Rural communities are abandoned when there are no hospitals, ambulances or doctors nearby

STATENVILLE, Ga. – Georgia’s Echols County, which borders Florida, can be called the healthcare desert.

It has no hospital, no local ambulance. A healthcare provider treats patients at a clinic for immigrant farmers, but, unlike a small public health department with two full-time employees, that level of care health care in a rural district with 4,000 inhabitants.

In case of an emergency, the patient must wait for an ambulance from Valdosta and be taken to a hospital there, or to a medical helicopter. It can take up to 20 minutes for an ambulance to arrive from Valdosta, said Bobby Walker, the county commissioner. “It was a pretty good ambulance time,” he added.

Walker tried to set up an ambulance service based in Statenville, the one-stop county seat in Echols, but the cost of providing one is predicted to be $280,000 a year. Without industry to support the tax base, the county couldn’t come up with that kind of money.

In many ways, Echols reflects the health care challenges faced in rural areas across the country, such as limited health insurance coverage, gaps in health services and supplier shortage.

Jacqueline Fincher, an internist practicing in rural Thomson, eastern Georgia, says such communities have a higher percentage of people age 65 and older who need broad medical services. widespread and much higher rates of poverty, including extreme poverty, than in the rest of the country.

For example, about 1 in 4 Echols residents do not have health insurance, and nearly a third of children live in poverty, under the County Health Rank and Roadmap program from the Population Health Institute of the University of Wisconsin.

Like Echols, some Georgia counties don’t have a doctor at all.

Dr. Tom Fausett, a family doctor who grew up and still lives in Adel, a southern Georgia town, said it was difficult to recruit doctors to a rural area before.

About 20% of the US population lives in rural America, but only about 10% of US doctors practice in such areas, according to the National Conference of State Legislatures. .

And 77% of the country’s rural districts designated as an area of ​​shortage of medical professionals. The Health Resources and Services Administration estimates an additional 4,000 primary care physicians are needed to meet today’s rural health care needs.

“Many doctors have not experienced rural life yet,” said Dr. Samuel Church, a family medicine physician who helps train medical students and residents in the northern mountain town of Georgia, Hiawassee. . “Some of them thought we were Alaska or something. I assure them that Amazon ships here.”

Rural hospitals also have difficulty recruiting nurses and other medical staff to fill vacancies. “We are all competing for the same nurses,” said Jay Carmichael, chief executive officer of Southwell Medical, which runs the hospital in Adel.

Even in rural areas with doctors and hospitals, connecting a patient with a specialist can be difficult.

“When you have an injury or a heart patient, you don’t have the trauma or cardiology team to take care of that patient,” said Rose Keller, chief nursing officer at Appling Healthcare in Baxley, southeast Georgia.

Dr. Zita Magloire, a family doctor in Cairo, a city in southern Georgia with about 10,000 residents, said access to mental health care is also a big problem. “It’s almost non-existent here.”

Dr. Zita Magloire, a family doctor in Cairo, Georgia, said that patients’ access to mental health treatment is a big problem in rural areas. “It’s almost non-existent here,” she said.(Andy Miller / KHN)

A map created at Georgia Tech shows many rural counties do not have access to autism services, Eg.

One factor behind the shortage of health care providers is what rural hospital officials call a “payer mix.”

Many patients are unable to pay their medical bills. The chief executive officer of Emanuel Medical Center in Swainsboro, Damien Scott, said 37 percent of patients in the hospital’s emergency room were uninsured.

And a large portion of rural hospital patients sign up for Medicaid or Medicare. Medicaid generally pays less than the cost of providing care, and although Medicare reimbursements are somewhat higher, they are lower than reimbursements from private insurance.

“The problem with rural hospitals is the reimbursement mechanism,” said Kirk Olsen, managing partner of ERH Healthcare, a company that manages four hospitals in rural Georgia.

Georgia is one of 12 states that have not expanded their Medicaid programs under the Affordable Care Act. Doing so will make more low-income people eligible for the public insurance program. Would that help? “Absolutely possible,” Olsen said, echoing the opinion of most people interviewed in the month-long Georgia Health News survey.

“If Medicaid is expanded, hospitals could become more viable,” said Dr. Joe Stubbs, an internist in Albany, Georgia. “A lot of people have to go to the hospital without being able to pay.”

Echols County isn’t the only one with ambulance service.

Brock Slabach, CEO of National Rural Health Association. It is difficult for local authorities to pay for the service when the number of patients in sparsely populated rural areas is very low, he said.

“If people are not careful, they will wake up and there will be no rural health care,” said Richard Stokes, chief financial officer of Taylor Regional Hospital in Hawkinsville, Georgia. “That’s my big worry.”

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