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How EM Healthcare Practitioners Can Thrive Working in Rural Areas

As of 2020, 92% or 44,908 of the 48,835 clinically active emergency physicians in the United States practice in urban areas. In contrast, only 8% (3,927) practice in rural communities, a 10% decrease since 2008. Due to the nature of rural areas, EM providers experience a lack of housing and travel long distances making working in rural communities challenging. Lack of community and medical resources may deter EM physicians from working in rural areas.  

While working in rural communities requires more autonomy and a broader set of skills, many emergency physicians feel ill-prepared to manage more than the first 20 minutes of most emergency conditions, let alone the many hours often required to stabilize a sick patient prior to successfully arranging transfer to a higher level of care. There is, however, a great opportunity for emergency physicians to not only hone their overall medical capabilities, but to grow their specialty, and own the practice of emergency medicine in both urban and rural localities,” emergency physician, Dr. Louis Yu states.  

Needless to say, practicing emergency medicine in rural communities is not an easy task. We’ve compiled five strategies to help EM healthcare workers to thrive working in rural communities. 

Build a supportive network around you 

Emergency medicine in rural communities can be isolating without others to lean on. Building a community of supportive and collaborative relationships, both clinically and non-clinically, will aid in building a community of practice. Lean on past and current colleagues, mentors, and other EM practitioners working in nearby hospitals and clinics for advice. Creating a network of understanding colleagues will create stability in a constantly changing workplace. 

Healthcare system adaptability 

Many rural hospitals and clinics do not have the same medical technologies and treatment options as other more urban and modern facilities. Be sure to adapt and re-learn new systems that rural facilities utilize. Remember the rich history of Mcgyvering that EM has cultivated since its inception. EM is the most adaptive specialty in medicine, and working in rural settings highlights your resistance to rigid thinking. Encourage telemedicine options and video conferencing for specialized care referrals within healthcare systems to ensure you can provide the highest quality for your patients at all times. 

Connect with community resources 

Working in small towns doesn’t mean you don’t have resources around you. Mental health and substance-related emergencies are not isolated to urban areas. Get in touch with your health facility, social worker, or local nurse/staff member to find out what resources exist in your community. You will feel more confident on how best to refer patients when knowing available community resources. 

Set boundaries – as best as you can 

Practicing emergency medicine, particularly in rural areas, results in more responsibilities across specialties due to the lack of physicians in the surrounding areas. Take care of your mental, emotional, and physical health as best as possible given these work responsibilities. Emergency medicine requires individuals to be quick on their feet, detail-oriented, and calm when under pressure. Take the necessary steps to feel ready for your shifts by prioritizing your overall well-being. 

Play it forward 

When you find balance while working in rural settings, share your experience, thoughts, and suggestions with the larger EM community.  We are all learning how to best serve our patients.  Rural EM needs its own advocates, teachers, and leaders to make sure that we are building a better healthcare system and owning our own specialty.   

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