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Residents in rural communities face limitations in healthcare

Rural Healthcare (FILE)
Posted at 6:24 AM, Apr 03, 2023

LAKE ISABELLA, Calif. (KERO) — During all this weather the lack of resources in rural areas is a big concern, especially when it comes to healthcare.

Recent storms can have detrimental effects on rural residents quality of care and their ability to get to speciality physicians. That's why lawmakers and physicians are working to improve the number of doctors and specialists in these communities.

“You don’t want to miss, and really for your health you can’t miss," said Beth Gagnon, a resident of Onyx, California.

For years, Beth and her husband Bob traveled from Onyx, down Highway 178, to get to Bob’s dialysis treatments in Bakersfield. When Bob was diagnosed, treatment options were limited and required constant travel to either Bakersfield or Ridgecrest.

Beth said Ridgecrest was only an hour away, but their treatment center was full. So they made the trip to Bakersfield three times a week.

“You have to know you’re going to spend three whole days commuting in the car, waiting for dialysis, for him sitting there for 3 and a half hours on dialysis, me waiting for him,” she said.

The back and forth took over theirs lives and at times it posed serious risks. With Highway 178 always at risk of closure during winter storm season, Beth said they often had to push forward, taking back roads and other routes to still make his appointments.

“Last winter we had to go over the old canyon road which is very narrow, very twisty, windy, it was raining and snowing, it was very dangerous," she said.

After five years of treatments, Bob passed away this last winter. Beth, however, is still making her way to Bakersfield now for cancer treatment. While the journey is still difficult, she says she has to keep a positive attitude, just like Bob did.

“My husband kept a wonderful attitude. Then again we had one another, to pump one another up," she said. "I think of people who are elderly or alone. They have to find someone to take them down there.”

Alanna Costello and Olivia Hayostek work for Clinica Sierra Vista, running a clinic in Wofford Heights. Hayostek is a Family Medicine Physician and Costello is a Family Nurse Practitioner. Each of them says that referring patients to specialists can be difficult.

“It’s challenging for a lot of people," Costello said. “We treat them as anyone would in primary care, the challenge comes when we have to refer them out to specialties which we do a lot, out in Bakersfield or Ridgecrest. So we do what we can here, but when people need more specialized care we have to refer them out.”

Both Hayostek and Costello offer primary care services at their clinic. They see around 20 patients a day and around half either need or are already seeing a specialist. They say the lack of resources can be detrimental to their patients, especially if weather keeps them from being about to see a specialist and keeps them from getting resources.

“Right now a lot of people don’t have reliable transportation, they’re really ill, maybe they’re not able to drive so they rely on friends," Costello said. "Some can arrange insurance to give them but a lot are hesitant to travel for care.”

Along with the inability to provide special services in most cases, their clinic is understaffed, leaving the two providers booked out for months.

"Just access to more providers is helpful. Even just for us our schedules are very full, it can be months of a wait to even see one of us so primary care is impacted," Hayostek said. “I think the big issue is there’s a shortage of primary care physicians in this county, so if people have the option of where they are going to go, access to other things, limits who’s going to come here. I think it takes a special type of person to come and do rural health care.”

Some physicians and lawmakers in California are working to address some of these challenges.

“I have seen first hand the severe shortage of providers. The valley has 22% fewer primary care doctors than the state average," said 35th District Assemblymember Jasmeet Bains. “Since most residents stay and begin their careers where they train this has been an enormous opportunity to recruit physicians who understand our needs."

Bains worked as a family medicine resident in Bakersfield. She's now working in partnership with Physicians for a Healthy California to provide programs like CalHealthCares and CalMedForce.

“CalMedForce has funded 252 new and existing residency positions in the San Joaquin Valley, 37 in Kern County alone," Bains said.

CalMedForce, administered by PHC in partnership with University of California, increases the number of available residency slots in California’s underserved communities. CalHealthCares, funded with Prop. 56 tobacco tax funds, provides loan repayments on educational debt for physicians and dentists in exchange for a five-year commitment to provide care to Medi-Cal patients.

"The San Joaquin Valley has the lowest ratio of specialties per 100k residents," said Olga Meave, CEO of Clinica Sierra Vista.

While they work to improve resources for these rural patients in need, Beth had this to say for anyone experiencing the same struggle.

“We decided early on that we were going to do that and we were going to do it with the right attitude," she said. "You have to wake up everyday and make that decision.”

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