My father's best friend while they grew up in India practiced in rural Missouri and we went out to visit him a few times. He was making a killing as basically the only specialist there for miles and miles (I think he did something nuero...) So yeah, being the only doctor for a huge swath of people is very real
Oh man , I’ve transferred a few patients starting with “this 80 year old farmer…” I usually get cut off with, “great, send them in!” “Don’t you want to know what’s wrong with them?” “”No, we’ll have every specialty on standby to treat them when they make their one-time life appearance “
My dad was 92 when he saw a doctor for the second time. The first time was his induction physical for WWll. He was amazed that he could just pee out all the fluid building up in his tissues. It kept him alive for four more years.
Oh man, Darlene I feel seen. With my 5th kid the doc had a med student with him and he told the student they could catch. The med student looked absolutely terrified and looks at the doc and asks if I should be pushing already. The doc does not even look up and says, "its her 5 baby, she knows what she is doing." LOL.
I was my mum's 4th child the nurses didn't even bother the Dr on call (rural hospital he was busy with another patient) they just let Mum do her thing. Unfortunately unlike my siblings I was born not breathing so the nurse had a little work to do and by the time the Dr had arrived I was breathing and everything was fine. Edit: he did do the paperwork to register my successful birth.
I love Rural Medicine. He's like the Johnathan of doctors, just making everything happen, no matter how crazy it is. Plus he's the mayor (assuming he didn't lose to that goat)
Really thought he would agree and come over and join. But Rural medicine seems as rushed as ever and decided to quickly interrupt reflective silence by shutting down the consideration with an implied word in his mouth.
I literally has a stack of faxed hand written medical records from my pediatrician. My pcp in the city admîtes to not making it through and was surprised they were hand written. I’m only a twenty soemthing but this was the standard of care twenty minutes outside a major city
The fact that he names Texaco Mike by name during his shutdown of Surgery, shows the level of respect Texaco Mike has earned from his many years of supplying the Rural hospital. Texaco Mike sounds like the kind of guy you want with you during your operation.
I love how dedicated to the job the rural Healthcare workers (including Texaco Mike) are! Those hospitals really are lacking equipment and professionals, unfortunately not many people want to work there - nice call out!
@@vidal9747 Private hospital run by doctor is possible, and it can be unprofitable financially, but if trade and barter work and you can get medical supplies, it can keep running.
Most rural hospital are not for profits. Usually they're satellites of a large hospital in an urban area. That one hospital may have two to four rural satellites in a 200 mile radius. Those satellites funnel patients to the large hospital and usually can keep a patient for 24 hrs if they need observation. They may also have a specialist come in once or twice a month to see patients. They're also highly dependent on state and federal money for grants. This is what I've seen in New England. I imagine out in the midwest/west those distances are at least double if not triple. Also in NE, those satellite hospitals are fed patients from local health centers, which usually have agreements with them and the main hospital. Those health centers are also recipients of lots of state and federal money/grants. The satellite hospitals are almost always established hospitals that were in place for decades until they couldn't afford to offer services anymore, and the urban hospital took them over.
I foresee a time when most medical care will look and feel a heck lot more like rural medicine. Good thing there are resilient people and resilient doctors.
@@queenbunnyfoofoo6112 and in the case of Oklahoma, many rural hospitals are closing because they don't have enough resources. If it's the same in New England then I wouldn't necessarily be surprised but if not then all the better.
I’ve been a surgeon foe 28 years at level 1-4 hospitals. I was always taught to accept whatever was referred no questions asked. If the other centers called for help, it was the patient we were serving. I found working at level 1 centers to be by far the easiest as they have everything needed to provide care. Working in level 3 and 4 centers is the most challenging with limited and often non existent support services. Trying to get patients transferred is a constant battle with some dying while waiting to be accepted. Anytime I get a smug surgeon telling me I should be able to care for whatever problem at my facilityI say I agree, I should be able to, but we can’t. We don’t have the specialties or services available for appropriate care, and I invite them to come out and see for themselves.
Thank you for your hands-on understanding of smaller healthcare centers. Your patients are quite lucky. As an anecdote, I grew up in rural 'merica but live near some of the top med schools and hospital systems in the world now. The problem I'm running into is that none of my providers have ever left the bubble of these large, esteemed healthcare systems. Some have their own practice, but they've got crazy amounts of resources at their disposal and most of their patients have had this level of care since birth. Trying to explain to doctors and dentists the medical system I came from is damn near impossible. I don't have many medical records from when I was a kid or young adult. I didn't have a dentist. I got my shots and saw a doc if I had bronchitis or pneumonia. There were no annual physicals. Specialists were a "luxury" only for extreme situations that we had to travel 2-4 hours for. There are things I'm JUST now getting diagnosed and treated that most people get taken care of in infancy or elementary school. (I'm an older millennial). And there are things that are taking a lot longer to figure out because of this bias that "if it was a problem, someone would have found it by now". There is genuine shock and disbelief over some of the differences I've tried to explain. I'm NOT slamming rural health providers. Not at all. They're resourceful as hell. Nor am I slamming city docs either- everyone's perspective is based on their own life experience. The healthcare landscape in the rural US is pretty much a different planet. And you don't always know what you don't know, you know? I just wish there were more incentives for docs to practice in rural areas, even if temporary. It could really help communities, and could help in bridging that understanding between small hospitals and the larger hospitals they shuffle into.
If we're not going to be civilized enough to bring critical healthcare infrastructure out to rural areas like we did with electricity, the least those of us in cities can do is make sure there are some extra beds waiting for when they need to come into town for something.
From personal experience I knew a family of farmers (doing it for generations) who were chopping wood, 5 year old son ignores the repeated warning of "don't go near the chopping block", dad goes to deal with something urgent inside for less than 3 minutes, little Sam wanders up, decides he's going to chop the wood despite the warnings, misses, puts the axe partially through his shin and calf muscle (hit kinda sideways), he pulled out the axe, and despite being only FIVE, in true farmer fashion, decided to try and walk it off. His grandfather had seen the whole thing but couldn't run to him in time to stop it happening and the kid's like 🤷🏻♀️ Also know someone who accidentally shot himself scaring dear from the crops after he propped the gun against a fence and it fell over (wasn't horrifically injured, but a few scars), then 3 weeks later crashes a quad bike racing his cousin, then did the same thing again about another 2 weeks later except this time he crashed in a field rather than on a dirt track. Rural farming people are just born like that honestly, it's wild
@@NiaJustNia I think it’s that there just isn’t much to do out there and when humans are bored we will do some insane shit. It’s also a lot easier to say “I’ll walk it off” when there isn’t medical care within 15 minutes drive in any direction. I will say that as a lm older teen I did e same thing the kid did but blunt side towards me. For a good minute I thought I had split my shin. …I was trying to get garden bed stakes out with the axe in rural Russia. It was not my best idea.
@@NiaJustNia reminds me of back home. i once fell so hard got a third degree sprain in my ankle, walked on it for two days using some stiff boots to keep it straight. by the time i decided to go to the hospital they had to cut the boot off because it was so too swollen to come off the normal way. only to eventually give me a different kind of stiff boot and tell me to stay in bed for some amount of time to walk on it. then i proceeded to return work the very next day doing my 9-5 keeping national park trails cleared on foot
I worked in a rural ER for awhile - saw almost the exact situation go down between our doctor and the surgeon; our doc responded with something along the lines of "are you saying you managed to pass your boards without being able to diagnose textbook appendicitis based on clinical signs and symptoms?" The doc got an apology call from the surgeon at the end of the shift - the patient's appendix had been very close to rupturing by the time they made it to the surgeon's hospital 2hrs away and probably would have if we'd had to wait for the radiology tech to come in and give contrast before transferring.
Consider yourself lucky. Dr’s and NP’s with any sort of actual clinical skills are a dying breed. Everyone relies on imaging and waits for the radiologist to tell them what to do, and the patient is the one who suffers.
The number of times my small ass BAS sounds like this rural med clinic… calling the big MTF and having them do shit like discharge the new diagnosis manic bipolar. On a Friday. With no transport 200 miles from our base. Saying “follow up with local mental health” - what mental health?? We had a psychologist (great doc, no meds) booked solid for 4 months in the future. And me, a GP who’s never dosed lithium out of one week 5 years prior. Patient didn’t even make it through the weekend before getting two police departments called, taken to the ER and B-52’d with geodon on top, carted by EMS back to the MTF on Sunday morning. I’m using lines from this skit on some big MTF peeps going forward…
In México we hired 500 cuban medical doctors to help in rural towns and lots of mexican doctors complained. Government opened a public request for mexican doctors to be hired as rural medical doctors, but not even 10% were fullfilled because none wanted to be rural doctors
Because what the government did was stupid and unfair They had absolutely no right to give to underprepared Cuban doctors the positions well prepared Mexican doctors deserved in the city areas Offering these well prepared Mexican doctors the rural positions while coddling FOREIGNERS is total bullshit and a slap to the face. Mexicans should always come first, not foreigners This government fucks up its own people and defunds our institutions to give away our resources to foreign powers that don't deserve them just because they're besties with that hateful pseudo socialist excuse of a president in office. Tell me how that's any good and how's that the local doctors' fault
Same in the US. Most doctors here don't want to be rural doctors. There's some programs where doctors can get med school loans forgiven if they practice in a rural area for a set number of years. Still hard to get doctors.
