Maryland's rural areas don't have enough doctors, report finds

Maryland’s rural areas don’t have enough doctors, forcing residents to travel elsewhere for some medical treatment.

Transportation is also a problem in rural areas, with many residents living far from towns and cities, making it hard for some people to get to the doctor.

Others living in rural areas can’t afford co-pays and high deductibles, so they sometimes skip getting treated.

These are just some of the barriers to adequate health care described in a rural health plan recently released by state health officials. The state contracted with the Maryland Rural Health Association to develop the plan. About 25 percent of Marylanders live in rural areas.

The next step is to implement recommendations to address barriers identified in the report, said Temi Oshiyoye, director of the Office of Rural Health at the Maryland Department of Health.

“We don’t want this plan to just sit on a shelf,” Oshiyoye said. “We want it to be a living, breathing document.”

The report defined rural Maryland as making up 18 of the state’s 24 counties, and some of the poorer parts of the state. Most of the state’s wealth is concentrated around the Baltimore and Washington, D.C., regions.

The Rural Health Association used information from focus groups, assessments from local health departments, Census data and a rural health work group set up by the General Assembly to come up with its findings.

Oshiyoye said the conclusions were not surprising but can be used as a guide to improving health care.

There are 20,188 physicians in Maryland — 4,133 of whom work in rural areas. The shortage means long waits for appointments, the report found. Some people end up going to the emergency room because they can’t get in to see a doctor. There is a particular shortage of dentists, the report found.

The report called for helping rural residents better control chronic conditions and coordinate care. It also said there is a need to better educate residents on health and insurance issues and look at ways to make health care more affordable.

“Numerous counties and focus groups discussed the difficulty of people adequately accessing and using the health care system, understanding their benefits, tracking costs associated with care and general use of their health insurance plan,” the report said. “While the onus to navigate the system cannot be put solely on the individual, people do need to be educated on how to use the system.”

Expanding telemedicine services could help get around the doctor shortage, the report found. It also recommended opening more school-based health centers, coming up with better ways to recruit doctors and improving behavioral health services.

The state will work over the next several months to implement solutions.

“Even though we don’t have a timeline, we are working very fast because we do want this to be a road map on how to deal with and address rural health issues,” Oshiyoye said.

The Maryland Department of Health, the Rural Maryland Council and the Robert Wood Johnson Foundation also collaborated on the report.

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