with, amnews noted. Even when not caring for patients in the office and conducting house calls, country doctors are used to being stopped in the grocery story to answer patients' passing health questions.

To handle these unique challenges, as well as the time and administrative pressures all doctors face, Nelson told amnews he uses the following strategies:

  • The practice has used an electronic health records system since 2008, though the practice is not yet paperless.
  • Nelson makes efficiency a priority, arriving to the office early to handle paperwork and setting aside evening time to return phone calls.
  • He schedules strategically to conduct simple, quick visits first and more involved cases later.
  • Nelson asks his patients to call the pharmacy before their appointments to have refill requests processed.

And with new demands of the Affordable Care Act expected to put even more pressure on rural communities, regions such as St. Cloud, Minn., are engaging in serious discussions about how to address the shortfall, the St. Cloud Times reported.

Many of these efforts center around the hospital, the article noted. For example, the hospital has begun using teleconferencing to connect the physician's assistant and nurses in the emergency room with an on-call doctor in Sioux Falls, S.D.

And to help limited numbers of providers stretch themselves further, panelists sitting on a discussion of how to improve the Minnesota's healthcare system emphasized the importance of creating medical homes.

Minnesota health system CentraCare, for example, already has about 2,000 healthcare homes, David Tilstra, president of CentraCare Clinic, told the St. Cloud Times. "We see that as a major way of dealing with those patients," he said.

To learn more:
- read the article from American Medical News
- see the story from the St. Cloud Times

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