That seems to be how it always goes tbh - immigrants come and do jobs the locals won't, the locals complain about immigrants "stealing jobs", and then you end up like the UK with fields full of rotting food because there aren't enough workers for harvest 🤷
@@shaydelre1898 I think there alot of people who would be great docs but don't have the $ for medical school. I remember there used to be three year nursing schools run by hospitals. Young women (not many males at the time) lived in dorms attached to the hospital. They'd have nursing classes in the morning, then the rest of the day they'd get hands on experience with the nurses. By the end of three years they had seen and done pretty much everything. It would be great if they had something similar for family practice/GP docs. (That three year hospital nurse was an RN just like the two year college nurse....just a different set up). It was less expensive than college too.
As a receiving ICU nurse in Texas, you are on point. So much respect for rural areas, they are incredible. If they say direct icu hit, we have crash cart, ventilator, renal and anesthesia on standby, & call ahead for overtime and call home to let the dog out because it is going to be a long busy night.
One of y'all's teams received me back in 2006 as a peds pt. Thank y'all for keeping me stable and able to heal until surgery almost a week later. Thank you guys so much for your care and attention.
It’s really nice to see Texaco Mike branching out with his skill set. For Christmas, I think we should all pitch-in to get him a MRI repair toolbox. Preferably in a color that matches his truck. A monogrammed version is in order. He’s earned it!
When we were at the hospital to have our first, a farmer drove herself up in a rustbucket landrcruiser, apparently in labour, and waddled inside. We later learned that she was there less than 3 hours, had her kid, and left. Apparently as the nurses begged her to stay longer, her response was "nah fuck that, gotta get home and cook the kids' tea".
Instead of being the eighth surgeon at a QUARTENARY care center. Glaucomflecken..always bringing out the truth.. Being rural myself....You sir...Today you made me feel so Proud.
Hey doc, I'm from the Philippines and I appreciate the videos about rural doctors. I am a med student scholar and we will serve as a rural doctor after we graduate. I'm excited and terrified since we had heard how hard it is. Plus the fact that there will only be 1 doctor per community (with 20,000 above population). I enjoy watching these videos as it somehow prepares me on what I might expect
hello kabayan, as someone from the provinces, i salute you! we need more people like you. my youngest daughter (she’s 10) wants to be a doctor and i hope she’ll choose your path also, and i am working hard to support her should she choose so. ❤
@@danetcaymo kabayan! I hope as she gets older, she will realize how much our country needs her ❣️ tama na ang pag-alis sa bansa, it's time to serve our own land
You’ll be fine. Just do the best you can with what you’ve got. Realize you will be doing it without help you don’t train on-site and you’ve got and endless well of ingenuity. This will teach you how to tap it.
More Texaco Mike lore please! Was he born near the clinic, or did he move there? Does he get a cut of the eggs and cheese at the clinic? What does he do for fun? Is he the rural doctor's heroic alter ego?
@@elyisus8145 OMG YES!!! We need Jonathan and Texaco Mike to join forces... there would be a cure for the common cold within a couple of hours. All cancers cured by the end of the week... a medication for eternal life by the end of the year.
What I found is that Texaco Mike manifests like so; they were willing and able to give someone needed a lift, stayed in the waiting room for emotional support, and since they were just sitting there not doing anything they might as well give Peggy a hand carrying those files... and as they do that Peggy's explaining why the machine that's meant to do the scan they're doing manually doesn't work and Texaco Mike has an idea... but the idea doesn't work the first time, so naturally he sticks around to make one more adjustment, and well he can't do that while there's people that need help and he's got an extra minute... and the next thing you know he's been there twenty years next August.
Rural med gives you some good opportunities, especially in the ED. When i was rural i used to ask the farmers if they wanted to go the city for plastics or give it a go in the ED; lot of them chose the latter with a shot or two of cefazol.
Can't rush Texaco Mike! Even coming from Australia, it's hard to appreciate just how many hyper-rural places there are in the US. I roadtripped through backwater Arizona and towns with maybe 5 streets would be 150 miles apart. Incredible how you can practice medicine under those conditions!
Any part of South Australia, Western Australia and Inland NSW and Queensland, more than 100kms from the capital city or East coast put up their hands ………us, us, us, us
If you can't appreciate rural isolation being from Australia then you need to go somewhere other than Melbourne, Sydney and their airports my friend. That region of Arizona sounds like a metropolis compared to central Australia.
At last trip to the ER, I was given the choice of pain # in farmer scale or regular. I laughed so hard cause I know where they got that. I even declined the pain shot. More rural medicine vids PLEASE!!!!!!!!!!!!!!
I had a patient from a motorcycle accident head to toe road rash shaking the bed frame in pain and he said it’s “maybe a 3” we had MANY discussions about normal people pain scales that day
Ha - Rural Doc needs to ask the local vet to borrow the ultrasound. My equine vet used to take his portable ultrasound (that he used rectally on horses) home and ultrasound his pregnant wife for fun.
Where my mom grew up as a kid, the livestock vet WAS the doctor for the community. Mom said he drank a lot, but nobody cared. He was a great doc and a great vet. This was back in the early 1950s on the Res.
We are not at all rural, but my mom had her third kid in the kitchen because the doctor didn’t think she was in serious labor, and then the ambulance got lost on the way the our house. (Pre-gps) This… okay , I can’t really imagine. Thank you all who do this!
Why it is almost essential to view it with humour... If you are not able to the wheels will most certainly come off, or you will end up having a heart attack.
You're not wrong. I come from a rural upbringing and it's pretty rough. One doctor on call living in a hospital for a week sometimes. Rarely much can be done but stabilize and hope the patient will get follow up care. My dad would get care from the veterinarian who came to the property to care for horses. I had my left thumb almost cut off and my dad wrapped it in paper towels and duct tape. My mom, thankfully, was a nurse and took me to the hospital in the city for it to be properly reattached.
@Alexandria Sounds about right. I grew up where nowhere met nothing in Texas. It was day trips to the grocery store, the post office doesn't deliver anything there so you have to go a few hours to town to a post office (and by town I mean a gas station, a post office a small market with basics, etc - still basically nowhere). If someone out there actually goes to a hospital it's probably pretty bad. And there might only be 2 or 3 doctors for the hospital and a couple of nurses, a pharmacist and maybe a radiology technician or two. The docs will do what they can but transfers hours away to a major hospital aren't uncommon if someone is really bad.
Facts! I love rural medicine! It’s hard but providers actually assess patients by putting our hands on them, get histories by actually talking to them, and create relationships by getting to know them. It’s a whole different world, and it’s beautiful!
True, unless you're at a FQHC. Then you dance to fed gov's tune, and folks get short shrift. No diagnosis, no time for "hands on," caring services. Give me Texaco Mike any day!
I live in Reno now (from Las Vegas), and I serve the Rural areas as a mental health worker. I was beyond elated when I found out my husbands cardiologist goes out to rural clinics to make sure they can see a specialist. Not just telehealth. What a great guy he is!
Mad respect for Rural Medicine. The fact that they can MacGuyver their way into pretty much every emergency without being reckless while butting heads with local communities so they can look at their untreated injuries will never cease to amaze me. Powerful people all around.
A friend of mine had her 5th kid on the couch in the living room, while waiting for her husband to finish the shower he wanted to sneak in before heading off to the hospital for a day or two. She called the EMTs but they didn't get there in time, the oldest kid caught the baby for her. Dude steps out of the bathroom into a room full of total strangers, wearing just a towel.
Thanks for making us rural medicine providers feel seen! I am one of only two full-time healthcare providers serving a community of 3,000 in rural Virginia. It’s a minimum 45 minute drive to see any sort of specialist, and two hours to the nearest Big Name Hospital.
This hit me in the feels. I was at our big regional hospital (1.5 hr drive), and the dr there was shocked I had to go so far for a specialist. I just laughed, saying we don't have that kind of specialist where I live. I have my GP, who is an absolute gem, and will try whatever she can to provide the best care possible!
