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Op-ed: Holshouser's Rural Health Vision Continues


For Immediate Release
Monday, July 24, 2013

Holshouser's Rural Health Vision Continues
By: Dr. Robin Cummings
The Pilot
July 23, 2013

The recent passing of former Gov. Jim Holshouser has provided an opportunity for many of us to reflect on his significant contributions to our state, as a statesman and as an advocate for all North Carolinians.

In my view, one of his most significant achievements was the initiation of the first state Office of Rural Health in the country.

In 1973, then-Gov. Holshouser recognized the need for our state to improve access to quality health care for citizens living in rural areas. His foresight made our state a model for the nation. There is now an Office of Rural Health in every state.

The Office of Rural Health and Community Care, part of the N.C. Department of Health and Human Services, has grown far beyond its original mission to establish a network of rural health centers in our state. Today, with the support of state, federal and philanthropic sources, the office administers a budget of about $37 million and provides services in all 100 counties.

It helps to recruit physicians, dentists and other health providers to underserved communities; assists with funding for capital and technology improvements for local safety-net providers; connects uninsured adults with a primary medical home and access to preventive care and chronic disease management; and manages a medication assistance program that provides free and low-cost medications donated by pharmaceutical manufacturers to patients who cannot afford them.

I recently had the opportunity to visit several rural health clinics in the eastern part of our state and saw firsthand how we are keeping Holshouser???s legacy alive in local communities ??? like Columbia, a small town in Tyrell County.

More than 20 years ago, at the request of and with the support of community leaders, the Office of Rural Health helped to build a clinic and recruit a physician to serve the approximately 4,000 residents of the county. The original physician retired, and his replacement has won the hearts of her patients.

Thanks to continued community support, the clinic is now a state-of-the-art primary care practice with an electronic health record. The leadership is exploring how to become a certified medical home, a growing requirement for success in health care delivery. And true to our goals, the clinic is now self-sustaining.

Over the past year, our office has brought more than 160 health care providers, including pediatricians, family practitioners and internal medicine physicians, to underserved communities in North Carolina. Through a carefully monitored loan repayment program and incentive contracts, we have been able to attract an average of 149 health professionals each year for the past six years.

Our work is not always easy. In places like Ocracoke Island, home to more than a million visitors during the summer months but just over 1,000 year-round residents, recruiting a physician to the area was a challenge. As a result of our recruiting efforts, the clinic now has two providers available seven days a week, year round. The clinic???s board of directors is initiating the use of telemedicine to bring much access to much needed medical specialties to the island.

Upon my appointment as director of the Office of Rural Health in March, I reached out to Gov. Holshouser and had the opportunity to speak with him by phone. His voice was strong, and he still had incredible enthusiasm and pride for the work we are doing to help the more than 1.5 million people without adequate health care in our state.

He urged me to look at new ways of meeting those needs. When you go there, he said, remember we created the office for what North Carolina needed 40 years ago, but things have changed, so be sure the office has kept up.

Under the leadership of DHHS Secretary Aldona Wos, we are embracing technology and focusing on bringing today's standards for quality measurement to bear in our rural health clinics. She is enthusiastic about our work - not only to recruit providers, but also to equip local communities with capacity for telehealth services, specifically telepsychiatry, to address unmet needs.

By empowering local communities and supporting them in developing innovative strategies to improve access, quality and cost-effectiveness of health care, the Office of Rural Health is a legacy of which I believe Jim Holshouser would be proud.

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Dr. Robin Cummings is the Director of the Office of Rural Health & Community Care and is a board-certified retired general surgeon in Pinehurst and most recently served as Medical Director and Executive Director for Community Care of the Sandhills.

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