In a state that is largely rural, it’s no surprise that rural health issues are increasing in Mississippi. Tops on the list of concerns are socio-economic issues and lack of access to healthcare professionals and facilities.
Dr. Luke Lampton, chairman of the Mississippi State Board of Health, says the state has a rural healthcare crisis. “According to American Medical Association statistics, Mississippi has the lowest number of physicians per capita in the union,” he said, “and the ones we have are mal-distributed in four urban areas. There are counties in the state without a single doctor within its borders.”
The majority of the state’s physicians are located in the urban areas of DeSoto County, Jackson, Tupelo and Hattiesburg. The Coast, which would normally be on the list, was affected by Hurricane Katrina but Lampton says its physician count is bouncing back.
“The study predicts this lack of doctors will probably get worse as many of those practicing in rural areas are nearing retirement age,” he said. “We haven’t faced the worst of the doctor workforce crisis yet. Medical leadership is putting pressure to get physicians to locate in rural areas.”
One way it is doing that is through the establishment of the Rural Scholarship Program, which Lampton calls the most innovative of its kind in the country. It was established in 2007 and funded for one year, but he is hopeful the Legislature will fully embrace it and continue funding.
“We are trying to grow our own physicians for rural areas by mentoring students from these areas, giving them medical scholarships and getting them back to these areas to practice,” he said. “There are a lot of obstacles in rural areas to get to medical school. These students are disadvantaged against students from urban areas. Studies show that most physicians who locate in rural areas are originally from those areas.”
It will take a few years to see the effects of this program, and there still may not be enough physician workforce, but Lampton says a practitioner moving into a small, rural town is that town’s Nissan or Toyota. A Mississippi State University study reveals an economic impact of $2 to $7 million annually and the creation of up to 35 jobs for a town by one physician.
Lampton, who practices rural medicine in Pike County, observes that rural physicians must deal with a high proportion of elderly and Medicare and Medicaid patients and very little private insurance. These federal programs’ reimbursements are at low rates.
“Health issues are different in rural areas where there’s still a lot of poverty and salaries lag behind urban areas,” he said. “Unfortunately, it’s not getting better.”
He also sees a critical need for nurses in rural areas where economies can’t compete for their services.
Rural hospitals with the numerous stresses on them must be supported. “Losing them will have a significant impact on healthcare,” Lampton said. “They must be maintained and not just as band aid stations.”
The Mississippi Hospital Association agrees. That’s why the Center for Rural Health was established in 2002 to work with these small hospitals in attaining grant monies. Mendel Kemp, a retired psychiatric hospital administrator and former employee of the State Department of Health, was recruited as executive director.
“Rural hospitals have several obstacles. For many, the infrastructure is old. They’re Hill-Burton hospitals built in the 1950s,” he said. “They don’t have a lot of money for capital improvements.”
These hospitals must be credit worthy to receive grants, and being critical care access facilities gets them better reimbursement. Several have been awarded improvement grants through the U.S. Department of Agriculture. Among those are Kings Daughters Hospital in Yazoo City, S.E. Lackey Hospital in Forrest and North Sunflower Hospital in Ruleville where a $9-million expansion is being built.
“Some hospitals are doing great things,” Kemp said. “They are improving their services and making themselves more attractive with what they do best, such as swing bed care. A lot of patients would rather go to these small hospitals where they get a lot of attention.”
He, too, laments the difficulty of attracting and retaining healthcare professionals to rural areas, especially physicians. “It’s particularly challenging in the Delta where Medicare and Medicaid reimbursements are inadequate,” he said. “The center is addressing these problems. Banding together and working as one is helping.”
Lampton applauds the landmark trauma bill passed by the Legislature in the 2008 session. The Department of Health is putting together a trauma system that will require participating hospitals to get patients with injuries from accidents and other trauma to where they need to be as quickly as possible.
“It’s in place and will have a good impact in rural areas,” he said. “All who worked on it deserve our gratitude.”
He notes that other rural health issues include access to mental health and improving preventative medicine.
Contact MBJ contributing writer Lynn Lofton at firstname.lastname@example.org.