continued fromDeveloping Niches To Increase RevenuesAnother survival technique for rural health care centers is developing specialties that attract paying patients and boost operating revenues.
The tiny Canby Family Practice Clinic, which is using a two-year, $80,000 grant from TCWF to sustain operations while a new building is completed this summer, has hired a dentist trained in all seven areas of dentistry. "He’s wonderful," said Administrator Greta Elliott of the new dentist. "We’ve had a lot of growth in that area and are marketing his specialty services, such as orthodontics and endodontics." Exploring New Emergency Care SystemsBecause resources are often limited and few rural clinics have full-time physicians on site, they may not be able to handle the most severe emergencies, necessitating long journeys to larger facilities. "Rural areas see high rates of unintentional injuries because residents often engage in higher-risk occupations, such as working with farm equipment, lumbering and fishing," said Buada of California Institute for Rural Health Management. "There is also a higher rate of auto accidents in rural areas, possibly because of hazardous road conditions." The Borrego Medical Center, like many isolated clinics, provides urgent care but not emergency care. The center boasts a helicopter pad for medical transports, but "it’s been parked at our doorstep for three days at a time, stranded by weather in the mountains," Borrego’s Taub said.
The costs for emergency care—which include long-distance ambulance services and out-of-town medical personnel—also discourage many residents from utilizing emergency care. Technology is beginning to provide help to these out-of-the-way sites. Most medical directors are available around the clock by phone, and experienced clinical staff can respond appropriately. Canby health practitioners are starting to use online "telemedicine" to work with specialists. It is a technology that is opening new opportunities for rural facilities.
Making Progress in Rural HealthIs there a future for rural health care centers? Buada said that, despite the many obstacles facing rural providers, those that are able to effectively address new challenges will be in a better position to sustain their services. "Each rural area and health facility is different and unique," Buada said. "Some are changing and some will never change. Resourceful clinics that are able to look at new ways of providing care will improve their chances for survival." With TCWF funding, many rural clinics have found ways to adapt to their environments and improve their systems of care by forming partnerships, attracting medical staff, establishing new ways to increase revenue and using technology to better serve their patients. The hope is that these types of efforts will contribute to the sustainability of rural health facilities. "Rural health care centers do a lot to provide access, but we have to continue looking at how to make them more stable," TCWF’s Procello said. "One of our priorities is to give them a little space, through our grants, to step back and see how they can maximize their resources to better serve their communities." |
Summer 2000
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