Rob: Well, thank you, Alisa.
Well, it certainly sounds like Drumright is becoming a true example for other
parts of our state.
Now, earlier, I sat down with Val Schott who is director for the Center of
Rural Health at Oklahoma State University, and talked with him about what
other communities can learn from the town of Drumright.
Rob: Well, Val, from early on in my career, it seemed like I was doing a story
on a rural hospital closing, like every year.
But, in recent years, it seems like that has slowed down; why is that?
Val Schott: That's exactly right.
About six years ago, Congress passed what we call the Medicare Rural
Hospital Flexibility Act which allowed small rural hospitals, the smallest
rural hospitals, those that are 25 beds or less in rural communities, to
become critical access hospitals.
And essentially what that does, it pays them 101 percent of their costs for
their medicare patient base.
That's significant, because that's 60 to maybe 80 percent of what their
para source is for most rural hospitals in Oklahoma, and, in other
parts of the country as well.
Rob: So, in addition to the changes that were made on the federal level, how
has technology helped these hospitals survive,
and even prosper, in some areas?
Schott: Well, that's a really good point.
When they had to look at, when the hospital administrator had to look
at how am I going to make payroll for the next two weeks, and that's what the
prospective payment system really did to those rural hospitals, they couldn't
look at making any improvements in their technology.
For instance, the radiology, in order to have current,
state-of-the-art equipment, it costs probably ninety thousand
dollars plus for a rural hospital to do that.
If you have to make payroll every two weeks and are concerned about
that, then you're not going to look at putting
money into the capital structure.
Rob: And as we just saw in the Drumright story, these are smaller facilities,
more targeted facilities as well.
Schott: Exactly.
And, they're built to take care of their primary care needs
for people in those communities.
Now that's not to say we're going to do
everything at rural hospitals.
We're not going to be cracking chests in every rural hospital in
Oklahoma, or probably none of them, except on an emergency basis.
But, we can do 60, 65 percent of all the healthcare that people
need in those small, rural, primary care hospitals.
Rob: We've talked a lot about technology, but I guess it warrants to say,
physicians, rural physicians are extremely important
to make any of this work.
Schott: Absolutely.
Our mission is to provide rural primary care physicians for Oklahoma,
and we do a really good job of that.
We're the only medical school in the country that requires their graduates
to take a telemedicine course.
I'm really ashamed to say that.
I think every medical school should do that.
But, our guys and gals, and they're great kids, they're great doctors,
have to take a telemedicine course before they can graduate, have to
make a presentation actually using telemedicine to do so.
Rob: Have the partnerships developed between the smaller hospitals and the
larger hospitals that they're doing this telemedicine with?
Schott: Absolutely, absolutely.
They look to the larger hospitals for specialty referrals,
those kinds of things.
We're doing cardiology follow-ups with telemedicine.
We're doing some psychiatry through telemedicine.
We've just really scratched the surface there.
But it gives a natural referral pattern for those types of situations, and
it ends that isolation that a rural doctor would feel.
Rob: Final question, what do you see the future being like?
Schott: Well, I think we're going to see more and more of telemedicine,
quite frankly.
We're going to see the physician as the person that manages that care.
We certainly will see some physician extenders in that process, but we have
to find ways to keep that primary care physician in that rural community.
That's the key, in my view, is to have primary care available in those
rural communities.