Rural Health Reform

        My friend and colleague, Dr. Therese Zink, is on the move.   She is the Med School Professor organized the Country Doc Compilation due out in 2010.  (I ain’t gonna let y’all forgot old Dr. B has an article in it!)

        Well, she’s done it again.  She’s now joined forces with the blog world, and has a new forum to address the problems faced by Docs like me.  Man, I heard Obama’s people will read this thing, so it is big.  

        I have a notion before it’s all over, Dr. Zink is gonna be like a female Moses and lead us all to the Promised Land.  One thing is certain- she has a very good handle on the problems faced by everyday Country Docs like me.

        Y’all check her out.  Here is her address:

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6 Comments on “Rural Health Reform”

  1. Julius Says:

    Thank you for posting this, otherwise I would have not known about it. So far I only saw one thread, but there are some good comments on that thread; well worth the read. Richard brings up a good point, concerning single-party insurance (national healthcare) and doing away with the private insurances and so forth. Others post numbers concerning the percentage of docs within rural areas compared to the metropolis areas. I agree that the rural areas are well underserved. I first came to medical school thinking I would go back to my hometown to serve the area that raised me. However, after attending one of the more expensive medical schools in the country, and will be in much greater debt than the average coming out of medical school, my focus has already shifted from family practice to internal medicine. Although it is still primary care, it does not serve always the purpose of the family doctor. As my current preceptor tells me, he knows more about the patients in his area and will know more about them than someone three times smarter than he that first comes to the area. He already knows what is going on with the patient just by seeing the name of the person than I can/could gather from the patient in an hour. In addition, as much as I wish it not, my focus may even still change to something more specialized, such as cardiology or pulmonology, just so I can repay that debt and be able to live. As much as I’d like the healthcare system to stay as it is from the perspective of getting ready to get into practice, the system definitely needs a change somewhere. A lot of it is from underinsured patients, who the rest of us have to pay for, increasing the costs. Another is from uncalled-for lawsuits, which increased the malpractice insurance, thus causing doctors to run a “shotgun” approach to medicine–ordering labs and imaging studies just to make sure something is not missed. Part of missing things is because patients are seen by physicians say 15-20minutes, 4 or less times per year–that is less than a percentage of that person’s life in units of time for that year; not everything is going to be found. So, it’s not just one character causing the healthcare system to become disorganized, but it’s a little from both sides adding up to the whole.

    Although I do hate to see change; change is inevitable. I only hope that it’s for the best. I will sit back, continue to learn patient management and work on my studies, and see where this goes; as this next year will probably bring major changes in healthcare, I will be thrown right into the middle of it when I finish medical school, for better or for worse.

  2. Will the Promised Land include a health care system that I don’t have to fear [with a shiver down my spine] when I think of it? I sure hope so. I am literally fearful of going to college next year because I’ll need to deal with this…

  3. drtombibey Says:


    Man I hope they read your comment, because it touches on many concerns that make it very hard to be a primary care Doc. One is very simply the students can’t pay back their loans on what they make.

    It reminds me of an old farmer. When asked what he would do if he had a million dollars he scratched his head and said, “I guess I’d keep on farming till I ran out of money.”

    Dr. B

  4. drtombibey Says:

    ms. slightly,

    Whatever Promised Land is delivered won’t be that if it doesn’t put the patient at the top of the list.

    It is sad, but everyone is scared of the system now. It only takes one big illness to change life forever, both in terms of health and finances.

    One thing I advise young people to do is at least try to keep catastrophic insurance. Sometime in college you can get lucky and get some things done at student health services.

    Dr. B

  5. Mrs. Chili Says:

    Oh, sure, Doc; JUST what I need – ANOTHER blog to read. Healthcare is important to me, though – I’ve got a disabled, unemployed, uninsured mom who was diagnosed with throat cancer last year, so I’ve got a pretty up-close and personal view of how one illness can change EVERYTHING – so I’m paying attention to policy and reform…

  6. drtombibey Says:


    Bless her heart, chili. Those are exactly the kind of situations that personify the problems nowadays. I am sure it is not easy to get all the care she needs.

    Dr. B

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