He beat COVID-19, but can rural health care?

By Steven Bartolotta

Dr. John GibsonIt started on Sunday night, October 25. Dr. John Gibson, TCOM’s Assistant Dean of Rural Medical Education, had been battling typical fall allergies, but then he lost is sense of smell…then his taste. He knew something was wrong.

Dr. Gibson tested positive for COVID-19 days later but, even worse, so did his entire household, which included his 64-year old wife and 91-year old mother-in-law. At 65 himself, Dr. Gibson is in the high-risk category, but his symptoms never rose to the level of concern.

“I was in contact with my primary care physician twice a day, monitoring my vitals and just making sure everything was okay,” said Dr. Gibson. He had an army of family and friends praying for his family’s recovery, and their story is one of success. The entire household, including his 91-year old mother-in-law, has beaten COVID-19.

The COVID-19 pandemic has walloped the health care system, but perhaps the most affected are rural health care communities. TCOM’s nationally recognized ROME program, that Dr. Gibson heads, has been training students to practice health care in rural communities after graduation and residency, and that landscape may be changed forever.

“It’s affected every rural community in Texas and the hospitals have been completely overwhelmed” said Dr. Gibson. “Many lack ICU’s and they are struggling. I’ve called many of my former TCOM students and residents and it’s hard not hold back the tears to hear how much they are hurting.”

One of those alumni, Dr. Robert DeLuca, who is practicing in Eastland, Texas, has seen firsthand what the pandemic has done to the community.

“Over the last few weeks, we have been unable to admit to our hospital due to lack of nurses and personnel,” said Dr. DeLuca. “We have a critical shortage of nurses, and respiratory therapists and we only have three ventilators.  A significant surge in cases that may overwhelm our ER.  Transfers to other larger hospitals is sometimes very difficult as their ICU’s are full too.”

The population in Eastland County is 22,000. The total number of coronavirus cases reported thus far for the county have been over 400, including two deaths. But since October 1, the number of cases has risen a staggering 51 percent. The local healthcare community is fighting to hang on.

“Almost every ROME student has seen a COVID death on their rotations in rural Texas,” said Dr. Gibson.   “It’s pretty hard when you’re a student with a rural preceptor with so many people in the hospital. Our students have been troopers; they have seen people die but they have also seen people survive.”

For Dr. DeLuca, and his wife and fellow TCOM graduate Dr. Valerie DeLuca, they worry about the long-term affect that the pandemic will have on rural communities and their profession.

“For many hospitals, this may mean closing the doors,” said Dr. DeLuca. “The loss of resources, lack of staffing and the high rate of uninsured in Texas places higher burdens on smaller hospitals.  It is likely many will close during this pandemic as finances become strained.”

Nobody knows what the future holds for rural or urban health care systems in the post-pandemic world. Telehealth and mobile medical care are options for rural health, but that can never take the place of a face-to-face visit with a physician. Accessibility to these types of technology and new methods of care may also be limited to those in rural communities.  One way forward though, as Dr. Gibson sees it, is to continue the training of ROME students and getting them into the rural healthcare communities as quickly as possible.

“Rural health deserves access to the best medical care. It might not be present in their communities all the time, but we can develop advanced care,” Dr. Gibson said. “We have the personnel that are training in rural medicine, but they need a place to go. If we can get an infusion of funding for rural health, then we can get these young people back to their communities making a difference.”

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