Written by Janice McDonald
4 min read
Many of the things that make rural living appealing to some – the remoteness, the absence of crowds, the simplicity – can make health care more difficult. Choices for doctors may be limited and health care facilities can be miles away. For some care, you may need to plan days or more in advance.
So while it’s always a good idea to look ahead for your health care needs, it can be especially important in a rural community.
“It’s better to establish care before you need it,” says Kevin Bennett, director for the Center for Rural and Primary Healthcare, University of South Carolina School of Medicine.
It’s not just about the aggravation of having to rush to find a doctor and get an appointment when you suddenly find that you need one, Bennett says. It’s also that in remote areas, a lack of health care planning is far more likely to result in bad health outcomes.
“People delay care. They don’t get the necessary care – primary or preventive – and then it becomes an issue,” he says.
As a basic rule of thumb, Bennett says if your distance from basic necessities like groceries require you to plan in advance, you probably need a plan for health care issues as well.
Start by educating yourself about what’s available in your own community, says Keith J. Mueller, director of The University of Iowa’s Rural Policy Research Institute.
Much of the information is available online. Or you can call up your local state or county health office for help. They will likely be able to guide you to the closest primary care resources and a path to specialist care if you need it. If you’re not already ill, Mueller says, start with primary care.
Even if your community is too small to support a medical doctor for primary care, many rural areas have primary care clinics staffed by a physician assistant (PA) or nurse practitioner who can do most of what a physician might do in that setting, Mueller says.
It’s a good idea to set up a checkup at one of these facilities closest to your home before you have an acute illness or health emergency, he says. This allows the clinic to get your health history in an electronic record early, so your medical team can have easy access to a list of medications you are taking, as well as past illnesses or surgeries. Then when you need fast treatment or referral to a specialist, the clinic will be able to move quickly, Mueller says.
In areas where hospitals and clinics are not available, state or local health authorities often will set up mobile health centers that pass through your community from time to time. Check for availability and schedules online or call your state or local health authority.
Finding a specialist in a rural area can be hard. While there are some specialists who travel to rural communities, their availability is often sparse and if your condition requires regular appointments, you may need to travel.
Where transportation is an issue, many communities organize volunteers to help you get to needed appointments. But however you get there, remember that travel times to reach medical treatment can be affected by weather, like rain or snow, and by the terrain, such as winding roads or hills.
And again, good specialist care starts with your primary care provider. That’s why you should establish care early. They’ll know about specialists in the area and the best way to see them. Once you’re in their system, even a mobile office will be able to make referrals and can send records and lab reports to specialists when necessary.
Telehealth may also be an option. In some states (where allowed by law), your primary care clinic may be able to set up a telehealth appointment with a specialist. Telehealth has become far more common since the beginning of the COVID-19 pandemic, but there are limitations. In general, telehealth doesn’t allow for checking temperature or vital signs and some remote areas don’t have broadband.
However, in some cases your primary care clinic can set up a more in-depth telehealth specialist exam with the help of a specialized mobile medical computer, called a COW (computer on wheels).
And some rural communities are working on other solutions like providing telehealth at local libraries.
Rural communities have their limitations, but they often have more health care options than it first seems, Bennett says.
“I think rural communities are really resilient and creative in how they approach these issues. How do we use what we’ve got? How do we ‘double-use’ what we’ve got?”
With few exceptions, Bennett says, there is little reason you shouldn’t be able to live a long, healthy, and vibrant life in a rural area. You simply have to put a few simple things in place.
If you’re new to an area, make sure you have enough medication for any prior conditions and you’re up to date on doctor visits. Meet your neighbors and find out about health care resources in your community (including transportation if you need it). And of course, make an appointment ASAP at the closest point of primary care.
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