Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

What happens when a community loses its health care providers?

Greg Smith, MD
Physician
November 2, 2016
104 Shares
Share
Tweet
Share

My father worked as a middle manager in the textile industry for many years after he graduated with a degree in textile engineering from Georgia Tech in Atlanta. As far as I know, he was the first to graduate from college in his family. I can only imagine how exciting it was for him to leave the little town of Cochran, travel to the big city of Atlanta, work to get a college degree, then go out into the world of work in the early 1950s. Business was booming, jobs could be had and an ambitious young man could go far if he just put his mind to it.

Things went well.

I was born and my brother came along four years later. My family was clearly living the middle-class dream: a nice, small brick home, two cars (one new, one used), food on the table and new school clothes from Sears every fall. I remember being very happy then, as happy as a kid could be in 1960s America, I think.

Something happened later on. When my Dad was clearly and firmly middle aged, he was laid off — downsized or rightsized or whatever they would call it nowadays. I only have vague memories of that time, but I don’t think my father was ever quite the same. The textile industry was pulling out of America shipping jobs to foreign countries where labor was plentiful and cheap.

My father would work various jobs until his untimely death at the age of sixty-two, but I can only imagine the pain he felt when he saw his beloved vocational framework slipping away. He was powerless against the tide of offshore industrial development.

Another community hospital closed its doors a few weeks ago in the small town of Barnwell, SC. We have a mental health center satellite clinic a stone’s throw from the hospital parking lot, and there was a freestanding medical clinic affiliated with the hospital twenty yards from our office. There are various stories and rumors about how the hospital got into trouble, but the fact remains that it could no longer afford to operate, and the decision to close came fairly precipitously, at least from the perspective of those of us who live or work in the community.

It was not the first and it will not be the last community medical facility to close. The fact is that it threw the town into a mini-crisis, leaving it to figure out how to manage medical emergencies, what to do when there is no emergency room to go to and how to establish new methods of caring for the needs of its citizens. Mental health was not immune to this, as we often used the hospital to evaluate, stabilize or refer mental health patients in crisis. The nearest hospitals for referrals are from seventeen to thirty-five miles away. Law enforcement, medical providers, ambulance services, probate court and other parties had to get busy creating new processes and lines of communication to ensure that services are provided when needed — even without a hospital. Telepsychiatry has become an active player.

It’s hard not to draw parallels between the textile industry of the 1960s and the medical industry today. Our services and institutions are not being shipped overseas for the most part, but small players are being swallowed by larger ones, the weak links are being forced to close, and managed care is moving in to regulate what remains. It is definitely a challenging environment to be working in, and I would certainly not call it fun.

As many small mill villages like the one I grew up in relied very heavily on that large manufacturing plant for jobs and security, many communities have been accustomed to having decent medical care close to home. When providers leave and hospitals close, the sense of security and safety often leaves with them. Communities are forced to think outside the box, come up with new links between the providers left behind or fashion completely new protocols.

I do not, like my father must have, worry about my job security. There are plenty of patients and plenty of positions in the mental health field and I do not see those going away soon, if ever. However, I mourn the loss of the small town family doctor, the local clinic and the community hospital. Some of these will never come back.

Health care in this country is going through tremendously stressful changes and passing on to a new system of health care provision.

I only pray that we never lose sight of why we all do this — to help the patients who need us.

To paraphrase Sir William Osler, one of the best physicians to ever practice the healing arts, maybe we should, “… listen to the system, and it will tell us what is wrong with it.”

Greg Smith is a psychiatrist who blogs at gregsmithmd.

Image credit: Shutterstock.com

Prev

A psychiatrist says don't spank your children. Praise them instead.

November 2, 2016 Kevin 3
…
Next

A physician's compassion well has run dry

November 2, 2016 Kevin 6
…

Tagged as: Primary Care

Post navigation

< Previous Post
A psychiatrist says don't spank your children. Praise them instead.
Next Post >
A physician's compassion well has run dry

More by Greg Smith, MD

  • The psychoanalytic hammer: lessons in listening and patient-centered care

    Greg Smith, MD
  • Clinicians are diamonds in the rough

    Greg Smith, MD
  • Shelter in the age of COVID

    Greg Smith, MD

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Emotional support animals for health care providers

    Brittany Ladson
  • Why health care replaced physician care

    Michael Weiss, MD
  • Behavioral health providers face challenges in value-based care

    Martin Lustick, MD
  • Turn physicians into powerful health care influencers

    Kevin Pho, MD
  • Health care needs more physician CEOs

    Alexi Nazem, MD

More in Physician

  • The harmful effects of shaming patients for self-education

    Maryanna Barrett, MD
  • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

    Wendy Schofer, MD
  • Skydiving and surgery: How one doctor translates high-stress training to saving lives

    Alexandra Kharazi, MD
  • Don’t be caught off guard: Read your malpractice policy today

    Aaron Morgenstein, MD & Laura Fortner, MD
  • The dark side of medicine: an urgent call to action against greed

    Don Gaede, MD
  • Dr. Glaucomflecken for president!

    Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The harmful effects of shaming patients for self-education

      Maryanna Barrett, MD | Physician
    • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

      Wendy Schofer, MD | Physician
    • The endless waves of chronic illness

      Michele Luckenbaugh | Conditions
    • Skydiving and surgery: How one doctor translates high-stress training to saving lives

      Alexandra Kharazi, MD | Physician
    • Telemedicine in the opioid crisis: a game-changer threatened by DEA regulations

      Julie Craig, MD | Meds
    • How this doctor found her passion in ballroom dancing [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Are We Losing the Personal Touch Because of the Way We Staff?
  • Orismilast Clears Skin in Moderate-to-Severe Psoriasis
  • Pediatric ICU Cases Becoming More Complex in Recent Years
  • New Combinations Promising in Advanced Urothelial Carcinoma
  • Embryo Development Delayed in Pregnancies Ending in Miscarriage

Meeting Coverage

  • Orismilast Clears Skin in Moderate-to-Severe Psoriasis
  • New Combinations Promising in Advanced Urothelial Carcinoma
  • No Survival Benefit With CRT Versus Chemo for Locally Advanced Endometrial Cancer
  • Ankle Sprain Physical Therapy Doesn't Shift the Pain Elsewhere
  • Use of EMR Directive Tied to Reduced Opioid Prescribing After Spine Surgery
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • The harmful effects of shaming patients for self-education

      Maryanna Barrett, MD | Physician
    • The power of self-appreciation: Why physicians need to start acknowledging their own contributions

      Wendy Schofer, MD | Physician
    • The endless waves of chronic illness

      Michele Luckenbaugh | Conditions
    • Skydiving and surgery: How one doctor translates high-stress training to saving lives

      Alexandra Kharazi, MD | Physician
    • Telemedicine in the opioid crisis: a game-changer threatened by DEA regulations

      Julie Craig, MD | Meds
    • How this doctor found her passion in ballroom dancing [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

What happens when a community loses its health care providers?
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...