In the mid-1800’s, the western trail took thousands of longhorn cattle through what is now Abilene. Though the city has grown significantly since then, the area is still known as “Big Country” because of its wide-open landscape. But that location, 150 miles west of Dallas-Fort Worth, could have cost Abilene resident Barbara Swisher her life two years ago, when she suffered a massive stroke. Luckily, her hospital had forged a smart long-distance relationship with Medical City Healthcare to anticipate just such a medical crisis.
Early in my career I had the good fortune to serve in leadership roles in rural hospitals in Louisiana and Georgia. It left a lasting impression. In smaller communities, the medical staff is typically comprised of dedicated individuals who have committed their lives to providing care in a setting that requires them to be generalists as much as specialists. Hospitals are often at the core of smaller communities, one of the largest employers in town and a source of civic pride.
However, one of the constant challenges in many rural hospitals is medical staff sustainability to provide a full continuum of services. When a facility is lucky enough to find a neurologist, urologist, or gastroenterologist who wants to make a small community hospital home, that single physician cannot possibly be available 24/7/365. To residents, that often translates to travel to the big city for quality care.
Today’s economics of healthcare also provide a steady stream of challenges for any hospital, much less small rural ones. Burdensome and constantly changing regulations, lower reimbursement rates, increasingly complex technology, and clinical advancements often provide demands unsustainable in rural areas.
Since 2010, 80 rural hospitals have closed in the U.S., according to the North Carolina Rural Health Research Program. Thirteen of those hospitals were in Texas—more than any other state during that time. Often, the result for the rural community is the loss of access to emergency healthcare for up to two hours in any direction. Other dedicated doctors often follow, leaving a potentially deadly gap in access to manage chronic conditions, complex emergencies or even routine pediatric care.
But, rural healthcare is important to the fabric of our state and nation. It is among the reasons why Medical City Healthcare recently purchased Weatherford Regional Medical Center, now Medical City Weatherford. And, it is why we have dedicated resources to assist rural healthcare markets expand clinical capabilities to sustain medical staff specialties that are critical to providing care locally.
Here’s how we’re committed to partnering with local, rural providers to care for their community:
- Satellite clinics: Medical City Healthcare provides satellite clinics to bring specialty care to rural markets that would otherwise go underserved. For example, Medical City Healthcare opened a satellite cardiac care office in Gainesville, in partnership with physicians at Medical City Denton. Those physicians improve access to care, provide better response times for appointments and increase the level of specialty consults.
- Clinical service development: Medical City Dallas recently partnered with Hunt Regional Medical Center in Greenville, northeast of Dallas, to create an interventional cardiac catheterization lab so that emergency heart attacks could be treated in the local market, rather than waste precious minutes on travel to a larger hospital. The community now has improved access to a critical service, resulting in better patient outcomes. The hospital now has a new and sustainable revenue stream and recently celebrated its 100th cardiac cath.
- Technology utilization: Medical City Healthcare has invested in extensive telemedicine capabilities and partnered with rural hospitals to bring emergency consultations to communities lacking key physician specialties. During Hurricane Harvey recently, our telemedicine program was able to provide emergency psychiatric, neurology, and other emergency consultations to hospitals cut off by flood waters. In addition, our neurologists and interventional neurosurgeons regularly provide expert advice for stroke patients in partnership with eleven rural hospitals. In rural communities without neurologists on staff, recognition and treatment of strokes can often come too late to prevent serious, long lasting damage.
In 2013, Medical City Healthcare partnered with Abilene Regional Medical Center to create a TeleNeuro/TeleStroke program. Two years after the program’s launch, the life of an RN at the hospital, Barbara Swisher, would depend on TeleStroke. Because of a prompt consultation with dedicated physicians providing neurology coverage, Barbara was able to receive quick treatment that minimized the complications of her stroke. She recovered completely and is now stroke coordinator at the hospital and a champion of the TeleStroke partnership.
Swisher, her family, and the millions like them that live in small towns across America is why Medical City Healthcare is dedicated to improving access to care in rural communities. After all, our mission to the care and improvement of human life extends to all communities, no matter where they are located.
Erol R. Akdamar, FACHE, serves as president of Medical City Healthcare, which includes 14 hospitals, 11 ambulatory surgery centers, 29 CareNow urgent care centers, more than 4400 active physicians, and 17,000 employees in the North Texas area. Akdamar is a Fellow with the American College of Healthcare Executives and currently serves on the Board of Trustees of the Texas Hospital Association and on the boards of the Young Presidents Organization and Dallas Medical Resource.
