This blog post was prepared by RNO Website Committee Chair Joan Grant Keltner.
While nearly 60 million residents live in rural areas, only 10% of general surgeons provide healthcare to these individuals. These rural patients also face many barriers, such as lower yearly incomes, inadequate health insurance coverage, a higher incidence of more complex chronic illnesses, and geographical barriers to sufficient healthcare to meet their needs. However, surgeons offer both physical and economic benefits to rural communities (e.g., almost $1-3 million/year in financial worth and 40% of revenues of small rural hospitals; Sarap, & Reiss, 2024).
These rural health providers have significant caseloads with inadequate relief coverage (e.g., every 2 to 3 days), which impacts their recruitment to rural areas (Sarap, & Reiss, 2024). Unfortunately, older surgeons also are facing retirement and there is a lack of surgeons willing to move to rural areas, instead choosing to specialize in selective illnesses. Compounding the significant demands of their practice, these rural surgeons and supportive health providers are significantly impaired without adequately equipped diagnostic and laboratory facilities and operating rooms (Kirby Surgical Center, 2024). Time, technology, and geographical constraints also impact rural surgeons’ and other health providers’ need to learn the latest surgical advancements for their patients (Sarap, & Reiss, 2024).
There is a need to develop innovative ideas for addressing these healthcare needs of rural individuals, surgeons, and other healthcare providers. Creative models designed to enhance rural surgical treatment and enhance skilled practitioners include those who offer or desire the following:
- 1) Utilizing telesurgery in which surgeons who live in non-rural areas perform surgery remotely through robotic and computer-assisted technology;
- 2) Offering E-consultations that enhance rural and urban collaboration about complex patients and chronical illnesses and medical and surgical treatment options;
- 3) Offering rural surgical training of health providers, such as nurses and general surgeons;
- 4) Providing skilled surgeons, anesthetists, and nurses to staff rural surgical mobile units to treat emergencies and select surgeries;
- 5) Establishing shared services (e.g., diagnostic procedures, treatment, after-care), and physical (e.g., equipment, medications), and personal resources (specialists traveling to rural communities during specified time frames);
- 6) Utilizing rural resources (e.g., community health workers) and other health professionals (e.g., home health nurses) who can identify patients who need potential surgeries;
- 7) Offering financial rewards (e.g., loan repayments; scholarships, housing) to surgeons and surgical healthcare personnel who relocate to rural areas;
- 8) Fostering new rural healthcare personnel (e.g., surgeons, anesthetists, and nurses) to be mentored by more advanced practitioners so they can then apply these skills in their rural practice;
- 9) Encouraging continuing education and professional development of newer surgical skills through on-line and face-to face training; and
- 10) Encouraging health providers to take advantage of rural training programs that prepare these individuals to practice and provide excellent surgical care in rural settings (Kirby Surgical Center, 2024).
References
Kirby Surgical Center (2024). Challenges and solutions in rural surgical health services. Challenges and Solutions in Rural Surgical Services (kirbysurgicalcenter.com)
Sarap, M., & Reiss, A. D. (2024). Rewards and frustrations of rural surgery practice. American College of Surgery. https://www.facs.org/for-medical-professionals/practice-management/private-practice-small-business/rural-surgery-practice/
