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A recent study of UW School of Medicine graduates found those who received training in underserved rural communities were more likely to work in rural communities after completing their training. The findings “emphasize that educational programs and policies are crucial public health interventions that can promote health equity through proper distribution of health care workers across rural regions of the United States,” wrote the authors in their conclusions.
While building a physician base is one solution, it will take time; in the meantime, telehealth is a more immediate way to address some gaps in care. Few telehealth services have been scrutinized as heavily as medication abortion, which was made available by mail, with remote counseling, during the COVID-19 pandemic; access to mifepristone, one of the drugs that make this possible, is currently at issue as part of an ongoing Supreme Court case and a Washington lawsuit.
But before the Supreme Court took up the mifepristone challenge, researchers at the University of Washington analyzed the impact medication abortion by mail and telehealth had on remote Washington communities. They found Washington women who lived the farthest away from clinics benefited most from telehealth abortion counseling, as did multiracial patients. The findings, published in the Journal of the American Medical Association, show the promise of remote treatment for abortion as a way to address disparities in access, and a potential model for telehealth as a way to bring clinician support and medications into areas where they would otherwise be inaccessible. “Washington’s model could be a template for providing abortion medicines equitably in other states,” said lead author Anna Fiastro in a news release.
Data shows telehealth services for other types of care also benefit patients. A University of Washington Information School study found telehealth services were especially helpful for patients with motor-neuron diseases like ALS, who reported less fatigue after remote care than in-person. Researchers also reported that telehealth benefited people who use assistive communication technology or live in rural areas.
But even in the case of medication abortion, a successful example of remote care, in-person services are still needed for some patients, said Mercedes Sanchez, executive director of Cedar River Clinics, the network of clinics examined in the UW study. And not all patients preferred telehealth when it was an appropriate option: Some wanted a more human experience, something that can’t quite be quantified in a study or statistical analysis or provided outside of an in-person interaction. Given the choice between picking up medication in person or through the mail, said Sanchez, “We were surprised that the majority chose to pick up their pills. We feel they wanted to be able to have a touch point with clinical staff, even if it wasn’t medically necessary.”