Save Rural Health Care: Time for a Significant Paradigm Shift

Submitted October 17, 2018; revision received January 31, 2019; accepted March 21, 2019. A ccess to health care in the rural United States is becoming increasingly difficult. Since 2005, 118 US rural hospitals have closed and almost 700 more are in danger of closing. 1 The decrease in access has resulted in detrimental health outcomes for people residing in rural communities. Recently, the University of North Carolina tracked United States rural hospital closures and gleaned results from 83 hospitals. The results identify 2 main factors for hospital closures: economics and lack of workforce. To remedy economic challenges facing rural hospitals, the Save Rural Hospitals Act/HR 2957 was proposed to Congress. However, the bill is not a sustainable solution for resolving economic challenges and the workforce shortage. Over time, we have seen dramatic reductions in lengths of stay, decreased census, and an exodus of health care professionals among other changes in the current rural hospital infrastructure. These changes have affected the osteopathic medical profession, particularly given our tendency to practice in primary care and rural settings. Osteopathic physicians tend to fill the primary care needs of rural communities at a rate 2.3 to 2.5 times higher than our allopathic colleagues. This article examines current challenges rural hospitals face and offers potential solutions to improve the rural health care delivery model. Implementation of multitiered solutions can improve access to necessary medical care and meet the rural population’s health care needs.