As a nurse that has worked rural, and currently lives rural, I feel this. In our area, the main rural clinics don't even have a physician, it's usually a nurse practitioner or physician's assistant working under "supervision" from a physician in one of the larger cities with the main hospitals in it. And while it's rural-ish here, I can't even imagine what it would be like in Wyoming and those other large, western states in the mountains.
Dr G thank you for showing respect for those in rural. Not much you can do when there’s hardly any providers. It seems as though those in the academic hospitals look down on rural hospitals from what I’ve seen.
The ones with hours of real experience under their belt won't. Unfortunately, that still leaves the droves of more recent graduates and junior specialists.
Not a doctor myself, but a ED-doctor told me that if a farmer walks ini it's high vigilance even when the farmer claims that nothing bad has happened before revealing a hand injury that runs down to the bone, having slashed pretty much everything. Farmer arrives by ambulance, all hands on deck and page everyone. One farmer was persuaded by his son, also a farmer, that he really HAD TO go to the hospital and that he'd deal with the cows and not to worry. The father's condition turned out to be quite serious. He'd been having problems for two weeks but didn't have time to deal with it mid-calving season. Shout out to all rural medicine doctors where pretty much everything turns out to be serious or on the verge of a critical.
It took me until going away to university to realise most people didn’t drive 3 hours for routine medical care. I went in to the emergency care a couple months back with lower right quadrant pain and basically had a chat about how if I started throwing up later from the pain I should go next town over for a CT but no one had ultrasound to see if it was my appendix so best of luck!
Appendix can be a scary thing to rupture. Its suppose to hurt like hell, but my father only felt mild pain. He simply thought he had overdone it while exercising. After 2nd day of no improvement we urged him to go to the hospital. His appendix had already burst and was sent to get operated immediately. He said the recovery was more painful than the appendix being ruptured.
You are so lucky to have Texaco Mike cooking up your constast media! In the rural town where I used to live, the pharmacist had to whip it up between developing people's vacation photos and calling PCS to fight insurance disputes....l
I work in a big hospital where I can order scans or MRIs in the middle of the night and speak to Radiology. I can call ortho and neurosurgery for a spine related issue. I can call ent or omfs for a dental abscess that’s worsening. It’s easier to do that. All I have to do is call people. Rural medicine is a totally different ball game.
I'm a family doc at a frontier hospital and this was basically my last hospital shift, including the OB patient rolling in - my favorite is when I call to transfer someone and the transfer center asks what room they're in. "Room 10," I say. "Oh, are they in the ER?" the transfer center asks. "I'm sorry, I thought you were the inpatient doctor." "No, you're right, I am the inpatient doctor," I reply. "We're a critical access hospital - we have 22 beds and 3 of those are for OB." After a moment of stunned silence the transfer center then says something like, "Oh, well, room 10 it is, then! I'll let our transport team know!" I did my OB fellowship at a hospital where the ER alone had more beds the hospitals and ERs of my county and the next two counties combined - it's a different world out here and I wish docs at a quaternary care center would come hang with me for even one week so they could see what it's like! Heck, they might like it - I know I love it here and I wouldn't leave my community (or my Jims, Peggys, Texaco Mikes, or especially my Darlenes) for the world!
And people around me don't realize there's a limit on how many beds you can have at a critical access hospital... Even if you have the staff to add ten beds for a pandemic or something, there's a whole mess of other requirements.
I worked in social services in a high poverty rural community for 11 years. I cannot tell you how much I appreciate you bringing a humerus (I couldn't resist it), but extremely effective spotlight to the needs of rural communities. As many have already said, this is a pretty accurate picture of what lifw is like out here
I always look forward to the rural medicine MD videos. As an RT with 3 modalities my boss calls me a unicorn, but Texaco Mike puts me to shame; I've never even considered making bathtub contrast during the shortage or operating a fan boat! Clearly missing out on some side gig income.
Aaannd this is the exact lesson that Dr. Peter Benton learned on ER when he got sent to a "rural hospital" that ended up being one ex-nun working out of a random tiny building. He thought he was too good for it all and that his talent was being wasted, until he realized that that one person was keeping an entire town alive through hard work and help from Sunoco Mike (they didn't have a Texaco). Even for a TV show, that episode was eye-opening to see
I work at a rural hospital but only 40 min from the city and the city Hospitalists always complain of us not able to manage patients ourselves without specialty support like for GI bleeds. I ask the guy if he ever single handedly managed GI bleeds without GI coverage and *crickets
I once travelled through some very rural places in Nevada... scary to know that your closest emergency room is a 3h drive away from you. If you're the only doctor and get sick... who's gonna take care of you? Life sure is different for rural folks...
I felt as if I had bronchitis, went to rural clinic. Listened to lungs and breathing, heart some erratic cardiac stuff. EKG machine was on the fritz, so they gave up with it and listened to my heart with stethoscope and assumed I had a blockage. Sent me to ER 70 road miles away, had several scans, was on a table getting a stent within an hour. "Bronchitis" was a heart attack...
had to wait for the coroner to finish combining a field and the NP was already being bartender when worked at rural nursing home. Stat lab draw meant drawn right before end of my shift so could drive it straight over to regional hospital sort of on my way home from work because there was no runner, didn't matter if was ordered 3 hrs before, the choice was send the person to ER hour away or stat has 3 hr delay. Owner of the pharmacy would open or drive to another pharmacy to get a specialty stat med. Never knew if the person in front of you was coroner,pharmacist, NP as they all dressed the same. Interesting.
This is so accurate, even in outback Australia it's like "cool,.so you're the only doctor in the only hospital for 300 miles and there's not even an x-ray machine here?' Those doctors are always next level amazing at their jobs too.
I can honestly relate despite not being a medical professional... Took my brother to the nearest er.. three hours away and.. in the waiting room was stitching him up with braided fishing line while we waited.. but we then found out after the x ray or something he had a embalisim? In his right lung brought on by blood clots post COVID(not the vaccine) and he didn't take baby aspirin.. so yay saved him
This rural surgery series has really made me understand why in Star Trek Dr. Mccoy was this old timey rural doctor. You need that kind of approach on the frontier.
I hear from some of my classmates who are in super rural areas about how this stuff happens. They pulled a MS3 into a room to suture up a guy with gunshot wounds who was on PCP. In one hospital I was at, it’s kind of in the middle of nowhere, but they at least had imaging available. But trying to get a surgeon to come in, even if it’s an active GI bleed, was like pulling teeth. All the doctors had to drive at least an hour to get there cuz they all lives in other cities. Anything even partly serious/acute would be shipped out immediately to another city an hour drive away.
Love it! I used to work as a transportation specialist driving people sometimes 7 hours away and back the same day to get higher level health care and even things like dentures. The average specialist moves here because they think rural living is romantic and relaxing. Then they start missing Macy's and five star restaurants, and can't leave fast enough!
This is the exact kinda of difference I experienced going to university in the North Country of New York (where Canada was closer than the nearest university hospital) then being in NYC Metro, where urgent care centers are in big multi speciality complexes and urgent imaging is actually possible. The North Country/Adirondacks is as rural as one gets in NYS and NYC Metro has numerous top rated University Medical Centers. Trying to get someone who went to medical school in NYC Metro to work as a doctor in the North Country is like pulling teeth.
I lived in that area once. You're speaking the truth. Another thing that isn't talked about is some of the doctors that rural areas get are less than stellar practioners....since the hospitals/offices are desperate they'll have to hire other places rejects. That said, I've seen some wonderful, dedicated doctors/mid-levels there too.
I went to Glens Falls and they found a rare tumor on my leg. I was sent to Memorial Sloan Kettering in NYC. In Glens Falls I was treated like a person, in NYC I was a number.
While I feel like the Jonathan and Feelings Bro videos are more popular, these rural medicine videos are the ones I loved to see made into a full TV series or something. I feel like the wacky adventures of rural medicine doctor, his fresh faced intern, and the bizarre but charming locals would make for actually good TV. Like the Andy Griffith Show but with doctors.
Without the clever comedy this is a very accurate depiction of what it’s like to practice in a rural underserved area. I’ve had similar conversations more times than I can recall when I practiced.
I had this conversation with a neurosurgeon last week, though my "If I had an MRI to look at the c-spine, I'd've already ordered it" wasn't appreciated or respected. He just chewed on me more. As long as they take the patient, I don't really care.
That's a classic. Worked at a remote clinic attached to a U.S. Naval Hospital that was also somewhat remote. We did the best we could with what was available, and that came to us after the hospital got their " share " of everything.
As someone who has lived rurally most of my life I feel this. We can barely keep a doctor in our town for very long. They always leave after a year or two. Most of us drive to the closest cities for most healthcare. My OB is two hours away. Lol the rural care we do get isn’t the most advanced and you often end up with not the best doctors, but the ones who choose to live around here and care, are incredible.
