Millions of Americans who live in rural areas travel long distances to get health care. Or they may go without it. But high-speed Internet connections now make it possible to bring a doctor's expertise to patients in far-off places, if those places are connected.
As part of its National Broadband Plan, the Federal Communications Commission has pledged $400 million a year to connect nearly 12,000 rural health care providers.
Overstretched Clinics, Hurting Patients
Redway, Calif., is more than 200 miles north of San Francisco -- a pit stop on the way for tourists heading to see the giant redwoods more than an hour up the road. The town of 1,200 has one health clinic. And Wendi Joiner is the only doctor at the Redwoods Rural Health Center.
There are 4,000 people from Redway and the surrounding area who use this clinic, so Joiner is one busy physician.
"It's a great job. It's a special challenge. I love it, but sometimes I feel like there should be two or three of me," she says. "It happens a lot where we're asked to do things that we're not specialists in."
Patients come in with skin problems, cancers, diabetes, hepatitis -- all diseases that require expertise Joiner may not have. So she has to send patients to doctors in cities 100 or more miles away. That can be hard on many of them, both physically and financially.
Take Marling McReynolds, a 61-year-old retiree with diabetes, arthritis in her spine and Parkinson's disease. She now has to have surgery on her shoulder, and she will have to travel for that. "I can't drive after the surgery. So I have to have somebody drive me, and it's just hard to get up there. It hurts," McReynolds says.
It's the follow-up visits that really have her worried. She'll have to set aside money for gas and tolls, and she'll have to arrange for someone to drive her. "It's gonna come out of my food money because I can't take it out of anywhere else. That's my choices. ... If I don't pay my property tax or my PG&E [electric] bill, then I don't have a home," she says.
The Broadband Program
That's where the FCC's rural telemedicine plan will help, says FCC Chairman Julius Genachowski. "If you have rural connectivity for health care, then patients don't have to drive two or three or four hours for their treatments -- instead, [they] can stay back where they live, consult with a medical profession[al] remotely," Genachowski says.
The FCC has had a pilot program for several years, which Genachowski says has been a success.
It's helped expand the reach of the telemedicine clinic at the University of California, Davis Medical Center.
Two afternoons a week, Dr. Alison Semrad, an endocrinologist, sits at a desk and consults with patients over a broadband video conference.
In a recent conference, Laura McKewan sat in a chair in front of a camera at a clinic 300 miles away in Eureka. She has Addison's disease, a rare condition that affects the adrenal glands. McKewan would have to drive six hours to San Francisco to see an endocrinologist, so she jumped at the chance to consult with Semrad.
"I'm so excited. I don't think you could get a more enthusiastic patient," McKewan told Semrad.
She's been suffering from serious fatigue that might be related to her condition. Her primary care doctor hasn't been able to help. But Semrad probes.
She spends an hour with McKewan. When she's done, Semrad will write up her recommendations and put them on a secure server where McKewan's primary care doctor can get them immediately.
McKewan has been to an endocrinologist once in the past seven years.
"It may not be quite as wonderful as sitting right there, but [not having to] to drive all the way and to save the expense and ... I think this has worked out really well," she says.
The UC Davis hospital serves around 3,000 patients every year who live in rural areas, says Dr. Tom Nesbitt, who heads the program. "The demand would even be greater if the remote locations had equipment, bandwidth and training," Nesbitt says.
That's what the FCC's annual $400 million is intended to do.
A Way To Save?
The money is already available through what's called the Universal Service Fund, which provides telephone service to rural communities. By transferring the money to broadband, Genachowski believes he can provide a lot of savings in health care.
But he still has to convince critics of government overspending.
"One of the greatest forms of savings will come from health care spending that we don't have to make because we catch problems earlier. ... We can treat and diagnose remotely," Genachowski says.
The FCC has been criticized by some broadband providers who don't like the competition from the government, but many rural areas don't have broadband connections because the rough terrain and low population density make it unprofitable for commercial carriers to build out there.
Genachowski says for those areas it makes sense for the federal government to step in.