CEO Corner April 2018
The Paradox of Rural Health Care
Naches, Ellensburg and Tieton all, over the years, reached out to Community Health of Central Washington for help. They needed better access to care, and they could not solve the problem alone.
There was a time not that long ago that those communities would have made the pitch to doctors who could go there, hang out a shingle, and go into practice. Those days are gone. Medicine has become far too complex for that to be a reasonable expectation. Some of the complexity is transparent. Everybody can see what it takes to schedule, conduct, and bill for an office visit. Minimalist approaches may work on the fringes of the population, but serving the community requires the use of electronic health records, coordination and integration of service, population health management and much more to be successful. Much of what is required is mostly invisible: insurance and other contracting; provider credentialing; audits and compliance requirements; employment matters; and so much more. It’s almost unthinkable that a private practice provider could be expected to provide all that. They would have no time for the care of patients.
People in rural areas are depending on people from urban areas to be interested in their problems and to extend their reach and resources to solve them. That’s what CHCW has done. April 1 marks 11 years of CHCW’s service to Naches. We have served Ellensburg for almost as long. December 2 was our two year anniversary of serving Tieton.
It shouldn’t come as a surprise. Twenty-five years ago, our founding mission and vision recognized a commitment to our rural neighbors. Our clinic may have been in Yakima, but a lot of people travelled to get care at CWFM. Our educational mission was quite focused on the needs of rural communities. To this day, the CWFM Residency training program emphasizes a level of training in obstetrics, hospital care, and skills that other programs have backed away from.
We have problems and needs right here in Yakima. It’s tempting to think that we should focus on those, and let the rural communities solve problems on their own…until you recognize that solutions are beyond their control.
Thank you for stretching. Reaching into those communities makes a world of difference to the people in them.