Challenges & opportunities in rural practice — 3 Qs with Dr. Gary Snook

Practice Management

Spine surgeons face unique challenges and opportunities outside of urban markets. 

Gary Snook, MD, is a board-certified orthopedic spine surgeon at Tooele (Utah) Medical Group Spine Surgery and a member of the medical staff at the 44-bed Mountain West Medical Center in Tooele. He recently spoke with Becker’s Spine Reviewabout challenges and opportunities facing surgeons in rural areas. 

Question: What challenges do surgical specialists face in rural hospitals? 

Dr. Gary Snook: Outmigration of specialty care hurts rural hospitals.

Outmigration of patients to larger health systems can make it difficult to recruit and retain quality surgical specialists as well as other healthcare professionals like nurses and surgical technicians.

When appropriate care is available locally, yet patients seek services in larger, more urban markets, volumes decrease and recruitment and retention efforts become increasingly difficult. As a result, the rural hospital's ability to provide specialty services to the community is damaged.

According to Merritt Hawkins, as of July 2018 there were 6,739 Health Care Professional Shortage Areas for primary care in the U.S., about double the number identified by the Health Resources and Services Administration 15 years ago. Over 65 million people live in a primary care HPSA, and 67 percent of HPSAs are in rural areas. With so many shortages in basic primary care, the need to support rural specialists is even more important.

Q: How do rural markets attract physicians? 

GS: If you have access to a specialty physician in a rural area, it's likely because the physician chose to live there and made a commitment to the community. Physicians select certain regions of the country for many different reasons. Often, it's because they are passionate about providing access to care in remote areas, and they likely also enjoy what a rural lifestyle offers, such as hunting, fishing or mountain biking.

Q: What opportunities do rural practice present?

GS: Aside from having a doctor who is invested in the community, patients may also receive more personalized care in rural areas. A rural healthcare setting allows for a more personable approach with patients. Your surgeon can be there every step of the way, from gathering your patient history to negotiating with insurance companies for approvals.

Consumers in rural areas may not be accustomed to having access to specialty care, making outreach mechanisms an essential part of creating healthier communities. For example, Mountain West Medical Center recently implemented an online Spine Health Risk Assessment to help consumers learn methods for healing, pain management and prevention. Depending on their assessment results, a patient may receive instructions on how to connect with a local specialist or primary care physician, depending on the severity of symptoms and risk category.

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