Medical Care in Rural Colorado (Denver, Colorado Springs: credit, insurance, travel)

[livecontent]

I want to bring up a discussion of rural health care and the availability. I think it is a very important issue for people considering retiring into these areas, especially Colorado.

When you age, you will, not probably, need more health care and frequent care. Today medicine relies on more technical analysis and procedures then in the past. These procedures, equipment and facilities do not exist in many areas of Colorado and they are very far away. In addition, the specialist and medical care providers congregate in larger population centers, so as to have access to this equipment and facilities in order to do the procedures. Also, I think medical professional do not want to work around to clock without support and all all trained in urban areas and grow use to the amenities.

There was a series of articles in the Denver Post about how difficult it is to get doctors to practice in many rural areas and service the hospitals. Not only would you need good nearby care for the problems of aging but you will need extensive and immediate care for trauma. Many of these areas do not have trauma emergency facilities and transport patients to the larger populations centers. Well, that takes time, and time is paramont in trauma care.

Also the small towns, in the mountains, have very difficult roads and extreme conditions so that 20 miles from medical care, can easily be the same as 60 miles or more in another less challenging area.

Today is not yesterday when the family doctor on the circuit was the care that was good enough. Today, Physicians can only practice their craft with support of technology. That is one of the reasons why populations are congregating more and more in urban centers and small town populations are dwindling.

Livecontent

[jazzlover]

Glad you brought this up. First, let me say that I have a lot of respect for medical practitioners in rural areas. They have a tough job, and many medical professionals now shun practicing in rural areas these days. So, those who do pracitce in rural areas deserve our thanks. Second, medical care has improved considerably in rural Colorado in the last 30 years or so. As an example, back in the early 1970's, I got scraped up (thankfully, that's all) in a car accident and wound up in a rural Colorado emergency room. The doctor on call, a local General Practitioner, came into the ER smoking a Chesterfield (which he put out in the scrub sink) and smelling of alcohol (I was reminded of the Beatles' lyric to "Rocky Raccoon": "the Doctor came in, stinking of gin . . ."). He then proceeded to stitch up my cuts like a New Jersey clothing seamstress without my having any benefit of local anesthetic. By the way, he was considered by most to be the best doctor in town at the time. After 30+ years, the scars have pretty much disappeared, but I still remember that night.

Still, no one should think that rural medical care in Colorado is a panacea today. Most specialized treatments and care will likely require one to travel to Denver or Colorado Springs (maybe Grand Junction for some things). When that can involve anywhere from a 200 to 700 mile round trip, it can be inconvenient, to say the least. I lived in rural Colorado for a number of years, and I--and just about everyone else I knew that lived in rural Colorado--has had to go to Denver or the Springs for medical treatment at one time or another. During one period, I had to do it 3 to 4 times a month for about 3 months straight--thank God, it was when fuel was still pretty cheap.

A serious medical emergency in rural Colorado may also mean being Medivac'ed to Denver, Grand Junction, or Colorado Springs by helicopter. As any knowledgeable helicopter pilot can tell you, helicopter flying in Colorado's high altitudes and unpredictable weather can be a harrowing experience. There have been a number of medical helicopter crashes in the last 25 years or so in Colorado or nearby areas served by Colorado medical helicopters--usually fatal to all on the aircraft.

Also, a lot of rural Colorado hospitals live at the very brink financially. Many of them are heavily reliant on Medicare and Medicaid payments and this can be a real financial hardship.

Bottom line: Rural Colorado medical care is not like some third world country, but it ain't the Mayo Clinic, either.

[livecontent]

Originally Posted by jazzlover

Glad you brought this up. First, let me say that I have a lot of respect for medical practitioners in rural areas. They have a tough job, and many medical professionals now shun practicing in rural areas these days. So, those who do pracitce in rural areas deserve our thanks. Second, medical care has improved considerably in rural Colorado in the last 30 years or so. As an example, back in the early 1970's, I got scraped up (thankfully, that's all) in a car accident and wound up in a rural Colorado emergency room. The doctor on call, a local General Practitioner, came into the ER smoking a Chesterfield (which he put out in the scrub sink) and smelling of alcohol (I was reminded of the Beatles' lyric to "Rocky Raccoon": "the Doctor came in, stinking of gin . . ."). He then proceeded to stitch up my cuts like a New Jersey clothing seamstress without my having any benefit of local anesthetic. By the way, he was considered by most to be the best doctor in town at the time. After 30+ years, the scars have pretty much disappeared, but I still remember that night.

