Saturday evening, I came upon a documentary film in the Independent Lens series on PBS about the problems facing a part of rural America in providing health care to a poor, mostly elderly, and under-served population.
The film, The Providers, presented a very human face to the physician shortage, as well as the opioid epidemic in rural America, specifically by following three healthcare professionals at El Centro, a group of safety-net clinics that offer care to anyone who walks through the doors in northern New Mexico.
The providers in the film are Matt Probst, a Physician’s Assistant, Leslie Hayes, a Family Physician, and Chris Ruge, a Nurse Practitioner.
The first clinic shown is located in Las Vegas, New Mexico, a far cry from that other Las Vegas, many of you have gone to for conventions and gambling trips. The population of this Las Vegas is 13,201, and the per capita income is $15,481.
As the opening segment states, in 2016, 70,000 deaths in rural American could have been prevented with better access to health care.
Among some of the other points the documentary brings to mind are:
- Hospital closures due to cuts to Medicaid
- Failure to expand Medicaid, or repealing expansion Medicaid under the ACA
Chris Ruge, the Nurse Practitioner, is part of a program funded by insurance companies called ECHO Care™, which is an innovative program designed to improve access to primary and specialty care for patients with complex needs while also reducing the cost of care by utilizing a multidisciplinary team-based approach. In New Mexico, the ECHO Care program expanded the capacity of primary care clinicians through:
- The assembling, training and placement of “Outpatient Intensivist Teams” (OIT) which dramatically improve care and reduce costs for the Medicaid beneficiaries served in this program.
- Special teleECHO™ clinic designed to support the OITs as they care for patients with significant multi-morbidity, including mental health and substance abuse.
At some point, as the viewer will learn, the companies funding the program want to terminate it, but the CEO of the clinic wants to continue it, whether or not it makes a profit, as long as they break even, because she recognizes the benefits outweighs the cost and profitability.
In order to make sure that they can continue to provide health care to the community, both in Las Vegas, and in another town, they are recruiting from the local high school for students interested in careers in health care.
This was a very eye-opening film and should be watched by anyone who cares about health care and access to care for rural populations, and those who deal with patients suffering from substance abuse, either opioids or alcohol.