Carolina Public Press has a feature story on the decline in the number of doctors in rural counties in Western North Carolina. In these areas, we've lost 9% between 2010 and 2014.
The loss follows a national trend - the loss of doctors and specialists in rural areas has been an ongoing problem with doctors choosing to practice in larger population centers.
It impacts not only residents of Western NC counties, but those outside the area as well. As my family has taken care of aging parents that live in the area, we've had to rearrange our schedules and take time off from work to drive family members to specialists outside the county. Local hospitals have also cut back on services because of a lack of doctors, with emergency cases that could have been taken care of in the county before being sent to hospitals in Winston-Salem.
According to a study by the George Washington University School of Public Health and Health Services, only 5 percent of new doctors choose to practice in rural areas. Today, nearly a quarter of all people live in rural areas in the United Sates, but only 10 percent of physicians practice in rural communities, according to the National Rural Health Association.
This trend can also be seen in the counties of Western North Carolina, where the number of physicians working in the 18 westernmost counties dropped by 9.2 percent from 2010 to 2014, according to data from the National Center for Health Statistics. Of the 18 westernmost counties of North Carolina, Avery and Graham counties are considered health professional shortage areas, with fewer than one physician per 3,500 people.
The state government in Raleigh isn't helping matters, cutting funds for rural clinics that help Western North Carolina residents.
Saluda Medical Center is celebrating its 40th anniversary this year, but cuts in the clinic’s budget have seriously jeopardized its future, according to Copeland.
In the past, the Medical Center has received funding from the state’s Office of Rural Health and Community Care to pay its providers, but this funding has been completely cut. In the last year and a half, provider salaries have amounted to $150,000 which Saluda Medical Center is now having to pay for from its general funds.
“It has made paying our bills hard,” said Copeland, who has gotten creative when it comes to cutting costs. “I send people home early if the schedule’s not full. I’m a stickler for turning off lights when you’re not in the room. If I’m here by myself I turn off the heater. I’m doing everything I can to keep us in business.”
The Office of Rural Health and Community Care currently funds Saluda’s medical visits with uninsured patients, which make up about a third of their 3,500 patients each year. But with the Affordable Care Act, Copeland expects to see a decline in the number of uninsured patients that the medical center sees. Indeed, over 200,000 uninsured North Carolinians have already enrolled for coverage provided through the ACA.
Of course, NC's Republicans want to get rid of the ACA, but aren't willing to pony up the funds to cover the uninsured.
Even with the ACA, access to qualified doctors and facilities will remain an ongoing problem in rural NC and it doesn't seem to be on the radar of Tea Bagger conservatives. Proposing solutions is an opportunity for liberals and progressives to make a difference.