COVID-19 Highlights Long-Standing Rural Health Care Provider Shortage

Mar 27, 2020

As the coronavirus continues to spread throughout the United States, we hear a lot about the shortage of Intensive Care Unit (ICU) beds. But there's another critical shortage, especially in rural areas, of health care providers.

When the first case of COVID-19 was confirmed in Park County, it turned out to be a Cody Regional Health Hospital employee. This sparked fear among the community about whether or not others in the hospital were exposed.

"That's not true, that's unfortunate, but people are scared. We understand that," said Doug McMillan, CEO of Cody Regional Health.

He said when the case was identified, the local public health officer, state health department and the Billings Clinic all assisted in an investigation.

"With that identified, [we] started with the individuals that are employees that tested positive during the times the employee was working, then we identified a number of employees that had potential exposure," said McMillan.

He said five to ten employees were sent home to self-quarantine since they were seen as high risk.

"We've been able to free up staff, as we've closed some of those departments for the safety of our patients and staff. And so we have been able to develop a essentially a labor pool," he said.

But this begs to ask the question, what happens if more health care providers at the hospital do get sick? For Alan Morgan, the CEO of the National Rural Health Association, it's not a question, it's an inevitability. It will happen.

"There have already been a couple communities that right now are really facing the surge of this case," said Morgan. "One rural community in Indiana has all the beds filled right now with COVID-19 patients and its clinical staff several, I think last I heard four of them, have been tested positive as well too."

And rural hospitals are especially at high risk.

"There have been long standing provider shortages in rural America. Almost by definition, rural is a health professional shortage area. So this has been a long standing concern," said Moran.

Wyoming is aware of this. Like many other states during this pandemic, the state has loosened regulations to allow licensed American doctors to practice in Wyoming even if they are not licensed in the state. Cody Regional Health is already taking advantage of this by bringing in providers from the Billings Clinic. But Morgan said rural areas are going to have to figure out more solutions.

"We're going to have a lot of creative solutions fast and going ahead. And that's going to happen in rural communities," said Morgan.

Jan Cartwright, the executive director of Wyoming Primary Care Association, said many health centers in the state have implemented a new system where a provider, medical assistant, and a front office staff are the only ones that come in contact with a patient during their visit.

"That way, if there were a patient who came in who was testing positive, then that team, of course, would have to self-isolate for 14 days, but it wouldn't wipe out the entire provider team," she said.

Cartwright added that hospitals, health centers and pharmacies are all trying to limit these human interactions.

"They have a walk in pharmacy, and they now have decided that they're going to take those prescriptions out to the patients to their cars, instead of having the patients come into the health center."

And it seems these efforts are effective in Park County for now. Park County Public Health Officer Dr. Aaron Billin said no matter what, there will still be more cases confirmed in the county.

"Every night, for the last three or four nights, I've been expecting a call from the state health officer informing us of a new positive result, but it hasn't happened. So to me, that's encouraging. And it tells me that we're on the right track," he said.

But Billin said for this to continue, it's really up to the community's cooperation with social distancing and non-essential businesses keeping their doors firmly shut. Morgan agreed.

"It's really important for local communities to isolate and take care of themselves and take this seriously just to keep their own clinical staff there present working and safe."

Whether or not residents follow that advice remains to be seen.

Have a question about this story? Contact the reporter, Kamila Kudelska, at kkudelsk@uwyo.edu.