There's something profoundly reassuring about walking into a doctor’s office. Somehow, simply sitting in the waiting room of a clinic with the promise of meeting a trained physician is enough to alleviate some worry; as making that first connection for help is half the battle. But for many patients in rural America, the professional reassurance that those of us in urban areas take for granted feels far out of reach. Consider these statistics: according to studies published by the World Health Organization, about half of the world's population resides in rural areas; however, only 38% of the nursing workforce services remote regions. The situation is even worse for children - in the United States, just 3% of pediatricians work in remote regions and are expected to serve a full 21% of the country’s youngest residents. This shocking disparity underlines a problem that rural regions have faced for decades. Many doctors don’t want to relocate to practice in isolated regions long-term; others lack the financial and institutional support needed for regular travel into these areas. The logistical problems inherent in the dilemma put rural inhabitants in an unenviable and underserved position, and have further led those in the healthcare field to call for greater integration of telemedicine into general rural practices.
Telemedicine isn’t the easiest term to pin down in a definition. Broadly speaking, it “uses electronic information and communications technologies to provide medical diagnosis and/or patient health care when distance separates the participants.” Within these bounds, anything from a simple phone call to videoconferencing to teleradiology constitutes telemedicine. For those in rural areas, a simple video-chat window can provide access to a specialist that they otherwise would have needed to take off work and drive hours to see. Telemedicine has the additional benefits of keeping healthcare spending local, fostering community health, and making it significantly easier for doctors in training to get the training they need for further accreditation. Thus, it just might be the solution that underserved rural populations need.
However, the path to integrating telemedicine systems into rural medical sites is marked with a number of barriers, the first and foremost of which is cost. According to writers at HealthCapital, the capital requirements for telemedicine integration stand at approximately $30,000 - a cost that might be acceptable to urban-area hospitals, but could be prohibitive for many rural institutions. Those hoping to institute telemedicine also battle regulatory and logistical uncertainties as they struggle to define which certifications doctors need if they practice telemedicine across state lines. Telemedicine has the potential to be invaluable in rural areas, but we have a string of logistical knots to untangle before it can be widely implemented.
So, what’s our solution? The need for available medical care in remote areas is clear and acute. To answer it, we must first push for a standardized and subsidized telemedicine system that can be readily implemented in remote areas. But telemedicine alone won’t solve all rural health concerns; the dearth of practicing professionals remains an issue. Rural communities - and especially children - need to have better access to the aid of an in-person medical professional. To that end, those of us in the medical community should begin rethinking how we address rural health issues during medical school and make more of an effort to encourage doctors to take on clinical rotations in remote areas. Telemedicine is an invaluable tool in a doctor’s toolbox - but it can’t fully meet the healthcare needs of underserved rural populations.