Still, no one should think that rural medical care in Colorado is a panacea today. Most specialized treatments and care will likely require one to travel to Denver or Colorado Springs (maybe Grand Junction for some things). When that can involve anywhere from a 200 to 700 mile round trip, it can be inconvenient, to say the least. I lived in rural Colorado for a number of years, and I--and just about everyone else I knew that lived in rural Colorado--has had to go to Denver or the Springs for medical treatment at one time or another. During one period, I had to do it 3 to 4 times a month for about 3 months straight--thank God, it was when fuel was still pretty cheap.

A serious medical emergency in rural Colorado may also mean being Medivac'ed to Denver, Grand Junction, or Colorado Springs by helicopter. As any knowledgeable helicopter pilot can tell you, helicopter flying in Colorado's high altitudes and unpredictable weather can be a harrowing experience. There have been a number of medical helicopter crashes in the last 25 years or so in Colorado or nearby areas served by Colorado medical helicopters--usually fatal to all on the aircraft.

Also, a lot of rural Colorado hospitals live at the very brink financially. Many of them are heavily reliant on Medicare and Medicaid payments and this can be a real financial hardship.

Bottom line: Rural Colorado medical care is not like some third world country, but it ain't the Mayo Clinic, either.

Actually, you brought up this issue in the thread, giving advice to retiring in Colorado--but I decided to hijack the topic, take credit and start a new thread. Well, actually, I did not want it buried; I wanted a more open discussion.

Your story is quite amusing. I knew you had some humor in that crusty, complaining, catankerous, curmudgeonly, cranky body. Again, you brought up some good points.

I am a person who has difficult medical problems--Oh, the pain, the pain; I am looking for sympathy.. It seems, I am always going to a doctor, having a test. I could never live in a remote area or even a rural town.

People come here from the east and say they want to retire in a rural town in the mountain. Many of them are thinking of rural eastern towns, which are easily accessible off a highway, better roads, closer to major medical centers and have more health care options in the town. I do not think that they are aware that many of these areas that they are considering, are a different type of rural experience and more difficult travel in and out, with lot less health care options.

I am on Medicare. People who have not retired are not aware that medicare options for health care plans and providers are limited in these areas.

Sometimes I cannot drive--so I use a the access disability service under RTD. However most people are unaware that the service cannot be provided if you live more than 3/4 mile from a commuter bus route. That is a federal regulation for federal funds. Couple of years ago, RTD was stretching that rule and was told to stick strictly to the regulations. Think about this. Even in the suburbs of Denver, many people cannot use this service because they live too far from a bus route. In rural areas, these services are very limited, if they exist at all.

Denver is good for me because it is not too big, compared to other cities. It is a regional health care center with all the technology, services and a VA hospital.

I do not care, how healthy you are now. There will come a time, when these services will become important. So to move to some of these areas, when you retire may cause a great deal of problems that could be avoided.

Livecontent

[Katiana]

Some out-staters may disagree with me on this, but the main health care scene in Colorado is the Front Range, particularly Denver. Denver has the state's only medical school, pharmacy school, physical therapy schools (2), and physical assistant schools. Most of the Bachelor's degree programs in nursing are along the Front Range, and all the Master's/PhD programs. The teaching hospitals are in Denver (St. Anthony's is moving to Lakewood, a Denver suburbs).

[livecontent]

Originally Posted by pittnurse70

Some out-staters may disagree with me on this, but the main health care scene in Colorado is the Front Range, particularly Denver. Denver has the state's only medical school, pharmacy school, physical therapy schools (2), and physical assistant schools. Most of the Bachelor's degree programs in nursing are along the Front Range, and all the Master's/PhD programs. The teaching hospitals are in Denver (St. Anthony's is moving to Lakewood, a Denver suburbs).

