Many of the things that make rural life attractive to some — remoteness, lack of crowds, simplicity — can make health care more difficult. Physician choices may be limited, and health care facilities may be miles away. For some care, you may need to plan several days or more in advance.
So while it’s always a good idea to know your health care needs ahead of time, it’s especially important in rural communities.
“It’s best to establish care before it’s needed,” said Kevin Bennett, director of the Center for Rural and Primary Health Care at the University of South Carolina School of Medicine.
Bennett says it’s not just the annoyance of having to scramble to find a doctor and make an appointment when you suddenly find yourself in need of one. Additionally, in remote areas, a lack of health care planning is more likely to lead to poor health outcomes.
“People delay care. They don’t get the necessary care — primary care or preventive care — and then that becomes a problem,” he said.
As a basic rule of thumb, Bennett said, if your distance from basic necessities like a grocery store requires you to plan ahead, you may also want to plan for health care issues.
Keith J. Mueller, director of the University of Iowa’s Rural Policy Institute, said the first step is to understand what services are available in your own community.
Much information is available online. Or you can call your local state or county health office for assistance. They may be able to direct you to the nearest primary care resources and pathways to specialist care if you need it. If you’re not sick yet, start with primary care, Mueller said.
Even if your community is too small to support a physician for primary care, many rural areas have primary care clinics staffed by physician assistants (PAs) or nurse practitioners who can do much of what a physician might do in that setting, Mueller said. .
He said it’s best to get tested at one of these facilities closest to your home before you develop an acute illness or health emergency. This allows the clinic to capture your health history early in the electronic record so your medical team can easily access a list of medications you are taking and past illnesses or surgeries. Then, when you need quick treatment or a referral to a specialist, the clinic will be able to act quickly, Mueller said.
In areas without hospitals and clinics, state or local health authorities often set up mobile health centers that will pass through your community from time to time. Check availability and schedules online or call your state or local health department.
Finding experts in rural areas can be difficult. While there are some specialists who travel to rural communities, their services are often sparse and you may need to travel if your condition requires regular appointments.
If transportation is a problem, many communities organize volunteers to help you get to your appointment. But no matter how you get there, remember that travel time to a medical location can be affected by weather (such as rain or snow) and terrain (such as winding roads or hills).
Again, good specialty care starts with your primary care provider. That’s why you should establish care as early as possible. They’ll know the experts in the field and the best way to meet them. Once you are in their system, even the operations office can make referrals and can send records and lab reports to specialists if necessary.
Telemedicine may also be an option. In some states (where permitted by law), your primary care clinic may be able to set up telemedicine appointments with specialists. Telemedicine has become more common since the COVID-19 pandemic began, but it also has limitations. Generally speaking, telemedicine does not allow checking temperatures or vital signs, and some remote areas do not have broadband.
However, in some cases, your primary care clinic may be able to conduct more in-depth telemedicine specialist examinations with the help of specialized mobile medical computers called COWs (Computers on Wheels).
Some rural communities are looking into other solutions, such as providing telemedicine services at local libraries.
Bennett said rural communities have their limitations, but they often have more health care options than they might seem at first glance.
“I think rural communities are really resilient and creative in solving these problems. How do we use what we have? How do we ‘double use’ what we have?
Bennett said that with few exceptions, there’s no reason why you can’t live a long, healthy and vibrant life in a rural area. You just put a few simple things in place.
If you’re new to an area, make sure you have enough medication to cover any previous conditions and that you’re up to date on doctor’s visits. Meet your neighbors and learn about health care resources in your community (including transportation, if you need it). Of course, please make an appointment at your nearest primary care location as soon as possible.
