Slamming Doors on Rural Hospital Care

By Chuck Norris

January 10, 2020 6 min read

While final statistics have yet to be revealed for New Year's Eve, it is a good bet that they will show a sharp uptick in emergency room visits beginning around midnight. Long before that hour, one regional facility in Madison, Wisconsin reported more people coming in with influenza or from accidents slipping on ice. On the night itself, Dr. Kyle Martin, the medical director at SSM Health's emergency room, estimated they would likely be about 20% busier than average before the night shift was over.

At Nassau University Medical Center in East Meadow, New York, emergency medical center physician Dr. Dean Olsen said the number of trauma patients can double or triple compared to a typical night in the emergency room. The bulk of those are likely to be patients involved in motor vehicle accidents or assaults.

That said, New Year's Eve is hardly the ER's most dangerous day of the year. That distinction goes to the Fourth of July.

According to a new Pew Research Center analysis of 2000-2018 injury data from the U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System, on average, more than 45,000 people visit U.S. hospital emergency rooms for treatment of injuries on July 4 and 5.

Almost every large hospital has an emergency room, and there are an estimated 5,000 or so hospital emergency departments around the country. Many a family's or an individual's journey to a hospital begins in the emergency department.

What if your community had no hospital? What if there was no emergency room easily reachable? What if your community had lost such a vital resource?

This is exactly the scenario that is playing out in rural communities across the country. Nearly 20 rural hospitals closed their doors in 2019, more closures than any year in the past decade. This trend is expected to continue.

What happens, for example, when a 70-year-old grandfather slips on an icy sidewalk and is now forced to choose between staying home and driving to the closest emergency department 30 miles away? When the only road is a two-lane highway jammed with rush hour traffic, and the cellphone service is spotty? What if there is no longer a local place to deliver a baby? Also, how will the hospital's closure affect the town's economy?

Sadly, in many parts of the country, the answers to these questions are playing out in real time.

Mayo Clinic recently announced the closure of facilities in Springfield and Lamberton in southwestern Minnesota early next year. The Mayo Clinic has closed or consolidated at least 16 facilities in southern Minnesota, Wisconsin and Iowa since 2009. Among the reasons given are difficulty in attracting and retaining doctors at these locations and facilities being underutilized.

Late last year, St. Louis-based Mercy health system announced that the 132-year-old Fort Scott Hospital would be joining the growing list of closures. Located about 90 miles south of Kansas City, Kansas, the news both shocked and surprised the community's 7,800 residents. Mercy is a major health care conglomerate with more than 40 acute care and specialty hospitals, as well as 900 physician practices and outpatient facilities. Fort Scott's hospital is the second one in Kansas that Mercy has closed.

As detailed in a series of Kaiser Health News reports, within weeks of Mercy closing, a newly built $9 million grocery store closed. A few weeks later, the cancer center closed and, by October, the town's dialysis center had closed.

"(It) leaves the community with few, if any, health care options," said Marilyn Serafini, health project director for the Bipartisan Policy Center, a Washington, D.C.-based think tank. "They may have to drive long distances to receive care, or they may have to do without care."

It is important to understand that these tectonic changes are occurring without any long-term plan to deal with the consequences, or understanding of what the closures mean to the health of people in rural America, where the burden of disease is generally greater than in urban areas. As the Kaiser Health News reports point out, nationwide, death rates have been higher in rural America compared with urban areas since the 1980s. It is a gap that continues to widen.

Fort Scott has become a prime example of this gap. It is a community where 1 out of every 4 children lives in poverty. Rates of diabetes, obesity and tobacco smoking are higher than the state average. Premature births are relatively high, and people often die younger here than the national average. Mercy Hospital in Fort Scott delivered more than 230 babies in the year before it closed. Now those mothers need to travel to the nearest hospital, 30 miles away.

If not a hospital to care for rural communities, then what is the solution? The answer is playing out in places like Fort Scott and could hold lessons for the rest of the country.

Let us not lose sight of the role hospital conglomerates play in all this. Retail drug spending represents 10% of U.S. health care spending, while hospitals receive $1 out of every $3 spent on health care. These closures are happening as hospital profitability is at its highest levels in decades. Now, what is the lesson in that?

Write to Chuck Norris ([email protected]) with your questions about health and fitness. Follow Chuck Norris through his official social media sites, on Twitter @chucknorris and Facebook's "Official Chuck Norris Page." He blogs at http://chucknorrisnews.blogspot.com. To find out more about Chuck Norris and read features by other Creators Syndicate writers and cartoonists, visit the Creators Syndicate website at www.creators.com.

Photo credit: vitalworks at Pixabay

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