In rural areas, local medical clinics are slowly vanishing, taking away access to healthcare for people who don’t always have the means to travel. When a doctor in a local clinic shuts the doors because staying in business is too expensive, that physician often moves elsewhere and joins a larger health system. But the patients that doctor once treated are often left in the cold.
Managed-care systems tend to flourish where there is a significant number of patients to treat. Most are not in the business of opening clinics in remote or underserved areas. This means that when a rural clinic closes down, a larger health system is not likely to take it over and bring it back to life. When such clinics close, they tend to close for good.
A report from consulting firm Merritt Hawkins that delves into the country’s worsening physician shortage points out that there is not only a shortage of doctors in America but a “maldistribution” of doctors, meaning that the shortage is especially severe in the country’s non-urban areas.
The Health Services and Resources Administration identifies more than 6,000 Health Professional Shortage Areas (HPSAs) for primary care across the country, with more than 65 million people living in those areas. Sixty-seven percent of HPSAs are in non-urban areas. The ratio of primary care providers to patients in these areas is less than one per 3,000, the report said.
This means every doctor practicing in an underserved area is an especially valuable resource, and that any further loss of clinics and doctors in underserved areas is likely to be devastating to these communities.
Unfortunately, independent doctors who run facilities outside of urban areas are under more financial pressure today than they have ever been, and the picture is not getting brighter for them.
Small clinics are seeing their budgets drained as they implement a system of electronic medical records, which requires costly technology upgrades. These costs are being piled on top of many other costs that larger health systems are much better equipped to pay, including the implementation of the ICD-10, the maintenance of certifications and the constant collection of co-pays and deductibles. These are just a few of the pressures that have caused a growing number of independent practices to close their doors.
The key to preserving access to healthcare in underserved parts of the country is to take steps to ensure that local clinics don’t go out of business in the first place. Rather than a bailout, what these independent doctors need is a toolset that will help them keep their doors open.
As the world increasingly goes digital, clinics in non-urban areas need to be connected to one another, to government agencies and to larger health systems. They need to be able to streamline operations and cut costs without hiring consultants and other staff members, which would only further strain the budget.
Healthcare for All | Beyond Borders of poverty and geographic limits
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An entirely new system of practice management is needed if America intends to provide good healthcare outside of urban areas, a system that gives small clinics access to the same expertise and technological advances that larger systems make use of.
Such a practice-management system should be built, and it is being built.
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