POCUS for Rural Healthcare
In the article, Strong Medicine is Needed to Solve America’s Rural Health Crisis, Dr. Traci Marquis-Eydman describes growing up in Fort Kent, Maine. A small town with less than 4,000 people. Growing up in this tight-knit community sparked her desire to become a family doctor in rural America. From childhood, Dr. Marquis-Eydman witnessed the dire need for a strong medical infrastructure in backwood neighborhoods, and unfortunately, the demand for it has only increased.
The Unique Healthcare Challenges of Rural Communities
The Centers for Disease Control and Prevention (CDC) have identified the five leading causes of death in the United States:
- Heart Disease
- Unintentional Injury
- Chronic Lower Respiratory Disease
The CDC notes that individuals residing in rural communities are more likely to die prematurely from these chronic illnesses than those in urban populations. There are several contributing factors that rural residents face that create severe health disparities in their communities.
Physician Population: Most medical schools are embedded in urban and city locations. Post-graduation, when it is time to practice, physicians usually stay close to where they have studied. They have come to know their surrounding areas, participated in rotations nearby, and formed relationships that make it most attractive to begin careers right where they learn.
Additionally, salary is a significant factor that healthcare providers must consider. Wages are usually lower in rural areas, and though the cost of living often aligns, medical professionals have to take into account school loans. The repayment requirements tend to steer physicians away from rural life.
Healthcare Access: Limited medical providers equate to limited medical resources. Small towns experience a lack of healthcare specialists, such as oncologists, cardiologists, or pulmonologists. In turn, medical facilities are also an insufficient supply. Critical care units, hospitals, urgent care centers, and transportation options are short and few, resulting in an additional healthcare hurdle faced by rural America.
Distance and Time: To be cared for, patients have to find treatment outside of a reasonable travel distance. Residents may have to drive for hours to seek medical attention, obtain routine office visits, or participate in preventive care. The miles and time it takes to receive health services become a discouragement creating the higher rates of rural residents dying prematurely from the most common chronic illnesses.
Fifteen percent of the U.S. population make up rural America—that’s 6.9 million people.1 The challenges they face can’t go ignored, of course. The CDC has an initiative in place working to improve the health conditions for these towns. In addition to the CDC’s efforts, the development and notoriety of point-of-care ultrasound (POCUS) are stepping in to change the rural medical narrative.
POCUS solves many of the health barriers and difficulties confronting rural towns. From the financial disparities to the extreme diagnostic time created by distance, POCUS can help. The imaging modality is cost-effective, non-invasive, easily accessible, decreases time to diagnosis, minimizes patient ED length of stay, reduces time to operative care, and improves acute care outcomes.
Here’s a tangible example, POCUS suggests diagnoses that, at times, are not considered initially in a physical examination. Or, it can augment the physical exam by confirming the findings. In this case, POCUS leads to a more deﬁnitive diagnosis, which avoids the transfer of patients to larger centers for further imaging or testing. The result eludes the unnecessary use of an ambulance required to transfer patients in locations where this service is limited.
Making room for POCUS and creating an on-ramp to training is essential in changing these communities’ narrative. When rural healthcare providers are equipped with the knowledge and means to use POCUS in local and remote community clinics and emergency departments, it expands their ability to diagnose select conditions timely and improve the quality of care delivered to community members.
Low resource settings should not define the level of healthcare received by its residents. When the obstacles to care are removed, patients can win at being healthy, regardless of where they live.
A vote for POCUS is a vote for resounding care to every neighborhood, in every corner of the globe.
(n.d.) Rural Health: Preventing Chronic Diseases and Promoting Health in Rural Communities. Retrieved July 7, 2020 from https://www.cdc.gov/chronicdisease/resources/publications/factsheets/rural-health.htm.
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