Demystifying Medicine One Month at a Time

Tag: rural hospitals

Truth Is Stranger Than Fiction

220px-Michael_ShadidThe year was 1929. Bad economic times were upon our land, and would only worsen.

A doctor born in far-away Lebanon found his calling helping distraught Midwestern farmers find their way to health care, where previously they’d had almost none.

For years the doctor had been haunted by the fact that hundreds of farm families scattered throughout the Great Plains country were not getting adequate medical attention. He saw first hand the tragedies among medically forgotten rural Oklahoma and Texas: farmers dying of ruptured appendixes, their wives and children defenseless against the ravages of pneumonia, diabetes and tuberculosis.

In tiny Elk City, Oklahoma, he helped open a cooperative hospital, where farmers from ten surrounding counties each chipped in to become shareholders in the new enterprise so that they and their families could receive heretofore unaffordable medical care. He had based his idea on farm cooperatives, in which farmers would collectively fund costly items like a cotton gin.

For his efforts, Dr. Michael Shadid was pilloried by his fellow doctors and the local medical society:

He almost lost his medical license for the unethical solicitation of patients. Doctors were reluctant to work for the Community Hospital if it meant defying the medical establishment. But the farmers who relied on the hospital rallied behind Shadid. “We think more of the few dollars invested in the Community Hospital than any investment we have ever made,” said one farmer. “I think this bunch fighting [Shadid] should be sat down so hard it would jar their ancestors for four generations.”

Change is hard, and unfortunately its disruptions often release vehement emotions. 

Hat tip for this post goes to Mr. Garrison Keillor.

Rural Hospitals Fewer and Farther Between

rural-hospital-photoUSA Today ran a great series on recent closures of rural hospitals, more than 40 of them in all, predominantly in the South.

In total, the closures add up to less than two thousand beds, which is not a big number. Medium and big urban hospitals are often licensed for hundreds of beds in a single facility.

But rural hospitals fill a vital niche — usually more than 35 miles or more from the nearest health care facility. Many of them are known as “critical access,” which means that they qualify for enhanced payments for services due to the rural demand they meet and their remoteness.

The thing is, it’s tough to compete with bigger, regional hospitals and medical centers. Economies of scale allow bigger places to purchase expensive technologies (think MRI machines and surgical robots) that further enhance their marketing power. And the whole hospital industry is undergoing massive consolidation as hospitals join networks of even larger holding companies or non-profit networks. Smaller and rural hospitals just don’t fit in this brave new world.

I was lucky to interview one the authors of the series, Laura Ungar, who is the national/regional health enterprise editor for USA Today, and the Gannett-owned [Louisville, KY] Courier-Journal.

If you’re interested, you can stream it here.

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