Healthcare for Rural Residents Improving

by Senator Dave Cox

The availability of health care and access to medical professionals can be challenging in rural communities.  Many people living in California’s more remote areas have trouble accessing health care.  It is not uncommon for residents to travel long distances to see a doctor and to experience delays in medical attention.  Efforts to improve healthcare accessibility for all Californians must be a priority.

Fortunately, access to health care now will be more readily available to rural communities through the technology of telemedicine and the Rural-PRIME education program at UC Davis.

Through the hard work of rural lawmakers and stakeholders who worked together with members of Congress, including Congressman John Doolittle, California received a $22 million grant from the Federal Communications Commission (FCC) to improve health care for rural residents by establishing a statewide communications network using broadband technology.  I was pleased to support this effort.

The distribution of the grant funds is being worked out by a coalition of advocates for rural interests, the California Telehealth Network.

Dr. Thomas Nesbitt of the UC Davis School of Medicine is helping to lead this effort along with Dr. Cathryn Nation in the University of California’s Office of the President.  They are tackling everything from surveying the needs of residents to helping coordinate an advisory board that will provide direction for the new network.  The advisory committee will consist of representatives of the Governor’s office, the California Emerging Technology Fund and the Public Utilities Commission.

While the finer details of implementing the project are still being developed, the main feature will be the ability of rural residents to “talk” to health-care experts in distant locations about their ailments. Telehealth and telemedicine services provide patients in rural areas with access through videoconferencing to critically needed medical specialists that typically work at academic medical centers and hospitals in large urban areas.

With this technology, specialists can monitor patients, make diagnoses and assist in treating patients who may be located hours away in a more remote area of the state. Residents soon will be able to track the progress of this telehealth project online through a Web site that is currently being developed.

Another improvement to rural health care is the expansion of medical training within the entire University of California system, including UC Davis.  The UC system plans to increase its medical school enrollment to 1,000 by the year 2020 and open a sixth medical school.  Last year, thanks to voter support through Proposition 1D in 2006, UC Davis School of Medicine was able to expand its entering class size for the first time in a generation, from 93 students to 105 students. The 12- student increase is a direct result of the UC system’s “Programs in Medical Education” (PRIME) which, at UC Davis, is called Rural-PRIME.  More information on this program can be found at: www.ucdmc.ucdavis.edu/medschool/rural_prime/.

Compared to the state's urban areas, rural populations typically have fewer health-care providers per capita and suffer from higher rates of chronic disease, hospitalization and cancer deaths.  By establishing a rurally focused curriculum and training more doctors each year, UC Davis can help address these issues.

The new program is focused not only on training future doctors for careers in rural communities, but it is also designed to recruit students from rural backgrounds who have a strong desire to return and practice in communities similar to the ones in which they were raised. Plus, they will be guided and mentored by experienced physicians who live and work in rural areas themselves.

Rural-PRIME combines a M.D. with a master’s in public health over the course of five years.  The first two years are the same for every UC Davis medical student. The third year consists of several four- to eight-week clerkships, which will include immersion in local communities and training at rural clinics and hospitals.

During the fourth year, students complete their master’s work, which will require the study of a rural health issue.  In their fifth and final year, students in Rural-PRIME take electives and special study modules focused on rural medicine. They may also go back to rural communities and continue to learn on-site.

Throughout their five years of medical school, UC Davis’ Rural-PRIME students will have numerous opportunities to train and live within rural communities.  The university is utilizing every possible tool to assist students in learning how to care for those residents living in remote areas of the state.  Using high-speed broadband connections, “rural learning labs” will provide video links to connect the medical students, patients and physicians with faculty and specialists at UC Davis in Sacramento.  The infrastructure for such connections will be funded through the FCC’s $22 million grant.

Real progress is being made to improve rural health care.  The University of California’s expansion of its medical program and the federal government’s grant of $22 million are great examples of what is being done to make health care more accessible to those living in remote areas of California.

Given its record of innovation and achievement in providing access to the underserved, UC Davis is already implementing these programs successfully and helping provide the type of health care every community deserves, no matter what its size or distance from an urban or suburban area.  New and expanded telehealth programs will help bridge geography and distance and can save money and time.  The university’s Rural-PRIME program complements this high-tech effort by specifically identifying and training new doctors who possess strong affinities with rural California and are dedicated to increasing access to better medical care.

While there is more work to be done to improve rural healthcare, these developments are moving in the right direction.

Cox was elected to the State Senate in November of 2004. He represents the residents of the First Senate District, which includes all or portions of Alpine, Amador, Calaveras, El Dorado, Lassen, Placer, Plumas, Modoc, Mono, Nevada, Sacramento and Sierra Counties.