Thank you thank you THANK YOU!! My husband and I worked at a rural hospital for years and we feel seen! We also just really love how you have an understanding of the different personalities of medicine and manage to incorporate them into all the specialties!
Rural medicine is my favorite offshoot. It’s so relatable. While my brother and I weren’t raised in the country our dad was and the 3 of us drive my mom crazy trying to be stoic unharmed /M E N/. She just doesn’t understand…
I've noticed a trend of the general surgeon just getting dunked on repeatedly by other medical professionals in these videos. Also, we need a dedicated Texaco Mike video. Even Jonathan would probably be in awe of TM's skills.
I’ve got the t-shirt! After my husband retired we moved south to a rural area. I called the local hospital as I had been a nurse at a large regional hospital in Nebraska. The DON told me I was hired after a ten minute phone conversation. I should have been suspicious and worried. It was during Covid. I received not one day of training. We literally and routinely ran out of everything, Tylenol, Morphine, Dilaudid, Metoprolol, various ABX, IV fluids, IV catheters, food for the patients, and even cups. We had only two ICU beds with our only heart monitors, a broken CT scanner and only traveling NPs as hospitalists . We could have used Texaco Mike! NOBODY would take our patients and as a floor nurse taking ICU level patients all night who we didn’t know what was wrong with and a 100 year old pharmacist who worked about two hours every day, it was a complete nightmare. I won’t even mention the Covid element. I quit after a little over one year. After recently having to take my husband to the ER for a dislocation I was told the entire night shift is now travelers. I don’t know how the hospital survives. My advice to the families that complained about the line down the sidewalk for the ER, if possible, you should drive them the hour plus to a major hospital.
As someone who wants to be a rural family doc and is in the process of matching, I have seen this sooo so many times. It's such a struggle. Some hospitals don't have cath labs, so half of the MIs have to be medically stabilized then shipped out.
Mad props to our rural doctors! I remember one Ed doctor who diagnosed a patient with malaria on thick smear within an hour of arrival to a rural Oregon hospital (not a hotspot for malaria).
I thought there would be Ortho coming, taking the phone from the Surgery, and saying something like "Hey, Village bro, how's things, get your patient here and I'll make his bones happy!"
Even ultrasound in a rural facility is scarce. They pulled ours last year when we shut down labor and delivery. We're sort of just a glorified urgent care with an ER and a few in-patient beds, at this point. Thankfully, our main hospital is only about 20 minutes away rather than two hours...but we do frequently have to fly people out to the even bigger hospitals in our area for the most severe traumas. They are about a 2-hour drive or about 45 minutes by helicopter in either direction, depending on which type of issue it is that needs a higher level of care than we can give out here. I never really thought about it because it has always been the norm, but we are definitely in the rural category.
Classmate of mine ended up giving birth in her bathtub in western Nodak after being sent back from the hospital that was an hour and a half away. Rural medicine is rough
Wow, they've got a CT machine and a walk-by MRI? They've got it going on! Lol. I work in a semi-rural hospital, so I'm basically in the middle of both of these. We have most of the amenities of a big hospital, about 20 minutes away from a trauma 1 center, but we have much less manpower, patients who often lack PCPs/preventative care, and we're looked down on quite a bit. I will say, even though I am the only rad tech on overnight and I do both xray and CT where it can get crazy, but I still prefer it to when I worked at the trauma 1 hospital. More autonomy, and my boss actually seems to care about her employees more.
Being in a rural area myself with limited healthcare, I always appreciate your videos about rural medicine. They're so spot on. And while Johnathans do not exist in our world, there are many of the Peggys who multitask to help cover some of that. Another great video Dr Glauc.
Honestly Rural Medicine makes me feel things. I'm rural, living about 25 miles from my clinic (the ONLY clinic in my admittedly small county, in the only incorporated town). There's no MD on staff there, but at least they've got Epic
I practiced in Montana for 12 years. This isn’t funny; this is a documentary. 😂😂
YES!!!
My father's best friend while they grew up in India practiced in rural Missouri and we went out to visit him a few times. He was making a killing as basically the only specialist there for miles and miles (I think he did something nuero...)
So yeah, being the only doctor for a huge swath of people is very real
This is supposed to be comedy?
You guys ever run out of contrast?
this is a funny documentary
Oh man , I’ve transferred a few patients starting with “this 80 year old farmer…” I usually get cut off with, “great, send them in!”
“Don’t you want to know what’s wrong with them?”
“”No, we’ll have every specialty on standby to treat them when they make their one-time life appearance “
🤣🤣🤣🤣
"We've got an older coal miner..."
"That's great. Bring him on in."
My dad was 92 when he saw a doctor for the second time. The first time was his induction physical for WWll.
He was amazed that he could just pee out all the fluid building up in his tissues. It kept him alive for four more years.
80 year old farmer coming in for something usually means shit is about to hit the fan.
@@polarbearhero9803 Did he go oooooh and aaaaah at all the modern medicine marvels and technology?
Oh man, Darlene I feel seen. With my 5th kid the doc had a med student with him and he told the student they could catch. The med student looked absolutely terrified and looks at the doc and asks if I should be pushing already. The doc does not even look up and says, "its her 5 baby, she knows what she is doing." LOL.
Mad respect for any woman who can go through that more than once, let alone 5 times.
With my fifth, my family doc was disappointed that I went with a midwife. His words: "Man, the sucker is just gonna fly out of there!" 😁
Yes we do 🤣
@@timothypryor7952 thank you.
I was my mum's 4th child the nurses didn't even bother the Dr on call (rural hospital he was busy with another patient) they just let Mum do her thing. Unfortunately unlike my siblings I was born not breathing so the nurse had a little work to do and by the time the Dr had arrived I was breathing and everything was fine.
Edit: he did do the paperwork to register my successful birth.
I love Rural Medicine. He's like the Johnathan of doctors, just making everything happen, no matter how crazy it is. Plus he's the mayor (assuming he didn't lose to that goat)
The goat probaly won
Don’t forget, he also delivers the mail!
The goat ate the pies.
I still think that was not cool.
@@celestialstar6450 and the milk
@@monkyyy0 To be fair, the goat had some really good ideas.
As a practicing Radiologist, I can vouch for Texaco Mike’s contrast…it’s the best.
Tastes great
But what about the bean buddies?!
Can I get cherry flavored?
@@ldr7125 Contrast induced kidney injury is a myth /s
He mixes it with moonshine with a drop of wood alcohol for taste. What doesn’t kill you makes you feel really good.
That surgeon had it coming: I hope rural medicine runs into the neurologist at some point in the future.
I'm pretty sure that encounter couldn't be contained in a short.
I hope so too :) great thought
I hope so three. Good idea.
OH GOSH YES.
The neurologist would end up seeing the therapist voluntarily.
I love that Rural Medicine was able to shut Surgery down so completely and so quickly.
Rural Medicine is so done with Big City Medicine's shit. xD
He Fights Farmers for a living to convince them to actually get their broken arm treated. Surgery is nothing in comparison.
@@rabidfirefox8914 He has zero time to deal with Surgery's BS 🤣
Really thought he would agree and come over and join. But Rural medicine seems as rushed as ever and decided to quickly interrupt reflective silence by shutting down the consideration with an implied word in his mouth.
I literally has a stack of faxed hand written medical records from my pediatrician. My pcp in the city admîtes to not making it through and was surprised they were hand written. I’m only a twenty soemthing but this was the standard of care twenty minutes outside a major city
The fact that he names Texaco Mike by name during his shutdown of Surgery, shows the level of respect Texaco Mike has earned from his many years of supplying the Rural hospital. Texaco Mike sounds like the kind of guy you want with you during your operation.
Texaco Mike and Jonathan are first round drafts on the Zombie Survival team
@@TheLadyloinplot twist: Texaco Mike is Jonathan in a trucker hat.
❤ Yep! After all ... That man can fan-boat like wind! 😂
I hope one day Texaco Mike gets a doctorate, with all that experience I'm sure he could pass a residency and get through med school.
At this point they'd just hand him his paper lol
No he had one but he traded it for the swamp boat XD
He could at least be a rad tech.
Too paraphrase Lex Luthor: "Do you have any idea how much power I'd have to give up be a doctor?"
More like a technician
I love how dedicated to the job the rural Healthcare workers (including Texaco Mike) are! Those hospitals really are lacking equipment and professionals, unfortunately not many people want to work there - nice call out!
Are those hospitals private? If so, how the hell do you get private companies to go to unprofitable places?
@@vidal9747 Private hospital run by doctor is possible, and it can be unprofitable financially, but if trade and barter work and you can get medical supplies, it can keep running.
