Category Archives: Barriers to care: logistics and transportation

Aug 19 2014
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Nurse Practitioners Make a Difference with Mobile Clinic

Nurse practitioners enjoyed prime time TV coverage when Sunday’s 60 Minutes program ran a segment about the Health Wagon, a mobile clinic serving six counties in an impoverished Appalachian coal-mining region in southwestern Virginia.

The segment, originally broadcast in April, highlighted the work of Teresa Gardner and Paula Hill-Meade, both doctors of nursing practice, who currently see approximately 20 patients a day in a converted RV, while also keeping up with up fundraising responsibilities related to the federal grants and corporate and private donations that keep the organization going.

Their patients “are people that are in desperate need,” Meade told 60 Minutes correspondent Scott Pelley. “They have no insurance and they usually wait, we say, until they are train wrecks. Their blood pressures come in at emergency levels. We have blood sugars come in at 500, 600, because they can’t afford their insulin. ...They have nowhere else to go.”

However, Gardner said, as demanding as the work is, “we get more out of it than we ever give.”

Watch the 60 Minutes segment on CBS News online.

May 2 2013
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A Personal Mission: Bridging the Oral Health Care Gap

Monique Trice, 24, is a University of Louisville School of Dentistry student who will complete her studies in 2015. Trice completed the Summer Medical and Dental Education Program (SMDEP) in 2008 at the University of Louisville site. Started in 1988, SMDEP (formerly known as the Minority Medical Education Program and Summer Medical and Education Program), is a Robert Wood Johnson Foundation–sponsored program with more than 21,000 alumni. Today, SMDEP sponsors 12 sites, with each accepting up to 80 students per summer session. This is part of a series of posts looking at diversity in the health care workforce.

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Diversity is more than ethnicity. It also includes geography, perspective, and more. I was raised in Enterprise, Ala., which is in Coffee County. The community’s demographic and geographic makeup set the stage for an oral health care crisis. Here’s how:

  • Enterprise is a community of 27,000 and just 15 licensed general dentists, three Medicaid dental providers, and zero licensed pediatric dentists to service Coffee County, a population of 51,000. In 2011, Alabama’s Office of Primary Care and Rural Health reported that 65 of the state’s 67 counties were designated as dental health shortage areas for low-income populations.
  • According to this data, more than 260 additional dentists would be needed to bridge gaps and fully meet the need. For some residents, time, resources, and distance figure into the equation, putting dental care out of reach. In some rural communities, an hour’s drive is required to access dental services.
  • Lack of affordable public transportation creates often-insurmountable barriers to accessing dental care.
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Growing up in a single-parent household, my siblings and I experienced gaps in dental care. Fortunately, we never suffered from an untreated cavity from poor oral health care, but many low-income, underserved children and adults are not so lucky.

Read more

Jan 4 2011
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Physician Faculty Scholar Studies Compliance with Illinois Law Requiring Prompt Transport of Trauma Patients

Marie Crandall, M.D., M.P.H., RWJF Physician Faculty Scholar (2008-2011), has an article in the December 2010 Archives of Surgery, in which she reports findings from her research into whether seriously injured trauma patients in Illinois are being transported to the care they need within a legally required two-hour period. Crandall and colleagues find that while just 20 percent of patients were transported within the required time period, the most seriously ill of the trauma patients were identified and transported rapidly. They also find no adverse effect on outcomes for patients whose transfer time exceeded two hours.

An abstract of the study is available here, and a story on it is available on the ORTHOSuperSite.