A family practitioner’s view of local healthcare challenges
Healthcare has been a thorny issue for our country, resisting the efforts of many to solve it including presidents, Congress and many in the healthcare industry. Sullivan County has a particular problem: its health status sadly has ranked near the bottom of the New York State listing of counties year after year. Why is this?
There are several key reasons. First, we are what is considered an economically disadvantaged county. In other words, many of our residents fall below the poverty line. While the working poor often make too much money to receive government subsidies to help pay for health insurance, they still cannot afford to pay on their own.As a result, there is a high percentage of people living in Sullivan County who do not have health insurance. This prevents them from seeing a doctor on a regular basis until they become critically ill. Then, like millions of Americans across the country, they must rely on the emergency room for their care, which adds to their financial burdens.
Transportation issues contribute to our residents receiving inadequate healthcare. Many live in remote areas of the county. There are elderly residents, many of whom now live alone, who often have no reliable way to get to the doctor and do not wish to be a burden on their family or neighbors. Young people have also come to my office in need of services I could not provide. They have confided that they do not have money for gas to travel the distance required to see a specialist. Or they may own a vehicle that is too old or in need of repair, and they cannot make it to their tests.
Sullivan County has several communities that are designated “medical shortage” areas. This means there are not enough physicians to care for the population within that area. It has been a challenge to recruit primary care doctors to move to or practice in these areas. Doctors come out of their training programs today with large debt and feel they will not be able to financially manage a practice in a rural, economically disadvantaged or medical shortage area. There are also social and perhaps cultural challenges for them as well. Despite our beautiful country setting and all that it offers, most physicians choose to practice and in urban or suburban areas for this reason.
Another problem that needs to be addressed when discussing healthcare deficiencies or poor health outcomes is substance abuse. There is a high incidence of tobacco and alcohol consumption in our county, which results in numerous health problems and disease, including heart disease, emphysema; lung cancer and cirrhosis. Alcohol consumption has also resulted in injury and death due to driving while intoxicated. And of course, one of the most dire health problems currently facing us—and communities around the country—is opioid addiction, which predominantly targets our youth but affects men and women of all ages and results in disability, overdose and death, in addition to its devastating effects on families and communities. Heroin is a drug that is easy to obtain and relatively inexpensive, which contributes to its growing rise and devastating impact.