Most rural hospital are not for profits. Usually they're satellites of a large hospital in an urban area. That one hospital may have two to four rural satellites in a 200 mile radius. Those satellites funnel patients to the large hospital and usually can keep a patient for 24 hrs if they need observation. They may also have a specialist come in once or twice a month to see patients. They're also highly dependent on state and federal money for grants. This is what I've seen in New England. I imagine out in the midwest/west those distances are at least double if not triple. Also in NE, those satellite hospitals are fed patients from local health centers, which usually have agreements with them and the main hospital. Those health centers are also recipients of lots of state and federal money/grants. The satellite hospitals are almost always established hospitals that were in place for decades until they couldn't afford to offer services anymore, and the urban hospital took them over.
I foresee a time when most medical care will look and feel a heck lot more like rural medicine.
Good thing there are resilient people and resilient doctors.
@@queenbunnyfoofoo6112 and in the case of Oklahoma, many rural hospitals are closing because they don't have enough resources. If it's the same in New England then I wouldn't necessarily be surprised but if not then all the better.
I’ve been a surgeon foe 28 years at level 1-4 hospitals. I was always taught to accept whatever was referred no questions asked. If the other centers called for help, it was the patient we were serving. I found working at level 1 centers to be by far the easiest as they have everything needed to provide care. Working in level 3 and 4 centers is the most challenging with limited and often non existent support services. Trying to get patients transferred is a constant battle with some dying while waiting to be accepted. Anytime I get a smug surgeon telling me I should be able to care for whatever problem at my facilityI say I agree, I should be able to, but we can’t. We don’t have the specialties or services available for appropriate care, and I invite them to come out and see for themselves.
Speak it!
Thank you for your hands-on understanding of smaller healthcare centers. Your patients are quite lucky.
As an anecdote, I grew up in rural 'merica but live near some of the top med schools and hospital systems in the world now. The problem I'm running into is that none of my providers have ever left the bubble of these large, esteemed healthcare systems. Some have their own practice, but they've got crazy amounts of resources at their disposal and most of their patients have had this level of care since birth.
Trying to explain to doctors and dentists the medical system I came from is damn near impossible. I don't have many medical records from when I was a kid or young adult. I didn't have a dentist. I got my shots and saw a doc if I had bronchitis or pneumonia. There were no annual physicals. Specialists were a "luxury" only for extreme situations that we had to travel 2-4 hours for.
There are things I'm JUST now getting diagnosed and treated that most people get taken care of in infancy or elementary school. (I'm an older millennial). And there are things that are taking a lot longer to figure out because of this bias that "if it was a problem, someone would have found it by now". There is genuine shock and disbelief over some of the differences I've tried to explain.
I'm NOT slamming rural health providers. Not at all. They're resourceful as hell. Nor am I slamming city docs either- everyone's perspective is based on their own life experience. The healthcare landscape in the rural US is pretty much a different planet. And you don't always know what you don't know, you know?
I just wish there were more incentives for docs to practice in rural areas, even if temporary. It could really help communities, and could help in bridging that understanding between small hospitals and the larger hospitals they shuffle into.
If we're not going to be civilized enough to bring critical healthcare infrastructure out to rural areas like we did with electricity, the least those of us in cities can do is make sure there are some extra beds waiting for when they need to come into town for something.
I'll bet not one has ever shown up. 😑
You can't refuse a higher level of care transfer anyway.
As someone who works in both 911 and Transport EMS in different rural areas I can say we take some crazy stuff to the big city hospitals.
Please provide us with some storiessss
From personal experience I knew a family of farmers (doing it for generations) who were chopping wood, 5 year old son ignores the repeated warning of "don't go near the chopping block", dad goes to deal with something urgent inside for less than 3 minutes, little Sam wanders up, decides he's going to chop the wood despite the warnings, misses, puts the axe partially through his shin and calf muscle (hit kinda sideways), he pulled out the axe, and despite being only FIVE, in true farmer fashion, decided to try and walk it off. His grandfather had seen the whole thing but couldn't run to him in time to stop it happening and the kid's like 🤷🏻♀️
Also know someone who accidentally shot himself scaring dear from the crops after he propped the gun against a fence and it fell over (wasn't horrifically injured, but a few scars), then 3 weeks later crashes a quad bike racing his cousin, then did the same thing again about another 2 weeks later except this time he crashed in a field rather than on a dirt track. Rural farming people are just born like that honestly, it's wild
@@NiaJustNia I think it’s that there just isn’t much to do out there and when humans are bored we will do some insane shit. It’s also a lot easier to say “I’ll walk it off” when there isn’t medical care within 15 minutes drive in any direction.
I will say that as a lm older teen I did e same thing the kid did but blunt side towards me. For a good minute I thought I had split my shin. …I was trying to get garden bed stakes out with the axe in rural Russia. It was not my best idea.
@@NiaJustNia reminds me of back home. i once fell so hard got a third degree sprain in my ankle, walked on it for two days using some stiff boots to keep it straight. by the time i decided to go to the hospital they had to cut the boot off because it was so too swollen to come off the normal way. only to eventually give me a different kind of stiff boot and tell me to stay in bed for some amount of time to walk on it. then i proceeded to return work the very next day doing my 9-5 keeping national park trails cleared on foot
Ever taken a fan boat in the swamps of Louisiana?
I worked in a rural ER for awhile - saw almost the exact situation go down between our doctor and the surgeon; our doc responded with something along the lines of "are you saying you managed to pass your boards without being able to diagnose textbook appendicitis based on clinical signs and symptoms?"
The doc got an apology call from the surgeon at the end of the shift - the patient's appendix had been very close to rupturing by the time they made it to the surgeon's hospital 2hrs away and probably would have if we'd had to wait for the radiology tech to come in and give contrast before transferring.
Consider yourself lucky. Dr’s and NP’s with any sort of actual clinical skills are a dying breed. Everyone relies on imaging and waits for the radiologist to tell them what to do, and the patient is the one who suffers.
Being in military medicine, this makes me laugh how similar this is. At least some doctors get how we all feel.
Was a former green side corpsman. Would be cool if Doc Guac could do a military medicine skit.
@@jamessandoval5843 Find a field medic with a channel and suggest that they collaborate.
"Take an ibuprofen and walk it off."
The number of times my small ass BAS sounds like this rural med clinic… calling the big MTF and having them do shit like discharge the new diagnosis manic bipolar. On a Friday. With no transport 200 miles from our base. Saying “follow up with local mental health” - what mental health?? We had a psychologist (great doc, no meds) booked solid for 4 months in the future. And me, a GP who’s never dosed lithium out of one week 5 years prior.
Patient didn’t even make it through the weekend before getting two police departments called, taken to the ER and B-52’d with geodon on top, carted by EMS back to the MTF on Sunday morning.
I’m using lines from this skit on some big MTF peeps going forward…
I have an ultrasound rig in my army ambulance.
In México we hired 500 cuban medical doctors to help in rural towns and lots of mexican doctors complained. Government opened a public request for mexican doctors to be hired as rural medical doctors, but not even 10% were fullfilled because none wanted to be rural doctors
Because what the government did was stupid and unfair
They had absolutely no right to give to underprepared Cuban doctors the positions well prepared Mexican doctors deserved in the city areas
Offering these well prepared Mexican doctors the rural positions while coddling FOREIGNERS is total bullshit and a slap to the face. Mexicans should always come first, not foreigners
This government fucks up its own people and defunds our institutions to give away our resources to foreign powers that don't deserve them just because they're besties with that hateful pseudo socialist excuse of a president in office. Tell me how that's any good and how's that the local doctors' fault
Same in the US. Most doctors here don't want to be rural doctors. There's some programs where doctors can get med school loans forgiven if they practice in a rural area for a set number of years. Still hard to get doctors.
That seems to be how it always goes tbh - immigrants come and do jobs the locals won't, the locals complain about immigrants "stealing jobs", and then you end up like the UK with fields full of rotting food because there aren't enough workers for harvest 🤷
If someone would give me and people like me a chance to go to medical school we would practice anywhere!
@@shaydelre1898 I think there alot of people who would be great docs but don't have the $ for medical school. I remember there used to be three year nursing schools run by hospitals. Young women (not many males at the time) lived in dorms attached to the hospital. They'd have nursing classes in the morning, then the rest of the day they'd get hands on experience with the nurses. By the end of three years they had seen and done pretty much everything. It would be great if they had something similar for family practice/GP docs. (That three year hospital nurse was an RN just like the two year college nurse....just a different set up). It was less expensive than college too.
As a receiving ICU nurse in Texas, you are on point. So much respect for rural areas, they are incredible. If they say direct icu hit, we have crash cart, ventilator, renal and anesthesia on standby, & call ahead for overtime and call home to let the dog out because it is going to be a long busy night.
Oh Lord, did they get found in the field?
