title: Reaching rural patients through otolaryngology visiting consultant clinics.
abstract: Providing otolaryngology care to rural populations is a major challenge. In this study, we focus on rural outreach by the otolaryngology workforce in Iowa, a state with a high proportion of rural residents. Using data from 2013, we find that almost half (46%) of Iowa-based otolaryngologists participate in outreach. Along with colleagues from adjoining states, Iowa otolaryngologists staffed more than 2100 in-person clinic days in 76 mainly rural sites. This system of rural outreach has expanded access from 20 to 85 of the 99 counties in Iowa. These efforts improve access for more than 1 million residents out of a total population of 3 million. However, this improved level of access comes at a cost as visiting otolaryngologists drove an estimated 17,000 miles per month. This established approach to serving rural patients may be negatively impacted by changes under the Affordable Care Act.
authors.affiliation: Tippie College of Business, University of Iowa, Iowa City, Iowa, USA Thomas-gruca@uiowa.edu.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Gruca
authors.affiliation: College of Business and Economics, Chung-Ang University, Seoul, South Korea.
authors.forename: Inwoo
authors.initials: I
authors.lastname: Nam
authors.affiliation: Office of Statewide Clinical Education Programs, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Tracy
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D016208:Databases, Factual; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D020380:Needs Assessment; D010036:Otolaryngology / Q000458:organization & administration*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D019035:Rural Health Services / Q000458:organization & administration; D012424:Rural Population; D014481:United States
keywords: geographic access; health care reform; otolaryngology workforce issues; physician shortage; rural outreach