Health care is an issue that commands our attention. The Health and Human Services subcommittee of the Virginia Senate Finance Committee has been traveling to hospitals around the state to hear about health care in different regions and for multiple categories of patients.

I wrote some months ago about our visit to Children’s Hospital of the King’s Daughters in Norfolk. In addition we have visited the Manassas General Hospital (check title), the Medical College of Virginia in Richmond,  and the U. Va. Medical Center in Charlottesville. This week’s meeting was at a small rural hospital, the Smyth County Community Hospital, in Marion, Virginia.

There are multiple challenges in providing health care in rural Virginia. The geography and long distances alone complicate the delivery of care. With limited transportation, just getting to a provider is difficult. Medical providers, especially primary care physicians, are in short supply and the need is very great. Many residents of the area are uninsured and many have complex medical issues.

In the face of these needs, rural providers are responding in innovative ways. Southwest Virginia Community Health Systems, Inc., has multiple sites in the region, including Saltville, Troutdale, Bristol, Tazewell, Radford, and clinics in Grayson and Washington County. They have a mobile clinic to serve residents of public housing and migrant farm families, telemedicine services, medication assistance, and a central pharmacy.

In the mountains of Appalachia, The Health Wagon brings services to the residents of Dickenson, Buchanan, Russell and Wise counties (combined population of 110,854). The mountainous terrain covers 1715 square miles with many locations that are very isolated. From the base clinic in Clinchco, the Health Wagon travels to eight sites on a weekly to biweekly basis providing acute and chronic disease management, low cost lab services and medication assistance, immunizations, x-rays, mammograms, telemedicine and referrals.

The executive director of the Health Wagon cited statistics that show that death rates from common causes are higher in their service area that in Virginia overall. For example, people in the region are 25% more likely to die from heart disease, 47% more like to die from pneumonia or influenza, 34% more likely to die from diabetes and 72% more likely to commit suicide.

The Health Wagon also sponsors health fairs. The best known of these is the annual Remote Area Medical (RAM) Health Expedition in Wise County. This free three-day event brings 1700 volunteer physicians, nurse practitioners, dentists, nurses, opticians, opthalmologists, dental hygienists and other volunteers to the Wise County fairgrounds to provide care to thousands of Virginians. It is the largest event of its kind in the nation.

Although health care needs are found everywhere, clearly there are special medical challenges in Southwest Virginia. Many wonderful people are doing their best to meet those challenges and provide care in spite of the geography, the large numbers of uninsured and/or indigent patients, and the limited number of both primary care physicians and specialists.

Senator Whipple represents the 31st District in the Virginia State Senate. She may be e-mailed at district31@senate.virginia.gov