@@williambrown319 , sometimes!
😂
One of y'all's teams received me back in 2006 as a peds pt. Thank y'all for keeping me stable and able to heal until surgery almost a week later. Thank you guys so much for your care and attention.
It’s really nice to see Texaco Mike branching out with his skill set. For Christmas, I think we should all pitch-in to get him a MRI repair toolbox. Preferably in a color that matches his truck. A monogrammed version is in order. He’s earned it!
Just, you know, make sure it's magnet safe, we don't want another accidental quench
@@jaggederest Yeh, he was really pissed when he had to make a batch of helium to fill it back up...
Texaco Mike: hmmm, does it come in "rust"?
When we were at the hospital to have our first, a farmer drove herself up in a rustbucket landrcruiser, apparently in labour, and waddled inside.
We later learned that she was there less than 3 hours, had her kid, and left. Apparently as the nurses begged her to stay longer, her response was "nah fuck that, gotta get home and cook the kids' tea".
Instead of being the eighth surgeon at a QUARTENARY care center.
Glaucomflecken..always bringing out the truth..
Being rural myself....You sir...Today you made me feel so Proud.
I can't wait to one day meet Texaco mike. I have a feeling he's the Jonathan of rural medicine
More talkative though.
It's hard to make a nod heard over the noise of a fanboat's engine.
Maybe he's Jonathan's cousin once removed 🤔.
Jonathan if his blood was mostly moonshine.
He runs the local Texaco and bakery, where you can get gas, a scratch ticket, MRI, and live bait along with your mile-high pie.
Hey doc, I'm from the Philippines and I appreciate the videos about rural doctors. I am a med student scholar and we will serve as a rural doctor after we graduate. I'm excited and terrified since we had heard how hard it is. Plus the fact that there will only be 1 doctor per community (with 20,000 above population). I enjoy watching these videos as it somehow prepares me on what I might expect
hello kabayan, as someone from the provinces, i salute you! we need more people like you. my youngest daughter (she’s 10) wants to be a doctor and i hope she’ll choose your path also, and i am working hard to support her should she choose so. ❤
Frontier medicine is harrowing and exciting in its own way.
@@danetcaymo kabayan! I hope as she gets older, she will realize how much our country needs her ❣️ tama na ang pag-alis sa bansa, it's time to serve our own land
You’ll be fine. Just do the best you can with what you’ve got. Realize you will be doing it without help you don’t train on-site and you’ve got and endless well of ingenuity. This will teach you how to tap it.
Good luck sa DTTB, doc! Serve the underserved! ✊️
This is so true. A fax, an x-ray and a really dedicated staff.
I knew Darlene was gonna leave at some point 😂
More Texaco Mike lore please! Was he born near the clinic, or did he move there? Does he get a cut of the eggs and cheese at the clinic? What does he do for fun? Is he the rural doctor's heroic alter ego?
Texaco Mike is just the rural equivalent of a Jonathan 😂
@@mrpink8951 OMG we need a cross over!
@@elyisus8145 OMG YES!!! We need Jonathan and Texaco Mike to join forces... there would be a cure for the common cold within a couple of hours. All cancers cured by the end of the week... a medication for eternal life by the end of the year.
What I found is that Texaco Mike manifests like so; they were willing and able to give someone needed a lift, stayed in the waiting room for emotional support, and since they were just sitting there not doing anything they might as well give Peggy a hand carrying those files... and as they do that Peggy's explaining why the machine that's meant to do the scan they're doing manually doesn't work and Texaco Mike has an idea... but the idea doesn't work the first time, so naturally he sticks around to make one more adjustment, and well he can't do that while there's people that need help and he's got an extra minute... and the next thing you know he's been there twenty years next August.
Texaco Mike is rural medicine’s Jonathan but with a more capable attending.
As someone who has practiced in both places....so spot on. Great job as always!
Rural med gives you some good opportunities, especially in the ED. When i was rural i used to ask the farmers if they wanted to go the city for plastics or give it a go in the ED; lot of them chose the latter with a shot or two of cefazol.
Can't rush Texaco Mike!
Even coming from Australia, it's hard to appreciate just how many hyper-rural places there are in the US. I roadtripped through backwater Arizona and towns with maybe 5 streets would be 150 miles apart. Incredible how you can practice medicine under those conditions!
You can drive in Texas for four hours and not hit a city with greater than a few hundred people
In one part of Arizona, I saw a billboard advertising a Burger King 187 miles away. It was probably the closest restaurant.
*Northern Territory enters the chat*
Any part of South Australia, Western Australia and Inland NSW and Queensland, more than 100kms from the capital city or East coast put up their hands ………us, us, us, us
If you can't appreciate rural isolation being from Australia then you need to go somewhere other than Melbourne, Sydney and their airports my friend. That region of Arizona sounds like a metropolis compared to central Australia.
At last trip to the ER, I was given the choice of pain # in farmer scale or regular. I laughed so hard cause I know where they got that. I even declined the pain shot. More rural medicine vids PLEASE!!!!!!!!!!!!!!
Should've scared 'em with "I'm here, ain't I?" 💀
The Farmer pain scale is so much easier to understand.
I had a patient from a motorcycle accident head to toe road rash shaking the bed frame in pain and he said it’s “maybe a 3” we had MANY discussions about normal people pain scales that day
@@embersanja221 must'a' been a farmer in this life or other life
I've been lectured by my chiropractor and my cardiologist about my farmer-like pain scale. I've learned to qualify my descriptions.
Ha - Rural Doc needs to ask the local vet to borrow the ultrasound. My equine vet used to take his portable ultrasound (that he used rectally on horses) home and ultrasound his pregnant wife for fun.
Where my mom grew up as a kid, the livestock vet WAS the doctor for the community. Mom said he drank a lot, but nobody cared. He was a great doc and a great vet. This was back in the early 1950s on the Res.
@@sevenandthelittlestmew Give me a drunk veterinarian over no one any day lol
the joke of Texaco Mike cooking up home-made contrast is so good
"You don't want to hurry that..." 😂
I understand Darlene. My 5th was out and in her father's hands before the dr had his gloves on.
Just curious, how many children do you have 😊
We are not at all rural, but my mom had her third kid in the kitchen because the doctor didn’t think she was in serious labor, and then the ambulance got lost on the way the our house. (Pre-gps)
This… okay , I can’t really imagine.
Thank you all who do this!
As someone living in a rural community, the fact that this really isn't too far from the mark just makes the reality hurt even more.
Why it is almost essential to view it with humour... If you are not able to the wheels will most certainly come off, or you will end up having a heart attack.
I literally clapped at the end! I always tell people that unless you've worked it, you have no idea what rural medicine can do.
"It's her fifth kid. She'll just do it herself."
I've lived there. This is not an exaggeration.
I love the phrase “me, Texaco Mike and the gang”
You're not wrong. I come from a rural upbringing and it's pretty rough. One doctor on call living in a hospital for a week sometimes. Rarely much can be done but stabilize and hope the patient will get follow up care. My dad would get care from the veterinarian who came to the property to care for horses. I had my left thumb almost cut off and my dad wrapped it in paper towels and duct tape. My mom, thankfully, was a nurse and took me to the hospital in the city for it to be properly reattached.
@Alexandria Sounds about right. I grew up where nowhere met nothing in Texas. It was day trips to the grocery store, the post office doesn't deliver anything there so you have to go a few hours to town to a post office (and by town I mean a gas station, a post office a small market with basics, etc - still basically nowhere). If someone out there actually goes to a hospital it's probably pretty bad. And there might only be 2 or 3 doctors for the hospital and a couple of nurses, a pharmacist and maybe a radiology technician or two. The docs will do what they can but transfers hours away to a major hospital aren't uncommon if someone is really bad.
Facts! I love rural medicine! It’s hard but providers actually assess patients by putting our hands on them, get histories by actually talking to them, and create relationships by getting to know them. It’s a whole different world, and it’s beautiful!
True, unless you're at a FQHC. Then you dance to fed gov's tune, and folks get short shrift. No diagnosis, no time for "hands on," caring services.
Give me Texaco Mike any day!
As a 40yr rural generalist sounds very familiar. There are some great exceptions, usually docs who worked rurally before specializing!
I live in Reno now (from Las Vegas), and I serve the Rural areas as a mental health worker. I was beyond elated when I found out my husbands cardiologist goes out to rural clinics to make sure they can see a specialist. Not just telehealth. What a great guy he is!
I’m out here in Dayton, and it’s a relatively foreign concept to many people that I have to drive 30 minutes if I need anything except urgent care…
Mad respect for Rural Medicine. The fact that they can MacGuyver their way into pretty much every emergency without being reckless while butting heads with local communities so they can look at their untreated injuries will never cease to amaze me. Powerful people all around.
