1. You get what you get: Most health systems allow you to choose an internal medicine doctor from a large pool of doctors. In geographically hard to reach communities, you have a choice of one, at most two due to shortage and poor retention of primary care doctors in those communities.
2. Drive 100 miles up the creek, then make a left: The means to get to health care services is a major factor in the use of health care when available. In Geographically hard to reach communities every where is far, transportation and the ability to take paid time off to access care becomes critical barriers to healthcare particularly preventative care.
3. Open Monday to Friday 10am to 3pm: In order for residents of geographically hard to reach communities to have sufficient access to care, necessary and appropriate healthcare services must be available and obtainable in a timely manner. In those communities however, it is hard to find after hours and weekend care that make it easy for residents to access.
4. Did you hear about Melba’s rash?: Most Geographically hard to reach communities are small where everyone knows everyone, trust that you can use health care services without compromising privacy may be a deterrent to seeking appropriate care when needed.
5. Your out of pocket is $50 for today’s visit: Typically, populations in geographically hard to reach communities have lower median household incomes, a higher percentage of children living in poverty and fewer adults with postsecondary education. The financial ability to pay for services or obtain health insurance is a major barrier to seeking care in those communities.
6. EMS will be there within 45 minutes: Greater distances result in longer wait times for emergency medical services (EMS) in geographically hard to reach communities. This can endanger patients requiring EMS treatment and may result in fatal outcomes.
7. A ruptured appendix does not qualify for a medivac to a hospital 100miles away: Jennifer lives in a geographically hard to reach community with no hospital or emergency department. She bought a supplemental medivac insurance for that reason. On the day she suffered a sudden ruptured appendix, her primary care physician did not think it was urgent enough to refer her for the medivac service that she pays for. She had to travel through treacherous roads for 2 hours to get to the hospital, by which time she had to go into emergency surgery. The near miss would have been prevented if she had been medevac’d to the hospital instead.

Geographically hard to reach populations face inequities that result in worse health care outcomes than that of urban and suburban communities.

What is your perspective? comment below and lets get the conversation going.

Its a RAP (Respect science, Address systemic racism, Promote awareness of ethnic and racial health disparities)