Rural Health Day: The Story of our Rural Health

Americans gather on the fourth Thursday of November to give thanks. But on the third Thursday, a lesser-known national observance celebrates the selfless service and community-minded spirit of providers and employees in rural healthcare. In the following interview with Rural Health Clinic Administrator Michelle Whalley, Ridgecrest Regional Hospital explores the challenges of providing rural care, the local milestones in expanding and improving care, provider investment, ongoing advocacy, and the future plans for protecting access to quality healthcare in our remote community.

Rural Health Clinic: our portal to world-class care

Since opening the Rural Health Clinic in 2010, Ridgecrest Hospital has expanded access to services in obstetrics, pediatrics, family medicine, mental health, dental, urology, gastroenterology, nephrology and more.

This stands in particular contrast to the national trends in obstetric and maternal health services that collapsed due to clinical shortages and financial constraints, with 165 rural hospitals closing these units between 2004 and 2014.

“This has been a real labor of love,” said Michelle Whalley, Rural Health Clinic administrator. “We are extremely fortunate to have the excellent pre-natal and obstetric services at RRH.”

Almost 20 percent of rural communities lack mental health services of any kind.

“While we are not yet fully meeting the need, we are focused on growing our mental health services,” said Michelle Whalley, Rural Health Clinic administrator.

Current offerings include outpatient psychiatry, therapy and substance abuse counseling services 5 days a week, as well as caring for the residents of Bella Sera.

RRH also worked hard to secure a contract under the “VA choice” program, making it possible for veterans to receive primary and specialty healthcare locally.

During the last several years, RRH has also consolidated its offerings so that providers and services that historically were not available to the un- or under-insured are now more accessible.

“The question of how to provide high quality, sustainable health care to our community has become paramount in recent years,” said Whalley.

“We don’t want our patients to make their decisions about healthcare based on what they can afford, or how far they have to drive — we want them to be able to make decisions based on their needs.” Rural Health Clinic services continue to bridge the gap between critical services and those most vulnerable and in need.

Challenges of rural health care, crisis fatigue

“Today’s healthcare workers are tired,” said Michelle Whalley, Rural Health Clinic administrator for Ridgecrest Regional Hospital. “This includes everyone from frontline staff to the behind-the-scenes staff — our environmental services team, our greeters, our excellent clinic teams, our volunteers and our leaders. They are the heart and soul of this organization, and I am proud to work alongside them.”

Local professionals were still recovering from 2019 earthquakes when the 2020 pandemic kicked in (the effects of which linger almost two years later).

But for those in rural healthcare, those temporary challenges only compound the inherent obstacles of providing high-quality medical care to individuals living in remote communities. In the United States, about 25 percent of the population live outside of major cities. But only 10 percent of providers practice in those communities.

Chronic illness is significantly higher in rural areas, exacerbated by factors such as isolation, increased poverty and overall aging are key reasons why.

The physician who chooses a rural life typically cares for an underserved and aging population, which is often less healthy and affluent than its urban and suburban counterparts. And for communities like Ridgecrest, the closest alternative for specialized care is 100 miles away.

“These unique challenges are what drive us, and we have addressed our challenges head-on,” said Whalley. “In fact, our dedication is stronger than ever.”

‘This is our community, too’

Providing healthcare to patients and families in a rural area has its challenges, but also some special rewards. At Rural Health Clinic, providers are deeply connected to their patients and communities, are and driven by a passion for what they do.

“When you look at everyone employed at Ridgecrest Regional Hospital, we are not just taking care of the community, we are caring for our own families, friends and loved ones. It is personal,” said Michelle Whalley, clinical administrator of rural health.

“I was born and raised here,” said Whalley, who was instrumental in helping open the Rural Health Clinic in 2010.

She moved away for college, and has spent time overseas, but keeps coming back to the place where her extended family lives. “Many of our staff and providers are in the same situation.” Having those kinds of roots, and an extended family, enhances the investment of those who serve here.

“I have lived other places and worked for other nonprofits, but it is different when the nonprofit you are supporting is about building and caring for the community you are a part of.”

Dr. Larry Cosner, another early champion of opening the Rural Health Clinic and its first medical director at RRH, has a story that parallels Whalley’s.

Cosner was born and raised in Ridgecrest, “and I was delighted to come back here to practice medicine because it is a wonderful community, full of wonderful people, and a great one in which to raise a family.”

Even when Cosner began his practice in 1986, Ridgecrest was in need of primary care physicians. “And it was, and is, a fabulous community to live in.

“The population served by our Rural Health Clinic — and indeed all populations which depend on such clinics — are among the most underserved populations, medically speaking. And so serving them is not only filling a deep need, but also taking care of a group of patients that is often the most kindly and thankful for the care they are being given. Which makes it doubly rewarding!”

Future offerings of Rural Health Clinic

“Service expansion is one of our highest priorities,” said Michelle Whalley, Rural Health Clinic administrator.

RRH has successfully recruited many well-trained primary and specialty care providers over the years, and is looking to branch out into others. While some options are available through local clinics and telemedicine consultations, there is a critical shortage nationwide of physicians in primary care, psychiatry, obstetrics-gynecology and pediatrics — and local recruitment efforts to bring in more have been ongoing.

“I am confident that our tremendous leadership teams and staff here have the vision to continue to innovate. Developing approaches to health care delivery that work for us, solutions addressing local challenges. Our focus on maintaining and increasing access continues, our community should be able to conveniently and confidently access services such as primary care, dental care, behavioral health, emergency care, and many other health and community services,” said Whalley.

“In the coming year, RRH is committed to continuing to explore and expand services in response to needs for our community, who are always at the heart of everything we do. I am grateful for the RRH team’s efforts, and their invaluable service to the community.”

Providing comprehensive services requires working to eliminate barriers. “The primary challenges are funding and transportation,” said Whalley. “We have made a lot of progress, but we are still working on improving those areas, as well.”

‘We have to have a voice’

The needs and delivery of healthcare, as well as the health and vitality of our economy, continue to shift on a domestic and global level. The leadership team of Rural Health Clinics, as well as Ridgecrest Regional Hospital in general, are constantly evaluating these changes to determine how to maintain accessible, comprehensive care.

“While regulatory influences and rural policy changes are targeted to ensure that care is accessible and high-quality, there are also drivers for value-based care and adopting population health approaches to deliver care at the lowest cost,” said Michelle Whalley,

The best level of care is offered when patients have access to preventive services, and early referral and treatment, at the early onset of symptoms. But historically, those without insurance wait until their healthcare reaches a level of crisis.

This is not only dangerous for the patient, it is the most costly form of care delivery. “The regulatory drivers behind value-based care are aimed at ‘bending the curve’” said Whalley. This means engaging in prevention, screenings and other services that make patients healthier and while reducing costs.

Whalley said that keeping patient health at the forefront of decision-making is a powerful motivator for our local healthcare professionals. “Sometimes it means we have to do more with less. But we know that when we are successful, our community benefits.”

Whalley said that our residents often feel overlooked, but this is very representative of what happens in rural America.

“We have to have a voice,” she said. That voice is strengthened when we partner with other rural communities, organizations and associations facing similar challenges to advocate at the policy- making level.

“There are always threats to us as an organization, as a community. Sometimes our legislators propose sweeping changes that do not serve areas like ours. So we work with our elected officials to make sure we are protecting our ability to serve our community,” said Whalley.

“And remember, we ARE the community. This is very real for us. We will always take care of each other.”