Specialty Care in Rural America


According to the Association of American Medical Colleges (AAMC), there are over 40 major clinical specialties, each serving a distinct group of patients whose conditions demand specialized knowledge to diagnose, treat, and manage. The ratio of physicians to patients for these specialties is a staggering 1:365 as of 2017. To say there’s demand for more specialty practitioners is an understatement, and the imbalance is even more dramatic in rural areas. There just aren’t enough specialists to go around.

Rural America’s shortage of specialty care

Specialty care encompasses medical professionals who specialize in a particular subsect of healthcare. Specialists have more in-depth knowledge on the causes, diagnoses, and treatments for ailments in their specialty, whether it’s cardiology, immunology, or oncology. While a primary care physician can manage a patient’s overall health and begin to identify health challenges, a specialist is often needed in the case of advanced health needs to administer the proper treatment.

Due to the level of training required to specialize, there are naturally more general practitioners than there are specialists. In rural America, there is an even greater divide between the number of general and specialty providers available.

Because there are higher populations to support their practices, specialists tend to be located in urban centers. This leaves fewer specialists available to rural healthcare facilities, which are typically located farther from patients’ homes to begin with. Rural facilities also have lower budgets than their urban counterparts, meaning they can’t pay specialists as much as other facilities.

The challenges of specialty care for rural patients

The shortage of specialty care in rural areas creates a big challenge for specialty care-seeking patients. In many cases, a specialist is not available in a patient’s primary healthcare facility — or even in the same city. Rural patients are often forced to travel longer distances — sometimes to the nearest urban center — in order to get the specialty care they need.

Fewer specialists also creates higher demand and longer wait times for patients. A patient might wait weeks or months for a specialty appointment. Should a follow-up be needed, they might have to wait even longer. And because specialists are far less available, patients don’t get as much face time with their providers. Together, these challenges may lead to an otherwise preventable condition and ultimately, a poor patient outcome.

Digital specialty solutions

Thankfully, modern digital solutions are helping to bridge the gap between specialists and their rural patients. Technologies like electronic health records (EHR) and telemedicine improve access to specialty care, which can improve patient outcomes and their quality of life.

Utilizing an advanced EHR system is one way providers can enhance communication and connections among a patient, their primary physician, and their specialists. Doctors in need of specialty consultations can easily share lab tests, diagnostic images, and other patient data to streamline the process — sometimes without the specialist needing to see the patient at all. Patients who see multiple specialists can rest assured their information is being shared seamlessly between providers. These things help reduce the confusion and frustration involved in seeing multiple doctors.

Additionally, telehealth services improve access across the board for rural patients. Digital consultations and follow-ups can minimize the need for patients to travel and wait for in-person specialty visits.

From anesthesiology to vascular surgery, there’s growing demand for specialists who understand their niche and can apply their knowledge to broader patient pools. In rural areas, where access is already limited, telemedicine and other technology tools are making inroads for specialty care and giving hope to those living with unique, chronic, or specific illnesses outside of urban city centers.

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