|
|
|
| Current Issue |
|
|
| Resources |
|
|
|
Medical Care in Rural America
| Article
# : |
19340 |
|
|
Section : |
MODERN THOUGHT
|
| Issue
Date : |
6 / 1991 |
4,700 Words |
| Author
: |
Julia E. Connelly
Julia E. Connelly, M.D., is associate professor of internal
medicine at the University of Virginia. |
For seven years, I have practiced medicine in rural Virginia. Our county's population is about eighteen thousand, and that of the town where I practice is four thousand, give or take a few. Although there is no hospital in our county and only two sites for plain x-rays--there are no CT scans, MRIs, barium studies, or even mammography machines--some dozen or so physicians practice medicine here. All of the physicians are primary-care doctors--some are family practitioners, some are general internists, and some are general practitioners. Whatever academic titles these practitioners hold, the community expects them to be able to manage most medical problems. On my first day in the community, a woman asked me, "What kind of doctor are you?" As I explained to her that I am a general internist, a specialist in adult medicine, she clearly informed me that in the country, "You'll have to take care of whoever needs you."
As primary-care physicians, we are patients' first contact with medical profession. They come to us with undifferentiated problems, that is, their symptoms may represent any number of problems, from severe diseases to psychological presentations of personal conflicts. One of our responsibilities is to listen to the patients' accounts of their illnesses, in the broadest terms, and then sort out the range of possible problems, weight risks and uncertainties, and involve the patients in deciding the best course for understanding or solving their problems.
Although our town and the surrounding countryside are, by all accounts, rural, the county is not considered medically underserved (defined by a ratio of one doctor per three thousand people). Ours is an unusual situation for a rural area; in contrast, 63 of Virginia's 95 counties are medically underserved. The lack of physicians is a common occurrence in many rural communities across America and obviously limits access to medical care. In 1985, only 20 percent of all physicians practiced in rural communities. Most of the physicians who practice in rural areas are primary-care physicians; in fact, about 65 percent of the generalist physicians such as family practitioners work in rural areas and only 35 percent of them work in urban cities. The overall distribution of physicians between rural and urban areas changed little between 1970 and 1985, although there have been numerous attempts to encourage physicians to move to rural areas. But other problems limit access of rural populations to health care, too, and these problems are reflected in the lives of individuals in rural America.
While distribution of physicians between rural and urban settings in the United
...
Read Full Article
Look for this article in Ask.com
|
|