A friend of mine had her 5th kid on the couch in the living room, while waiting for her husband to finish the shower he wanted to sneak in before heading off to the hospital for a day or two. She called the EMTs but they didn't get there in time, the oldest kid caught the baby for her. Dude steps out of the bathroom into a room full of total strangers, wearing just a towel.
Thanks for making us rural medicine providers feel seen! I am one of only two full-time healthcare providers serving a community of 3,000 in rural Virginia. It’s a minimum 45 minute drive to see any sort of specialist, and two hours to the nearest Big Name Hospital.
This hit me in the feels. I was at our big regional hospital (1.5 hr drive), and the dr there was shocked I had to go so far for a specialist. I just laughed, saying we don't have that kind of specialist where I live. I have my GP, who is an absolute gem, and will try whatever she can to provide the best care possible!
1.5 hr drive is a short drive in rural America
@@ostint912 Word.
As a nurse that has worked rural, and currently lives rural, I feel this. In our area, the main rural clinics don't even have a physician, it's usually a nurse practitioner or physician's assistant working under "supervision" from a physician in one of the larger cities with the main hospitals in it. And while it's rural-ish here, I can't even imagine what it would be like in Wyoming and those other large, western states in the mountains.
Dr G thank you for showing respect for those in rural. Not much you can do when there’s hardly any providers. It seems as though those in the academic hospitals look down on rural hospitals from what I’ve seen.
Academics in every field look down on those actually doing the work.
The ones with hours of real experience under their belt won't. Unfortunately, that still leaves the droves of more recent graduates and junior specialists.
In my 18,000 people county we just voted in a new tax on ourselves to keep our hospital going.
Not a doctor myself, but a ED-doctor told me that if a farmer walks ini it's high vigilance even when the farmer claims that nothing bad has happened before revealing a hand injury that runs down to the bone, having slashed pretty much everything.
Farmer arrives by ambulance, all hands on deck and page everyone.
One farmer was persuaded by his son, also a farmer, that he really HAD TO go to the hospital and that he'd deal with the cows and not to worry. The father's condition turned out to be quite serious. He'd been having problems for two weeks but didn't have time to deal with it mid-calving season.
Shout out to all rural medicine doctors where pretty much everything turns out to be serious or on the verge of a critical.
It took me until going away to university to realise most people didn’t drive 3 hours for routine medical care. I went in to the emergency care a couple months back with lower right quadrant pain and basically had a chat about how if I started throwing up later from the pain I should go next town over for a CT but no one had ultrasound to see if it was my appendix so best of luck!
Appendix can be a scary thing to rupture. Its suppose to hurt like hell, but my father only felt mild pain. He simply thought he had overdone it while exercising. After 2nd day of no improvement we urged him to go to the hospital. His appendix had already burst and was sent to get operated immediately. He said the recovery was more painful than the appendix being ruptured.
@@popenieafantome9527 “Luckily” in my case it was a rupture, but ovarian cyst not appendix
@@silversleeper1193I had a few of those and my first one also landed me in the ER (also thought appendix. I was 14 😢)
@Alexandria buy yourself a bottle of urine dip-sticks. Maybe $20 for 50 tests? They are honestly the exact same test the hospital is running
God I wish we had a CT scanner. We've got an ultrasound though, but no one's particularly good at using it.
Sounds like an opportunity to make yourself useful
You are so lucky to have Texaco Mike cooking up your constast media! In the rural town where I used to live, the pharmacist had to whip it up between developing people's vacation photos and calling PCS to fight insurance disputes....l
I work in a big hospital where I can order scans or MRIs in the middle of the night and speak to Radiology. I can call ortho and neurosurgery for a spine related issue. I can call ent or omfs for a dental abscess that’s worsening. It’s easier to do that. All I have to do is call people. Rural medicine is a totally different ball game.
For how much was happening the scene, I expected Darlene to be a farm animal with enough sentience to say that she doesn't want to be a bother
I figured the 2 minutes were too much and the next thing we'd hear is she was headed home with the baby.
I'm a family doc at a frontier hospital and this was basically my last hospital shift, including the OB patient rolling in - my favorite is when I call to transfer someone and the transfer center asks what room they're in.
"Room 10," I say.
"Oh, are they in the ER?" the transfer center asks. "I'm sorry, I thought you were the inpatient doctor."
"No, you're right, I am the inpatient doctor," I reply. "We're a critical access hospital - we have 22 beds and 3 of those are for OB."
After a moment of stunned silence the transfer center then says something like, "Oh, well, room 10 it is, then! I'll let our transport team know!"
I did my OB fellowship at a hospital where the ER alone had more beds the hospitals and ERs of my county and the next two counties combined - it's a different world out here and I wish docs at a quaternary care center would come hang with me for even one week so they could see what it's like! Heck, they might like it - I know I love it here and I wouldn't leave my community (or my Jims, Peggys, Texaco Mikes, or especially my Darlenes) for the world!
And people around me don't realize there's a limit on how many beds you can have at a critical access hospital... Even if you have the staff to add ten beds for a pandemic or something, there's a whole mess of other requirements.
I worked in social services in a high poverty rural community for 11 years. I cannot tell you how much I appreciate you bringing a humerus (I couldn't resist it), but extremely effective spotlight to the needs of rural communities. As many have already said, this is a pretty accurate picture of what lifw is like out here
I always look forward to the rural medicine MD videos. As an RT with 3 modalities my boss calls me a unicorn, but Texaco Mike puts me to shame; I've never even considered making bathtub contrast during the shortage or operating a fan boat! Clearly missing out on some side gig income.
Depends on if you consider half a butchered cow in the freezer income
Deer is good too
Aaannd this is the exact lesson that Dr. Peter Benton learned on ER when he got sent to a "rural hospital" that ended up being one ex-nun working out of a random tiny building. He thought he was too good for it all and that his talent was being wasted, until he realized that that one person was keeping an entire town alive through hard work and help from Sunoco Mike (they didn't have a Texaco). Even for a TV show, that episode was eye-opening to see
I work at a rural hospital but only 40 min from the city and the city Hospitalists always complain of us not able to manage patients ourselves without specialty support like for GI bleeds. I ask the guy if he ever single handedly managed GI bleeds without GI coverage and *crickets
It’s impressive how much people in rural medicine do with few resources
I once travelled through some very rural places in Nevada... scary to know that your closest emergency room is a 3h drive away from you. If you're the only doctor and get sick... who's gonna take care of you? Life sure is different for rural folks...
Man, it's always a good day when Surgery gets ego-checked.
I think it's an intense challenge to be a surgeon in a rural hospital. Almost sounds like being a surgeon in a military hospital
In some places general surgeons are the backup for doing c-sections for family medicine who does the OB care.
I felt as if I had bronchitis, went to rural clinic. Listened to lungs and breathing, heart some erratic cardiac stuff. EKG machine was on the fritz, so they gave up with it and listened to my heart with stethoscope and assumed I had a blockage. Sent me to ER 70 road miles away, had several scans, was on a table getting a stent within an hour. "Bronchitis" was a heart attack...
had to wait for the coroner to finish combining a field and the NP was already being bartender when worked at rural nursing home. Stat lab draw meant drawn right before end of my shift so could drive it straight over to regional hospital sort of on my way home from work because there was no runner, didn't matter if was ordered 3 hrs before, the choice was send the person to ER hour away or stat has 3 hr delay. Owner of the pharmacy would open or drive to another pharmacy to get a specialty stat med. Never knew if the person in front of you was coroner,pharmacist, NP as they all dressed the same. Interesting.
This is so accurate, even in outback Australia it's like "cool,.so you're the only doctor in the only hospital for 300 miles and there's not even an x-ray machine here?'
Those doctors are always next level amazing at their jobs too.
I can honestly relate despite not being a medical professional... Took my brother to the nearest er.. three hours away and.. in the waiting room was stitching him up with braided fishing line while we waited.. but we then found out after the x ray or something he had a embalisim? In his right lung brought on by blood clots post COVID(not the vaccine) and he didn't take baby aspirin.. so yay saved him
This rural surgery series has really made me understand why in Star Trek Dr. Mccoy was this old timey rural doctor. You need that kind of approach on the frontier.
What this needed right after “that’s what I thought” 2:11 was a bless your heart! ❤
Technically we are a township.
Also Unincorporated Piscataquis
Even better we do need a decent ophthalmologist here 😂
I hear from some of my classmates who are in super rural areas about how this stuff happens. They pulled a MS3 into a room to suture up a guy with gunshot wounds who was on PCP. In one hospital I was at, it’s kind of in the middle of nowhere, but they at least had imaging available. But trying to get a surgeon to come in, even if it’s an active GI bleed, was like pulling teeth. All the doctors had to drive at least an hour to get there cuz they all lives in other cities. Anything even partly serious/acute would be shipped out immediately to another city an hour drive away.
