Empathy for the Rural Hospitalist

In residency, we had derisive nicknames for the hospitals in the surrounding rural areas that would frequently send us patients. After we were notified of the transfer, we stayed on edge until the patient arrived, unclear of what was going to show up. At best they were sending us a difficult patient who was going to require a great deal of work; occasionally, as we paged through the photocopied progress notes and labs, we expressed more and more righteous indignation at the decisions that were made that I as a cocky intern never would have done. In the end, it tended to leave us feeling like we were just a dumping ground for the outside hospital’s mistakes. Now I’m the physician working in these areas. The memory of those nicknames drives me to do everything I possibly can to help my patients, but in the back of my mind is the knowledge that there are situations beyond my capabilities that require transfer. I understand that few hospitalists have worked in a truly rural setting and don’t understand the challenges this represents. It’s also easy to become myopic and forget the huge shifts that have occurred in the relationship between rural hospitals and larger referral centers over the past few years. Rural counties in the U.S. suffer from multiple challenges that make caring for patients more difficult. There are roughly one-third of the total doctors and one-fifth of the specialists per capita to provide care in rural areas compared to urban ones. On top of this, th...
Source: The Hospitalist - Category: Hospital Management Authors: Tags: Career Practice Management Transitions of Care Source Type: research