Definition of rural medicine

[dreamweaver1988]

Question: What is the actual definition of rural medicine?

I grew up in a Midwestern town of 25,000 people, with the total county population at around 34,000 (I now live in a "big" city of around 50,000). The area of my home county is 850 mi^2 thus the density is low, about 40 persons/mi^2.

I think I would really being an internist a town with 20,000 +/- 10,000 people; would this be considered rural medicine? I guess the confusion arises from my own personal definition of rural; I am accustomed to towns with 34 people and no stoplights, graduating classes of 8, etc. Perhaps cities I consider normal are considered rural by you big city folks...

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[CopToEM]

Question: What is the actual definition of rural medicine?

I grew up in a Midwestern town of 25,000 people, with the total county population at around 34,000 (I now live in a "big" city of around 50,000). The area of my home county is 850 mi^2 thus the density is low, about 40 persons/mi^2.

I think I would really being an internist a town with 20,000 +/- 10,000 people; would this be considered rural medicine? I guess the confusion arises from my own personal definition of rural; I am accustomed to towns with 34 people and no stoplights, graduating classes of 8, etc. Perhaps cities I consider normal are considered rural by you big city folks...

When I think of rural or remote medicine I don't necessarily think about the demographics of the individual areas and/or the county. I think of areas without tertiary care hospitals.

In these communities, primary care docs manage a lot more patients than their counterparts in other areas. In larger areas with tertiary care providers iabetics with a difficult time controlling their blood glucose, for example, might be referred to an endocrinologist for more intense care. In rural areas, on the other hand, there may not be an endocrinologist in an hour radius. My area is exactly like this.

We do not have a single endocrinologist, pulmonologist, neurologist, nephrologist, etc. within an hour of here. So, for some things, the primary care doc simply does the best he/she can within their ability. If it's bad enough, they send patients on anyway and make them commute.

For reference, my town has 4,000 citizens and my entire county (405 square miles) only has 40,000.

 

[dreamweaver1988]

When I think of rural or remote medicine I don't necessarily think about the demographics of the individual areas and/or the county. I think of areas without tertiary care hospitals.

In these communities, primary care docs manage a lot more patients than their counterparts in other areas. In larger areas with tertiary care providers iabetics with a difficult time controlling their blood glucose, for example, might be referred to an endocrinologist for more intense care. In rural areas, on the other hand, there may not be an endocrinologist in an hour radius. My area is exactly like this.

We do not have a single endocrinologist, pulmonologist, neurologist, nephrologist, etc. within an hour of here. So, for some things, the primary care doc simply does the best he/she can within their ability. If it's bad enough, they send patients on anyway and make them commute.

For reference, my town has 4,000 citizens and my entire county (405 square miles) only has 40,000.

Thanks, my hometown hospital is a 99-bed facility that is a regional hub for medical care. It offers pain management, nephrology, urology, ENT, orthopedic surgery, general surgery, OB/GYN, IM, pulmonology, pediatrics, radiology, and ophthalmology. Sooo not exactly rural medicine.

 

[MT Headed]

I've discussed this with some of my interviewers, and amongst the professionals the big cutoff seems to be childbirth. If primary care providers deliver babies themselves, it is rural. If primary care providers can reasonably send mothers to a nearby facility with OB/GYN specialists, then you are within the umbra of a more urban environment.

The federal government also designates areas as 'Medically Underserved Area' or 'Health Professional Shortage Area'. If you google these terms, they will take you to various .gov websites with nifty maps and searches and stuff.

 

[FutureDrB]

I've discussed this with some of my interviewers, and amongst the professionals the big cutoff seems to be childbirth. If primary care providers deliver babies themselves, it is rural. If primary care providers can reasonably send mothers to a nearby facility with OB/GYN specialists, then you are within the umbra of a more urban environment.

Hmm. I've never thought about it like that, but it's a good way of looking at it. I too was always trying to figure out a population cutoff. 100,000? 20,000? 2,000?

 

[CopToEM]

I've discussed this with some of my interviewers, and amongst the professionals the big cutoff seems to be childbirth. If primary care providers deliver babies themselves, it is rural. If primary care providers can reasonably send mothers to a nearby facility with OB/GYN specialists, then you are within the umbra of a more urban environment.

Interesting perspective for sure. I'm in an area that is about as medically underserved as it gets and I don't know a single primary care physician who handles deliveries. I know of ones in surrounding areas, however, but we're still very rural. In fact, there are two rural medicine fellowships in this area as well as four medical schools with missions specifically to increase health and wellness for our citizens.

Perhaps that answers the question in itself, though... there probably is not a clear cut answer.

 

[camierz]

I grew up in a town with the population of 2,000 that has only a single doctor's office. I picture that as being somewhat like rural medicine. However, if anything serious happens there are bigger cities 15 minutes away and the university hospital is only 30 minutes.

 

[Prncssbuttercup]

Cabinbuilder is a rural doc. She is also a DO... Hopefully she'll see this post and chime in. Rural medicine isn't defined, as MT said, so much by the number of people, but how many doctors there are available. Summit County Colorado has a 'low population' that could be considered 'rural' however, because it is Summit County and home to Breckenridge, Keystone, A-Basin, and Copper mountain, it does not qualify as rural medicine. If you go south 15 miles to Alma/Fairplay area, you are suddenly in a 'high need/underserved' area. That said, at some point I'd really like to practice in that area, so I am hoping in 10 years it still is an underserved area! One thing is to look up the National Health Service Corps. If you look up your area and there are jobs listed, your area is designated as a shortage area. http://nhscjobs.hrsa.gov/Search_HPOL.aspx

 

[dreamweaver1988]

Cabinbuilder is a rural doc. She is also a DO... Hopefully she'll see this post and chime in. Rural medicine isn't defined, as MT said, so much by the number of people, but how many doctors there are available. Summit County Colorado has a 'low population' that could be considered 'rural' however, because it is Summit County and home to Breckenridge, Keystone, A-Basin, and Copper mountain, it does not qualify as rural medicine. If you go south 15 miles to Alma/Fairplay area, you are suddenly in a 'high need/underserved' area. That said, at some point I'd really like to practice in that area, so I am hoping in 10 years it still is an underserved area! One thing is to look up the National Health Service Corps. If you look up your area and there are jobs listed, your area is designated as a shortage area. http://nhscjobs.hrsa.gov/Search_HPOL.aspx

Many thanks to everyone for their input. I'm glad we muddled the issue even more!