Rural Health Equity Matters
How one Kansas hospital is addressing its sustainability challenges and advancing health equity
By Duane Reynolds
Earlier this summer, I had the good fortune to visit Kearny County Hospital, a 25-bed critical access hospital in Lakin, Kan., to learn about its success in caring for a unique rural community. Under the leadership of CEO Benjamin Anderson, the hospital revamped its recruitment efforts to bring some top physicians to practice medicine in a rural but progressive environment.
As rural hospitals across the country struggle to keep their doors open, Anderson knew it would take bold, innovative thinking to attract and retain top talent and continue to provide to patients far and wide.
Creating a new model of physician outreach
To ensure that Kearny could continue providing services — especially obstetrics services — Anderson hired graduates from the nearby Via Christi Family Medicine Residency, which is part of the Ascension Kansas Ministry Market and is located a couple hundred miles east of Lakin in Wichita. This program, which includes a one-year international fellowship, trains doctors in full-spectrum family medicine.
By targeting his outreach to physicians interested in missionary work overseas who also were trained in obstetrics, Anderson built a team that could address the hospital’s high rate of complicated births. He emphasized to incoming physicians that they could get hands-on experience delivering babies in developing countries, except they would be in rural Kansas, caring for a large population of Somali refugees and immigrants who reside in the area.
To attract and retain physicians, Kearny’s recruitment efforts included medical school loan forgiveness and time off (10 weeks) for doctors to serve internationally. This experience helps doctors better address health disparities, poverty in rural, remote areas, and generally be more equipped to serve a population whose health needs may be similar to what they find overseas. Under Anderson’s vision, Kearny has become a labor and delivery hub, attracting expectant mothers from other nearby counties.
Caring for a community with cultural competency
I learned firsthand how the staff at Kearny County Hospital have embraced their community, which is largely comprised of immigrants and refugees. For example, one physician assistant moved into the same apartment complex as many Somali immigrants, which ultimately led to stronger patient-practitioner relationships and trust, a better understanding of their health needs and a greater appreciation for social determinants of health.
Providers learned how to effectively care for a population with complex medical needs. For the past several years, they have asked questions about Somali culture, fostered relationships to build trust and ultimately were able to help many who may have otherwise delayed necessary care. For example, many of the women in this vulnerable population are in need of reconstructive surgery for female genital mutilation, and it was through the relationships forged with hospital staff that these Somali women came forward to get care and, subsequently, encouraged their peers also to get care.
How health equity factors into the patient experience
In today’s day and age, hospital and health system leaders strive to provide culturally competent care to all patients regardless of background, age, race or ethnicity, or geographic location. That’s why it is critical for leadership forums and hospital boards to reflect a culturally and ethnically diverse make-up of health care leaders. Patients want to receive care that comes from decision makers who look like them, understand them and fight for them.
I urge hospital and health system leaders to think about how health equity factors into value-based care, and how we can work together to make small changes that lead to systemic improvements in patient experience and engagement.
Anderson recently departed Kearny County Hospital for the Colorado Hospital Association, but his legacy will live on in Kansas. His efforts at Kearny underscore the critical importance of innovative thinking, bold ideas, new partnerships, a willingness to engage the community and apply for grants, and empathy at its finest. With the help of other health care organizations and many talented physicians, Kearny will continue to serve as a beacon of hope to rural hospitals everywhere.
Duane Reynolds is former president and CEO of AHA’s Institute for Diversity and Health Equity.