My better half already retired...and the minute I get out we are headed to work in rural healthcare!
Love it! I used to work as a transportation specialist driving people sometimes 7 hours away and back the same day to get higher level health care and even things like dentures. The average specialist moves here because they think rural living is romantic and relaxing. Then they start missing Macy's and five star restaurants, and can't leave fast enough!
I'd take Farm King over Macy's any day of the week.
The Rural Medicine ones are my absolute favorite coming from a rural area lol
This is the exact kinda of difference I experienced going to university in the North Country of New York (where Canada was closer than the nearest university hospital) then being in NYC Metro, where urgent care centers are in big multi speciality complexes and urgent imaging is actually possible.
The North Country/Adirondacks is as rural as one gets in NYS and NYC Metro has numerous top rated University Medical Centers. Trying to get someone who went to medical school in NYC Metro to work as a doctor in the North Country is like pulling teeth.
I lived in that area once. You're speaking the truth. Another thing that isn't talked about is some of the doctors that rural areas get are less than stellar practioners....since the hospitals/offices are desperate they'll have to hire other places rejects. That said, I've seen some wonderful, dedicated doctors/mid-levels there too.
I went to Glens Falls and they found a rare tumor on my leg. I was sent to Memorial Sloan Kettering in NYC. In Glens Falls I was treated like a person, in NYC I was a number.
Shout out to Canton-Potsdam General. My friend with cancer had to drive to Burlington for chemo back in the ‘80s. I’m not sure it’s any better now.
Same here in Utica, NY. Short supply of quality healthcare providers.
@@alphabetsoup6681 They got bought out by Rochester Regional Health so they now have some specialists at CPH and the surrounding area.
As a medical biller, we still use fax machines daily.... I have been begging my boss to consider getting virtual fax services
I just wanna know, did the rural doctor win the mayoral debate against the goat opponent?
The best Man did not win.
The mayor is the Goat!
While I feel like the Jonathan and Feelings Bro videos are more popular, these rural medicine videos are the ones I loved to see made into a full TV series or something. I feel like the wacky adventures of rural medicine doctor, his fresh faced intern, and the bizarre but charming locals would make for actually good TV. Like the Andy Griffith Show but with doctors.
Dr. Quinn, Medicine Woman
Virgin River
Doc Martin (British)
Plenty more rural doc tv shows
@@Joy21090 Cool to know. Guess I'll have to look into those
@@Joy21090 All Creatures Great and Small on the veterinary side in the Yorkshire Downs. Both the TV show and the books are great.
@@theeth3242Northern Exposure. Great series if you can find old episodes.
Without the clever comedy this is a very accurate depiction of what it’s like to practice in a rural underserved area. I’ve had similar conversations more times than I can recall when I practiced.
I had this conversation with a neurosurgeon last week, though my "If I had an MRI to look at the c-spine, I'd've already ordered it" wasn't appreciated or respected. He just chewed on me more. As long as they take the patient, I don't really care.
That's a classic. Worked at a remote clinic attached to a U.S. Naval Hospital that was also somewhat remote. We did the best we could with what was available, and that came to us after the hospital got their " share " of everything.
Lived out in the boonies. The best hematologist I ever had worked there. God bless him.
"She'll do it herself" "What?" 🤣🤣🤣 I grew up in rural America and want to get back there, these ones are my favorites.
This is so relatable! I love living in a small “middle of nowhere” town. But serious medical issues require 1-2 hours travel.
As someone who has lived rurally most of my life I feel this. We can barely keep a doctor in our town for very long. They always leave after a year or two. Most of us drive to the closest cities for most healthcare. My OB is two hours away. Lol the rural care we do get isn’t the most advanced and you often end up with not the best doctors, but the ones who choose to live around here and care, are incredible.
The reason they only last a couple of years is because they are getting their student loans paid off through NHSC.
@@jeepstergal4043 I didn’t realize that was even a thing offered to anyone.
Growing up in rural sw Idaho, I find the rural medicine skits hilarious and somewhat accurate!
As a mom of 6...I get you, Darlene! My 5th was born in the hospital as the doctor came running into my room, leapfrogging at least one nurse.
I love rural Healthcare workers. They're the most dedicated, hard working, and adaptive people you'll ever meet.
Thank you thank you THANK YOU!! My husband and I worked at a rural hospital for years and we feel seen!
We also just really love how you have an understanding of the different personalities of medicine and manage to incorporate them into all the specialties!
Rural medicine is my favorite offshoot. It’s so relatable. While my brother and I weren’t raised in the country our dad was and the 3 of us drive my mom crazy trying to be stoic unharmed /M E N/. She just doesn’t understand…
I've noticed a trend of the general surgeon just getting dunked on repeatedly by other medical professionals in these videos. Also, we need a dedicated Texaco Mike video. Even Jonathan would probably be in awe of TM's skills.
What a great doctor and human being!! He really gets it!! ♥️✨
I’ve got the t-shirt! After my husband retired we moved south to a rural area. I called the local hospital as I had been a nurse at a large regional hospital in Nebraska. The DON told me I was hired after a ten minute phone conversation. I should have been suspicious and worried. It was during Covid. I received not one day of training. We literally and routinely ran out of everything, Tylenol, Morphine, Dilaudid, Metoprolol, various ABX, IV fluids, IV catheters, food for the patients, and even cups. We had only two ICU beds with our only heart monitors, a broken CT scanner and only traveling NPs as hospitalists . We could have used Texaco Mike! NOBODY would take our patients and as a floor nurse taking ICU level patients all night who we didn’t know what was wrong with and a 100 year old pharmacist who worked about two hours every day, it was a complete nightmare. I won’t even mention the Covid element. I quit after a little over one year. After recently having to take my husband to the ER for a dislocation I was told the entire night shift is now travelers. I don’t know how the hospital survives. My advice to the families that complained about the line down the sidewalk for the ER, if possible, you should drive them the hour plus to a major hospital.
As someone who wants to be a rural family doc and is in the process of matching, I have seen this sooo so many times. It's such a struggle. Some hospitals don't have cath labs, so half of the MIs have to be medically stabilized then shipped out.
HELL YES!! Rural medicine requires you to be everything! Thank you for representing and also defending 💜💜
Mad props to our rural doctors! I remember one Ed doctor who diagnosed a patient with malaria on thick smear within an hour of arrival to a rural Oregon hospital (not a hotspot for malaria).
This sounds vaguely familiar to some of the telemedicine shifts I cover 🤣 Spot on sir! Keep’em coming!
Hmm, telemedicine would be an interesting series too!!
@@jamesburton1050 maybe I could get a cameo appearance 🤣🤣
I thought there would be Ortho coming, taking the phone from the Surgery, and saying something like "Hey, Village bro, how's things, get your patient here and I'll make his bones happy!"
Even ultrasound in a rural facility is scarce. They pulled ours last year when we shut down labor and delivery. We're sort of just a glorified urgent care with an ER and a few in-patient beds, at this point. Thankfully, our main hospital is only about 20 minutes away rather than two hours...but we do frequently have to fly people out to the even bigger hospitals in our area for the most severe traumas. They are about a 2-hour drive or about 45 minutes by helicopter in either direction, depending on which type of issue it is that needs a higher level of care than we can give out here. I never really thought about it because it has always been the norm, but we are definitely in the rural category.
Glad there's a main hospital 20 minutes away. My first thought when you said they shut down L&D was what? Did they stop making babies there?
Classmate of mine ended up giving birth in her bathtub in western Nodak after being sent back from the hospital that was an hour and a half away. Rural medicine is rough
Wow, they've got a CT machine and a walk-by MRI? They've got it going on! Lol.
I work in a semi-rural hospital, so I'm basically in the middle of both of these. We have most of the amenities of a big hospital, about 20 minutes away from a trauma 1 center, but we have much less manpower, patients who often lack PCPs/preventative care, and we're looked down on quite a bit. I will say, even though I am the only rad tech on overnight and I do both xray and CT where it can get crazy, but I still prefer it to when I worked at the trauma 1 hospital. More autonomy, and my boss actually seems to care about her employees more.
Currently doing my rural fam med round, my guy couldn’t be more on point
Being in a rural area myself with limited healthcare, I always appreciate your videos about rural medicine. They're so spot on.
And while Johnathans do not exist in our world, there are many of the Peggys who multitask to help cover some of that.
Another great video Dr Glauc.
Honestly Rural Medicine makes me feel things. I'm rural, living about 25 miles from my clinic (the ONLY clinic in my admittedly small county, in the only incorporated town). There's no MD on staff there, but at least they've got Epic