Angela Howard and Roger Wells

Left to right, Angela Howard and Roger Wells. Both providers met with the Bertrand community Monday.

BERTRAND — As rural areas around the country struggle with accessing healthcare, Lexington Regional Health Care has been purposeful in extending their service to smaller communities in Phelps and Gosper Counties.

On Monday, Feb. 3, LRHC held a provider meet and greet and the Blue Moose Bar and Grill in Bertrand, the community could come out and meet the providers who are at the LRHC clinic in town.

In fall 2018, LRHC opened a clinic in Bertrand after nurse practitioner Ruby Houck closed her clinic down in 2017.

The two providers manning the Bertrand clinic are Roger Wells, PA-C and Angela Howard, NP.

Wells is a family provider at Family Medicine Specialists. He can also be seen at the Bertrand Clinic on Wednesdays from 8:00-12:00 p.m. Roger joined Lexington Regional Health Center September of 2019. He recently started assisting Orthopedic Spine Surgeon, Dr. John Ray in the outpatient clinic, according to LRHC information.

Howard works in Family Medicine Specialists Walk-In Clinic. She can also be seen at the Bertrand Clinic on Mondays from 8:00-12:00 p.m. Angela also specializes in wound care.

On Monday evening both were able to meet with members of the community, to introduce themselves and show the services which are open to the Bertrand community.

“Making high quality health care available in rural areas is an essential ingredient in community economic vitality and quality of life,” said LRHC CEO Leslie Marsh, “We look forward to working with Bertrand to build an ongoing relationship that fosters a healthy and strong community and health center.”

As the landscape of healthcare ebbs and flows, rural areas have been increasingly cut off from quality healthcare due to multiple factors.

According to the website of the Rural Health Information Hub, “In order for rural residents to have sufficient access, necessary and appropriate healthcare services must be available and obtainable in a timely manner. Even when an adequate supply of healthcare services exists in the community, there are other factors to consider in terms of healthcare access.”

The Rural Health Hub lists different factors for quality healthcare access,

• Financial means to pay for services, such as health or dental insurance that is accepted by the provider

• Means to reach and use services, such as transportation to services that may be located at a distance, and the ability to take paid time off of work to use such services

• Confidence in their ability to communicate with healthcare providers, particularly if the patient is not fluent in English or has poor health literacy

• Trust that they can use services without compromising privacy

• Belief that they will receive quality care

Barriers to healthcare access in rural areas include,

Distance and transportation: rural populations are more likely to have to travel long distances for access, particularly if they have to see specialists. This can cause burdens of travel time, cost and time away from the work place. Compounding this, public transportation services are often lacking in rural areas, putting the burden of travel on the patient.

Health Insurance coverage: A 2016 study found, 43.4 percent of uninsured rural residents reported not having a usual source of care, which was less than the 52.6 percent of uninsured urban residents reporting not having a usual source of care. The brief reports that 26.5 percent of uninsured, rural residents delayed receiving healthcare in the past year due to cost.

Poor health literacy: Understanding the jargon of healthcare can be a challenge, with all the acronyms and abbreviations, it can be difficult to discern just what exactly a provider does or the care they are capable of providing. Confusion like this can lead to people’s inability to understand information and instruction or navigate healthcare in general.

Social Stigma and Privacy: Rural areas have little anonymity and there could be a heightened concern about privacy issues when residents are seeking care. Looking for care for mental health, substance abuse, sexual health, pregnancy, or even common chronic illnesses can be difficult for people who wish to keep their treatment between them and their provider. People may worry about other residents seeing them accessing such services.

Workforce shortage: Shortages in key healthcare provider positions can impact a rural population’s ability to find the professional they need to see about their condition. A recent study by the Nebraska Children and Families Foundation found Dawson County has a shortage of professionals across a wide variety of healthcare disciplines. Mental health access is also becoming increasingly important and there are shortages in this area as well.

To combat these issues, there are strategies which are being implemented to include different healthcare delivery models, affiliations with larger systems or networks, telehealth and efforts to build up a healthcare work force.

Rural communities and residents provide the backbone in several key areas such as agriculture. It is important to ensure the well-being of these populations, especially with quality health care access, to maintain and grow these areas which are depended upon by so many people.

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