I was hopint that you would add to this thread with your expertise. That is the point I am making, most technology of health care is very concentrated in Colorado and is not spread out into this vast state.

Just to give you some new information that you may not be aware. There is a new private medical school being established in Colorado. It will be an Osteopathic College of Medicine Rocky Vista University.

I know that you would know, but most people are not aware that an Doctor of Osteopaty (DO) has the same training and privileges to practice medicine as a Doctor of Medicine (MD). So, I am saying this to clarify the issue. I have gone to an Osteopathic Physician and I find no difference in care.

Livecontent

[Katiana]

Thanks. I did not know about this school.

[BarryK123]

Originally Posted by livecontent

I know that you would know, but most people are not aware that an Doctor of Osteopaty (DO) has the same training and privileges to practice medicine as a Doctor of Medicine (MD). So, I am saying this to clarify the issue. I have gone to an Osteopathic Physician and I find no difference in care.

Livecontent

One thing to consider, though. Why would someone choose to become a DO instead of an MD? While there may be a handful that prefer the DO approach, probably because they didn't get into medical school.

[Katiana]

Originally Posted by BarryK123

One thing to consider, though. Why would someone choose to become a DO instead of an MD? While there may be a handful that prefer the DO approach, probably because they didn't get into medical school.

DOs and MDs take the same state boards, so they have the same body of knowledge.

[livecontent]

Originally Posted by BarryK123

One thing to consider, though. Why would someone choose to become a DO instead of an MD? While there may be a handful that prefer the DO approach, probably because they didn't get into medical school.

Yes, you ar probably right. However, that does not mean that the person is not qualified to study medicine. Medical Schools have very restricted admissions, rightfully so. The osteopathic schools use the same medical college admission test and apply the same admission standards.

However, the expansion of Medical schools may have been blocked by the medical establishment to create shortages so as to decrease competition.
So, there are many people who can become physicians if there was more available training.

I believe that medical care is served better when there are more providers with specific training to handle care at all levels. I have had care from MD, DO, NP(Nurse Practioners), Physician Assistants (PA), Registered Nurses (RN), Clinical Pharmacist etc. and they all have given excellent care in a supportive and team approach to medicine.

We need more health care providers; we need more places to train them so I am very happy that an Osteopathic University is opening in Colorado.

I am not very knowledgeable in the health industry but I know as a patient what works for me and my family. I have learned to become my own advocate in medical care and I try to understand the issues.

Livecontent

[AMB8301]

Durango and surrounding areas have a serious primary care doc shortage. It is hard enough to find a doc that will take new patients, (I waited 6 months on a list, and I have insurance), and almost impossible if you are a new patient and on medicare. I know of several people who are driving from Durango to Cortez because that is the only doc they could find to take them. I don't know if any family practice docs in the last couple years have taken any new patients with medicare. So many people do not have proper medical care that the city and the hospital teamed up to open a clinic as a stop gap solution until something else can be done. This takes many newcomers by surprise, medical care is something many people do not plan ahead for when they are moving.

There are several pediatric offices in town, they all are very busy. I do know that they have a high # of medicaid patients, which makes it difficult to break even. That is one of the reasons the large Valley Wide clinic shut down last year, their Durango clinic had very high operating costs (rent, etc...), and then a large amount of medicaid/medicare patients, they operated at a loss for several years.


Other things to think about is the altitude, Colorado isn't high, but it can be high enough for those who have respiratory issues. My grandmother moved here from FL several years ago to be closer to us, she is fine at sea level, but now has to wear O2 24/7 in CO. My second daughter was on O2 until she was 7 months old because of respiratory issues related to the altitude. Had we been at sea level, it is very unlikely she ever would of spent a day on O2. In hindsight, had we known it was going to be so long with her being on O2, I would of taken her to sea level for a while, but everyone kept thinking it was going to be any day, any day, and some how it turned into months... I am very familiar with the disadvantages of living in a rural area when it comes to medical care after her. Her docs were consulting with Children's very frequently, and the only reason we were not flighted there was because they/we all agreed there was nothing else they could do for her.


Interesting topic, I'm glad it was brought up.