Team approach improves rural health care

By Joanie Stiers

A 40-year veteran of the health care industry says recruiting rural youth to study broad-based family medicine and a team approach to care would improve health care’s access and success in rural areas.

“We have a tendency to think that, ‘We need a doctor in this town or a nurse practitioner in this town,’” said Dr. Les Mathers, a Mason County farmer who has practiced family medicine and served in senior administrative roles for major health care systems since 1979. “It’s not just recruiting a doctor to come live in town. It’s a long-range picture of trying to be supportive of an educational system that takes in medical students who will also want to live in rural areas, communicate really well and can develop the team dynamic so you can take care of more people.”

Mathers promoted a team approach to health care during his presentation to members of Illinois Farm Bureau’s Health Care Working Group last month. He said that medical team could include family physicians, physician’s assistants, nurse practitioners, physical therapy experts and behavioral specialists who collectively deliver broad-based health care in a rural community.

RelatedIFB's Health Care Working Group makes final recommendationRead more here.

This team’s coaching of patients and families, combined with a deeper understanding of patients and their backgrounds, can promote healthier lifestyles and prevent future health issues. Mathers also believes this approach can discourage unnecessary and sometimes costly referrals for evaluations, tests and treatments.

“These broad-based primary care teams could effectively and efficiently care for more than 95% of families’ day-to-day needs,” Mathers said. “Research shows that people do far better in their own community than going off to a subspecialist 60 miles away, have certain things told to them and they don’t understand the why and how come. It’s always good to have your home-based team to help you and communicate well with you.”

When the team deems specialty care necessary, the growing use of telehealth, or health services delivered via telecommunications or digital technology, offers a viable option to bring high-level care closer to home. Mathers said telehealth also allows specialists to coordinate with a patient’s local health care team for better understanding and outcomes.

In an Illinois Farm Bureau survey of Illinois hospitals, eight of nine responding hospitals reported use of telehealth services. Several indicated the opportunity to connect with distant specialists is one of the service’s most significant impacts.

RelatedIFB surveys community hospitalsRead more here.

Throughout Illinois, most rural areas lack a collaborative approach to health care, Mathers said. Part of the solution can come with recruitment of bright, young medical students from rural communities, the type of people who will want to return to rural areas to practice. The health care industry also needs to encourage more of these students to become primary care physicians, family physicians and other clinicians who can provide broad-based care.

Mathers said the education system currently trends toward specialists because of the “cool” factor and the ability to generate higher incomes to address college debts that average near $200,000, with many owing around $300,000. In addition, most professors and mentors have small-niche medical backgrounds, centering a student’s educational experiences around specialty care.

“It’s going to take a lot of steps and not just flipping one switch,” Mathers said. “There has to be a group of people who are coming into the education and then getting the broad-based education and being mentored by folks to learn how to do broader experience work and find it enjoyable and rewarding. You also need to be attractive to them to get their debts paid off and feel good about living in a smaller community.”

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