Rural areas in desperate need of dermatology care

Dermatologists from rural areas in the U.S. made a plea for their peers to come join them in Monday’s session, “Dermatology in Rural America” (U094).

Robert T. Brodell, MD

“We have a significant problem with access in rural health care,” said Cindy Firkins Smith, MD, an adjunct professor of dermatology at the University of Minnesota and the CEO of Carris Health in Willmar, Minnesota. She said that 30 million Americans live more than one hour from a trauma center, and 673 rural hospitals are currently at risk of shutting down. Accidental deaths are already 50% higher in rural areas, due in large part to the distance from an ER, a percentage that will likely increase if facilities continue to close.

This is an indicator of what’s to come for urban and suburban health care as well, said Dr. Firkins Smith. “Rural America,” she said, “is the ‘canary in the coal mine’ for health care professional shortages.”

Problem identification

Dermatologists are in short supply in rural areas,  Dr. Firkins Smith said, and those dermatologists are aging and not being replaced as they retire. This leads to more aggressive malignancies, more inappropriate, delayed, or unobtained care, and increased expense for patients in those areas.

How to fix this problem? Dr. Firkins Smith said rural state medical schools often don’t have dermatology teaching programs. Limited exposure, she said, tends to lead to less interest. Rural students themselves are at a disadvantage; how can they get dermatology exposure if it doesn’t exist in their areas? Dermatology, she said, needs rural residencies.

“We need to serve people in rural America as well as we serve them in urban America,” she said.

Getting more access

Robert T. Brodell, MD, professor and chair of the department of dermatology at the University of Mississippi Medical Center and an instructor in dermatology at the University of Rochester School of Medicine and Dentistry, has been working to help Mississippi’s rural areas get access to dermatology.

In addition to satellite clinics, Dr. Brodell has helped to institute volunteer dermatology clinics in the Delta, one of the poorest regions in the country. This practice is not driven by a profit incentive, but rather simply to provide access to a dermatologist at Rolling Forks High School once per month.

Dr. Brodell is also pleading with young dermatologists to come to Mississippi, offering residency slots and salaries for those who can commit to a faculty position somewhere in rural Mississippi after residency.