The challenges and rewards of rural medicine

From Kevin MD

Rural medicine, I guess, can be defined as health care that happens in places that aren’t big cities or referral centers. The vast majority of the populated earth’s crust that has any health care at all is served by rural practitioners. I have done a little bit of rural medicine in Haiti, in Mexico and now a bit more in South Sudan. I have also worked in a rural health care system in Idaho for nearly 20 years. People benefit hugely from health care delivered to them in their less densely populated home turf, despite the fact that health care in such locations lacks technology and specialist services that are often available cities or university medical centers.

In the US, most rural health outposts are within an hour of a major medical center, either by ambulance or helicopter, so transfer to a high tech center is usually possible when there is an indication. In developing countries people are often grateful for any medical care that can be provided and transfer to a higher level of care is much slower or impossible.

When a person in the US discovers that he or she is very sick they usually call an emergency medical service team which sends at least 2 trained medical technicians within a few minutes to evaluate the patient and transport them to a hospital if that is necessary. In some areas like the Alaskan bush and truly isolated parts of the US this is not true, but the vast majority of non-city dwelling Americans have access to emergency medical services. In rural South Sudan a person who is very sick will first receive any folk remedy available and if that is not effective, will begin the long journey, on foot or carried on a litter by relatives, to the nearest health care facility. Such a trip may take days.

Continuing story on KevinMD


Rural medicine in important in many countries. A field often shunned by doctors due to the lure of a city career. In Malaysia, it is often by force that doctors are required to serve out time in rural areas. This article illustrates the challenges of a rural practice.

Perhaps the final line sums it up well ” There is so much that they can’t do, but, much more importantly, so much that they can do. ”

Malaysia needs to make rural medicine interesting. Offer good career prospects and get peers to share their interesting experiences with the medical students and new graduates. It is then hoped that doctors will choose to serve in rural areas, where the need for better medical services is apparent.

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