This month, Reckon talked with young doctors who live and work in communities across the South. We asked them what they think are the biggest problems facing rural healthcare in the South, and how they’d fix those problems if they had unlimited resources. Read on for their real-world solutions.
If you know a young doctor with smart ideas on tackling the health care crisis, email [email protected]
Dr. Justin Turner, Jackson, Miss.
Justin Turner left corporate healthcare in 2013 to open his own practice, TurnerCare LLC, because he was dissatisfied with the way he had been practicing medicine.
“I was encouraged to see patients every eight minutes or so,” he said, “but I had patients that needed so much more. I could not perpetuate a cycle of being a pill dispensary and not addressing all of the underlying issues.”
Turner, who has won local and national awards for his medical practice, now spends as much time with his patients as they need. He sees mostly middle-aged and elderly patients at his Jackson clinic, many of whom are economically disadvantaged, he said.
His goal is to treat the whole person, talking with them about what they’re eating and the nutritional content of those foods – and how that might be contributing to health problems like high blood pressure or diabetes.
Many of his patients don’t understand the ways in which their diet and lifestyle contribute to the medical problems they have, he said. Some of his patients have educational barriers; some don’t have reliable broadband internet access.
“It’s a cycle that continues and has done so for decades, where patients go into doctors’ offices and hospitals primarily looking for Band-Aids (to their medical issues) when they may really need a doctor to sit down and explain what hypertension is and what a low-sodium diet looks like, and how to get better.”
He gave the example of one patient who came to him with a long list of chronic conditions including degenerative joint disease, back pain, acid reflux, sleep apnea and high blood pressure. After helping her reexamine her diet and lifestyle, she has worked to lose 70 pounds, he said. Much of her chronic pain has subsided and she’s able to go on a vacation with her family again. For other patients, he said, lifestyle changes help them whittle down the number of prescription medications they need.
In rural areas, obesity-related problems like diabetes or heart disease are particularly pronounced. But the problem is that much of the medical establishment isn’t set up to prioritize preventative care, he said.
It’s been difficult for his patients to get referred to a nutritionist or dietician because insurance often doesn’t want to cover those kinds of preventative services, he said. Insurance may not cover a visit to the doctor just to discuss addressing obesity, he said, even though obesity is an underlying contributor to a host of other medical complications.
“Insurance will pay for a heart operation, a knee replacement or a back operation that may cost tens of thousands of dollars,” he said, “but they’ll fight with me over an obesity visit that may cost $100. The emphasis is not on preventative medicine; it’s on reactive medicine.”
Turner said he works with other doctors and clinicians in Mississippi to lobby at the state capital for improved insurance coverage of preventative care, both through private insurance and Medicare and Medicaid.
He thinks the medical community and patients need to continue organizing and pushing for reforms that would make preventative care more affordable for everyone. Mississippi is one of 12 states that haven’t expanded Medicaid to cover more lower-income people. State leaders have signaled they’re not interested in expansion.
“It’s one thing to run a political campaign and say that while we’re not going to expand Medicaid, there are other ways to improve medical care in Mississippi,” Turner said. “But if those alternatives have not resulted in the increase in improved healthcare to our fellow residents, then it comes off as lip service and insensitivity to the needs of the ‘least of these.’”
He’s passionate about the issue, he said, because preventative care in rural areas affects “your aunt, my grandma, that teacher who gave us opportunity.
“A lot of people brag on my medical training but it’s the Sunday School training that taught me not to forget who I am but Whose I am,” he said. “Everyday Americans are suffering at the hands of greed when it doesn’t have to be this way.”