At a time in everyone’s life, we come to find ourselves in a situation where the music stops, and we must go on.  The unfortunate truth about life is that the unexpected will happen. Some of us learn from it, some of us change because of it and some of us find our life’s calling because of it. The latter was the case for me.  After our dad picked us up from middle school, we spent that afternoon like we had every afternoon that month. We went to the oncology unit at the hospital, where my brother was admitted.



I remember him. I remember the man in the dark blue sarong the same way I remember the lines on back of my own hand. He was hunched over next to a column on a dirty platform at a railway station in Calcutta, India in the middle of the harsh summer sun. His hands were withered, his fingers and toes looked like tiny nubs, and he was completely malnourished and alone. He had opaque blue eyes, as if fog had taken place of his irises and pupils.



I studied insects in college; my favorite insects were the bees (I found them diligent and so helpful to humankind).  One of my favorite classes was about medical diseases caused by insects. My professors noticed my interest in the medical side of things and connected me with a professor who did clinical research. Our work focused on a clinical trial for children with intractable epilepsy and exposed me early on to patient care and patients.


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things most people inquire about when searching for a job is the benefits package. Specifically, “How good is the health insurance?” Rural communities typically have very few jobs with great benefits such as those in manufacturing or government. 

I believe that loosening the ties between employers and health insurance would greatly benefit rural populations access to health care. We rely heavily on the contributions of rural residents to our society. I can’t think of any farmers that I know (and I know a lot) that get insurance benefits from their job. That’s because they are self-employed. Buying a private insurance plan is outrageously expensive in our country. That’s why many of these hard-working, self-employed citizens choose to go without it and gamble that they will stay healthy. With these men and women stuck out in the dead of winter and the heat of summer doing the work the rest of our population couldn’t fathom, we know that the odds of avoiding medical accidents are sadly not in their favor. That is why there needs to be an affordable option for healthcare that isn’t tied to who your employer is.

Without a doubt, changes are going to have to be made to the way healthcare is delivered in order to improve access for rural residents. As a current medical student who plans on returning to my small hometown to practice, I have spent a lot of time pondering what needs to be done. I certainly don’t have all the answers but I think the three suggestions I made above would be a great start. We need to improve utilization of telehealth technology, implement more satellite clinics for specialty care, and provide an affordable option for health insurance that is not tied to employers. It is our responsibility as future and current physicians to do all we can for our patients. This not only includes direct patient care but also working to improve the healthcare system as a whole.

Growing up in a small town in southern Kentucky taught me many valuable life lessons for which I am forever grateful. However, there are also many unique challenges that rural residents face. One such challenge that I have witnessed firsthand is access to healthcare for citizens of rural communities. People from small towns all across America consistently have worse health outcomes across the board when compared to urban dwellers. Although it is unlikely that any change in policy or healthcare delivery will eliminate this disparity completely, I believe the gap can be closed significantly with a few key changes: increased utilization of telehealth technology, more satellite specialty clinics, and an affordable option for health insurance for self-employed individuals such as farmers.

The first change I believe that needs to be made in healthcare delivery is the further utilization of telehealth technologies. It would be a tough task to find a rural town in America that does not have access to the Internet. Sure, connections may be slower and computers may be older but the technology is still there. I believe that forming partnerships between the major academic hospitals and the rural hospitals surrounding them is a major first step in implementing telehealth programs. This would allow the physicians at rural hospitals to consult with specialists and improve the level of care patients can receive in rural hospitals.

In addition to expanding telehealth technologies, satellite clinics are also woefully underutilized in rural areas. I believe more satellite clinics in rural areas would vastly improve the quality of care rural residents


receive. In my hometown, for instance, an orthopedic surgeon comes down from his main office in a larger town bi-monthly to see patients in our area. This allows patients to get specialist care close to home. Although a town with a population of approximately 2,500 isn’t large enough to justify a full time orthopedic surgeon, his clinic is always busy on the two days a month he is there. 

Both of the first two suggestions I make for changes in healthcare delivery tackle the geographical barrier standing between rural residents and better health. It’s obvious that many people in small towns just do not have the means to travel great distances for care. First, it’s expensive. Second, it can easily take an entire day. People who live in the city can miss two hours of work for an appointment. For many people in small towns, they have a two-hour drive one way just to get to the physician they need to see.

My final suggestion for improving healthcare in rural areas tackles the financial barrier standing between many residents of rural communities. Although I know finances are a barrier for many people across the country in receiving healthcare, small town populations face unique challenges. From what I have seen growing up in a small town, a large portion of residents are self-employed. One of the first


A current second year medical student at the University of Kentucky, Alex is from Russell Springs, KY and attended Western Kentucky University for his undergraduate degree in Biology. His beautiful wife, Julia, is a nurse in the NICU at UK.