Over 80 doctors, nurses and students from the University Medical Center brought much needed attention to the Appalachian region in a three day outdoor clinic head July 26-28.
The volunteers, who set up make-shift examination rooms in army tents at the Lonesome Pine Airport in Wise County, saw over 2,600 patients, many of whom stood in line for hours.
The trip highlighted the plight of the region's ill, who often do not receive the care they need because of the lack of locally available care in Appalachia.
In addition, many patients are uninsured and cannot afford to pay caregivers who do not accept Medicaid, according to program co-organizer Dr. Claudette Dalton. The prospect of long journeys to seek treatment also is daunting to many patients who may not have access to cars or who may fear interstate travel.
For Dalton, the Appalachia outreach program is a way for the University medical community to overcome these obstacles.
"For us to go to them once a year is something that brings the care to them in a form they can access," she said. "I can't tell you how many of them told us that they had never had anyone take this much time with them and be so persistent about getting them what they needed."
Dr. Diane Snustad said that while the clinic was very successful in treating patients who otherwise may not have received care, the demand for services during the three days highlighted needs that cannot be fulfilled by existing programs or services.
"It was very rewarding because these people need help, but it was also disappointing because the long lines show how many people who need care have fallen through the cracks," she said.
The answer to improving medical care in rural areas may be to encourage caregivers to make their homes in rural areas. Dalton said the Medical Center hopes University medical students will one day serve rural areas on a more permanent basis.
"We are trying to encourage them to consider practices in rural, under-served sites," she said.
However, Dalton said she understood the reluctance of future practitioners to choose to make their homes in rural areas because of the lack of cultural outlets these areas afford.
"The only thing these students know is the big city, and the idea of living in these areas is the idea of going to a backwater where there is nothing to do," she said. "It's reverse culture shock."
Dalton said that financial incentives and their own rural backgrounds can influence future caregivers to commit to providing care to rural areas, but that ultimately it is exposure to patients in these areas that encourages students to commit to serving them. "It's the needs of the patients that turn them around," she said.
Mary Jane Kelley, Medical Center resident education coordinator, reiterated the medical school's commitment to service.
"There is definitely a place for outreach and it's emphasized in the training of residents in the primary care fields: internal medicine, family medicine, pediatrics and obstetrics/gynecology," she said.
Dalton added that the five University medical students who went on the trip all told her that they considered it a life-changing experience.
"Most people in medicine want to do good things for people," she said. "Sometimes you have to be up to your elbows to understand the scope of the need"
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