Many rural residents lack access to general surgery services in the United States. Those living outside metropolitan areas must often travel long distances to receive surgical care at a regional referral medical center. As a result, patients may choose to delay or forgo surgical treatment because they are unable or unwilling to leave home. The financial and emotional costs associated with travelling great distances to access surgical care can be an overwhelming burden for both patients and their families. Trauma victims and patients with surgical emergencies certainly benefit from more immediate access to surgery services.
While 25% of Americans live in rural areas, approximately 12% of physicians practice in rural settings. This is especially true among surgeons as it is estimated that 10% of general surgeons currently practice in rural environments while some forecast the number needed to adequately care for the rural population as close to 19%. Along with primary care physicians, general surgeons are a crucial component of the rural healthcare team. The rural general surgeon provides necessary surgical services, trauma care, and critical care in small hospitals. Additionally, a broadly trained, experienced rural general surgeon can also perform obstetrical, gynecological, urological, orthopedic, and endoscopic procedures. Present graduates of many general surgical residencies, however, are not obtaining the variety of experience necessary to practice effectively in a rural setting.
The community hospital often suffers adverse consequences when local residents obtain surgical treatment elsewhere. A hospital without a surgical program may have fewer admissions resulting in lower overall revenue. Surgical programs commonly make a substantial financial contribution to a hospital’s fiscal health. Frequently, the ability to provide surgery services is seen as critical to the survival of small rural healthcare facilities. Patients who receive surgical treatment outside the local community may obtain other medical care there as well. The local hospital and associated clinic may end up providing fewer medical services as a result.
A Need for Action
The Mithoefer Center for Rural Surgery was established in 2004 to confront this serious problem. We are committed to developing comprehensive solutions that benefit rural citizens, rural surgeons, and rural hospitals alike.