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Northeast N.C. counties experiencing 'medical deserts,' forced to drive long distances for medical care

Doctor shortage 110819
Posted at 5:00 AM, Mar 10, 2022
and last updated 2022-03-12 16:15:31-05

GATES Co., N.C. - Gates County, North Carolina is an area along the North Carolina-Virginia state line.

10,478 people call Gates County home, including Emily Truman and her four kids.

“It's where I grew up and where I hope to raise all of my kids,” Truman told News 3.

Among the white picket fences, shops, post offices and water tower, for Truman, one thing's missing. No primary care doctor, pediatrician, or any physician.

“It's 45 minutes to a hospital. It's 45 minutes to anything,” she said. “I've moved my care to Elizabeth City, which is about a 45 to 50-minute drive to that doctor.”

She recalls one time when her 7-year-old daughter had severe stomach pain.

“We ended up going straight to Children’s Hospital of the King’s Daughters, which is over an hour to get to, and we would not have done that with a more local physician,” she said. “My husband or I have to stay here [at home] with the other kids. Having them in the backseat and unable to touch them and comfort them and care for there for that long drive can be stressful. You know when a child is not feeling well or they're hurt, they want their parents. Not having that for that long drive can be scary for them.”

News 3 Investigates dug through data from the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.

According to the data taken in 2019, Gates County was one of two counties in the state with zero physicians of any kind. This includes primary care, OBGYN, pediatrics and urgent care medicine.

“There's 100 counties in North Carolina, so 2 percent, the bottom 2 percent there is not a good place to be,” Truman said.

In another area of Gates County, Leslie Small came back to her hometown of Corapeake after graduating from NC State to be close to family.

Whenever she needs a checkup, it's across the state line at Sentara Obici Hospital in Suffolk.

“I'm very privileged. I have a car [and] I have gas money,” Small said. “I'm able to get to things outside of our community.”

News 3 took the drive from her front door to her doctor's office. The one-way trip ended up being just less than 35 minutes in good weather and no traffic.

“If it’s something where I'm like I need antibiotics today, I call the doctor. I hope I can get in, take off work, make up my hours later at night, and then come back and keep going,” she said.

The data from UNC breaks down the number of physicians from more than 50 specialties across the state.

When taking a look at other counties in northeast North Carolina, Camden County had one physician. Perquimans County had five physicians. Currituck had eight physicians.

That’s compared to other counties such as Dare County, which had 64 physicians, and Pasquotank County with 112 physicians.

“it's a substantial problem,” Dr. Saif Khairat with the Cecil G. Sheps Center for Health Services Research at UNC-Chapel Hill said.

Dr. Khairat studies health data at UNC. He considers Gates County a “medical desert,” or a county that doesn’t have a primary care physician or practice.

“That's not a recipe for overall health in this country.

Dr. Eric Wallen, a Professor of Urology at UNC-Chapel Hill specializing in studying men’s health, has been looking for solutions to this issue. Lately, he’s been working with community health groups, as well as people at the state level and at UNC, to deliver more access to health care.

“The more touch points you have with patient, the more times you interact with them, the better their outcomes are,” Dr. Wallen told News 3. “With funding, we might be able to dream some day of bringing a mobile health clinic that does have its own hot spot for internet access so we can have both physical and virtual appointments for patients in those communities.”

He and Dr. Khairat believe other solutions are training providers to serve their home communities and more opportunities for telehealth, given its rise in the pandemic.

“If you don't have a doctor in town, at least make telehealth, something like that, more accessible to everyone,” Small said.

“An established physician that people can know because I feel like the comfort of knowing your physician is also important,” Truman said.

Meanwhile, both Small and Truman will continue making the drive for doctors. They hope to eventually get more care closer to home.

“It upsets me, because I feel like our community is really good about giving back and taking care of others,” Small said. “Just because we live out in the middle of nowhere doesn't mean that we all don't deserve equitable access to health care.”

News 3 reached out to Albemarle Regional Health Services (ARHS), the health department serving eight counties across northeast North Carolina.

In response to our questions, an ARHS spokesperson sent News 3 this statement:

While limits in providers and health professionals in rural counties remains a concern, Albemarle Regional Health Services (ARHS), looks to a regional care model and integrated health to help our communities across the eight-county district access needed health care services. ARHS offers core and essential public health services in the areas of; Environmental Health, Solid Waste Management, Public Health Preparedness and Response, Health Education and Healthy Communities programming, WIC/Nutrition, Communicable Disease Control, Immunizations, Women's Preventive Health, Maternal Health including High Risk Maternity Clinic, Pregnancy Care Management, Child Coordination for Children, Child Health Services, Interpretive Services, Adult Health, Diabetes Care Management, Behavioral Health, Children's Developmental Services Agency, and the Inter-County Public Transportation. These programs and services offered across the region allow us to help bridge the gap in access to health care by connecting patients to many services under one roof.

ARHS is focused on patient-centered care and serves as a medical home for patients who could otherwise not afford services. Our multidisciplinary team of providers employs strategies to assess clients' needs, including social determinants of health, provides case management and integrated care services. In addition, ARHS is a Tier 3 medical home primary care provider. Utilizing a district model for services allows ARHS to offer services across county lines allowing for availability and access to care.

ARHS collaboratively works to meet the needs of priority populations by leveraging resources, implementing health programs, and sharing best practices, lessons learned, and referrals. ARHS has strong partnerships with local health care providers including the local hospital systems; Sentara Albemarle Medical Center, Vidant Bertie and Chowan Hospitals, and Vidant Roanoke – Chowan Hospital. External health and support services related and cross referral collaborations with Community Care Clinic, Roanoke-Chowan Community Health Center, the Albemarle Pregnancy Resource Center, Smart Start, Head Start, College of the Albemarle, PORT Human Services, Gates County Community Paramedicine Program, and other medial and behavioral health providers across the region. In a rural community where resources can be limited relationships with partner, stakeholders, and providers are key to ensuring community members have access to and are educated about where to seek care.

Routine medical supervision is under the direction of a local Physician who also serves as the Chairman of the ARHS Board of Health. The Medical Director and local OB/GYN physicians provide oversight and medical supervision to ARHS Nurse Practitioners. In addition, ARHS nurses complete Enhanced Role Registered Nurse (ERRN) training. ERRNs function in an expanded nursing role, with duties related to physical assessment and screenings. This model strengthens the delivery of care, as it allows nurses to provide additional preventive services by standing order from the ARHS Medical Director.

Any efforts or new initiatives that can help provide better access to care and help reduce barriers is always needed and appreciated. ARHS seeks out new partnerships and additional grant and program funding to help assure we are serving our communities and helping them access the best most high-quality healthcare they can receive.

ARHS has purchased and installed telehealth equipment at each local health department in the region to improve access and sustainability to healthcare services. ARHS patients are able to utilize telehealth services for strengthened accessibility to providers. ARHS also offers non-traditional service hours on Thursdays nights in addition to after-hours calls performed by ARHS nursing staff. Five of the ARHS health departments operate an on-site pharmacy for increased access for patients to receive prescribed medications.

ARHS also has a wellness bus that can allow us to provide needed healthcare services directly in the community.