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National Rural Health Day: Education’s role in meeting the expanding health care needs of rural communities

Cascades East
Joyce Hollander-Rodriguez, M.D. (left) gives Oregon Governor Kate Brown a tour of the Cascades East Family Medical Clinic in Klamath Falls, January 24, 2017. (OHSU/Bob Applegate)

Twenty percent of the U.S. population lives rurally. Traditionally, rural individuals tend to be sicker, poorer and older than their urban counterparts, yet only 10 percent of physicians practice in rural areas. Given this clear imbalance, it is necessary to question whether all communities -- both here in Oregon, and across the country -- have the same opportunities to achieve health and access to necessary health care.

As we observe National Rural Health Day – a recognition of all who work for health in rural communities – I am struck by the importance of addressing rural health care needs as we work to come together as a medical community and as a nation.

Experiential rural health education is key to expanding our rural workforce, filling health care gaps and making broad health care access a reality.

Twentieth century medical education reformer Abraham Flexner noted in 1914, that “medical education is not just a program for building knowledge and skills in its recipients … it is also an experience which creates attitudes and expectations.” With this and the ever-evolving medical landscape in mind, health care professionals and educators now work to broaden and advance student training to increase hands-on clinical experience in rural and underserved settings.  OHSU’s Campus for Rural Health is a prime example of such innovation.

The OHSU Campus for Rural Health allows dentistry, medicine, advanced practice nursing, physician assistant and pharmacy students to learn together in an interprofessional environment across rural communities. Here, they gain clinical experiences while giving back to the community through a longitudinal, community-engaged project that addresses a local health issue. Both the interprofessional learning experiences and the community project focus on understanding the rural context within which we provide care.

Successful rural health professionals must be adaptable, courageous and comprehensive, demonstrating humility and awareness of their limits while succeeding in the face of scarce resources. They must be collaborative, reflective and resilient, showing integrity and being responsive to their community. I see these attributes in my colleagues working in rural health every day. I am humbled and grateful to work with people who choose to go to communities with unmet health care needs, to live in and serve these communities for decades. Despite this arduous calling, they do their work with joy and take the time to teach the next generation. They are the heroes whom we celebrate today.

The attributes described above are not unique to rural health providers. My hope is that we cultivate these qualities in all of us. However, we notice such characteristics more acutely when we see providers working in areas of greatest need, and our rural communities are one of these areas. Rural rotations allow our learners to see these qualities highlighted, and it gives the learner opportunities to foster these qualities in themselves. OHSU’s Campus for Rural Health has designed a curriculum to foster recognition of the rural context of care,  including potential barriers to health in rural areas, and to promote reflection on what it means to be a successful rural health care provider.

Rural communities can be the much-needed microcosm in which our learners become the ideal health care professionals that rural Oregon, and rural America, needs. National Rural Health Day allows us to celebrate our rural health care providers and to reflect on the ways that we can educate a health care workforce ready to serve our rural communities.

After all, we know that health begins where we live, learn, work and play.

Joyce Hollander-Rodriguez, M.D., is regional associate dean for the OHSU Campus for Rural Health – Klamath Falls.

Governor Kate Brown declared Nov. 16, 2017 as National Rural Health Day in Oregon. National Rural Health Day is an opportunity to honor the selfless, community-minded spirit that prevails in rural America. The observance brings to light the unique healthcare challenges that rural citizens face, as well as the efforts of rural healthcare providers, State Offices of Rural Health and other rural stakeholders to address those challenges.


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