CEO Update: CMH is a leader in rural health services

National Rural Health Day is Nov. 16, 2023, and I want to highlight the essential role of health care providers in our rural communities. Rural health clinics fill a critical need in rural communities by increasing access to care. Nationwide, rural health clinics serve more than 37 million people.

At CMH, we serve approximately 130,000 people in a rural eight-county area north of Springfield, Missouri. Twenty-five percent of Missouri’s population lives in rural areas, yet 70% of health professional shortages are in rural communities.

Fourteen of our 34 physician clinics are certified rural health clinics. In addition to traditional medical care, our clinics include:

• Behavioral health services in our clinics and in our local schools.
• Addiction recovery.
• Chronic care management.
• Care coordination services.
• Community resource specialists who connect patients with other organizations that can help with basic needs such as transportation, food or housing.

The importance of rural health care

Our physicians in our rural health clinics provide safe, quality and compassionate care to their patients. Two of our rural physicians shared their experiences. Watch the summary video or continue reading to learn more.

Kurt Bravata, M.D., FASAM, is a family medicine physician in Buffalo and see patients in long-term care. He has additional board certification in addiction recovery and is director of the CMH Addiction Recovery Program.

Bethany Dhondt, D.O., is a family medicine and OB/GYN physician at CMH rural health clinics in Humansville, El Dorado Springs and Willard.

Why do you work in rural health care?

Dr. Bravata: I grew up in upstate New York in a rural community. It’s a small dairy farming community. My experience in medicine from a young age was with a small rural hospital, and I had a chance to shadow a surgeon there when I was in my teens. My mom was a nurse, and we took care of most of our medical needs there in the home, having a mom who knew what to do. I always felt an affinity for rural communities and the needs in those communities.

Dr. Dhondt: I grew up in small areas, far away from everything, and I always noticed that everybody needed care in those areas. I often had to drive an hour to get someplace when I was a child. All of the people in the small areas need medical care, as well. I like being one person who can be nearby that everybody knows, and I know everybody there. For me, it’s more about a family. I get to know everybody’s family.

Why is rural health care necessary?

Dr. Bravata: Health care is necessary no matter where you are. But it’s important to understand the specific regional needs of a rural community and the types of employment in those communities, the types of injuries people might sustain and the educational needs. We want to meet those needs and make sure that we’re providing a full spectrum of health care in an area that might otherwise be underserved.

Dr. Dhondt: A lot of people wouldn’t have care if it wasn’t there, or they would have very limited care. I also have a lot of patients who aren’t willing to go a long distance, so they just don’t do things. But with our clinic right there and easy access and feeling like a part of the community, they’re more likely to come in, get the preventative things, get the tests they need, and come when they need help.

How do your clinics impact the local communities?

Dr. Bravata: If specialty services are needed at the hospital, whether at CMH in Bolivar or traveling to Springfield, we have patients who may struggle financially or have difficulty with having a dependable vehicle. Especially now, with high gas prices, it can be difficult for patients to make appointments, especially if those appointments require regular visits.

Traveling to a local town or a city can be difficult. Because of that, we do bring some of the specialty services to our clinic in Buffalo. We currently have podiatry. We’ve brought orthopedics to the clinic in the past. We’ve brought cardiology. We have psychiatry. We have counseling services. We try to bring as many of those services to the clinic as possible.

Dr. Dhondt: We have a huge impact, not just as far as medicine but support in general. We know when people need other things outside of medicine. We’ve given out formula and diapers. We stay on top of those things and help fundraising by getting the word out when something else is going on in the town.

And then, of course, when somebody comes in and I know what else is going on because I know all the families, it makes it easier for me to have that discussion and understand where they’re coming from and what other things may be factoring into their lives.

What are some patient success stories?

Dr. Bravata: I’ve had a lot of patients who were a little bit reluctant to develop a relationship with a physician. They didn’t understand why they had to return for labs or routine visits. They were a little concerned when they had to start medications, maybe for congestive heart failure or diabetes, which they may not have known that they had.

Over time, you develop that relationship and are really able to get those patients to start making small incremental lifestyle changes that make a huge difference. It can be a very transformative process. And in the end, patients are very grateful as they start feeling better and seeing their laboratory numbers improve. Overall, it’s a pretty rewarding thing to experience.

When I came to CMH, there were a number of patients who I realized very quickly had unmet addiction recovery needs. When we started providing those services, it made a huge difference for those patients. The Rural Health Information Hub features the Addiction Recovery Program as a model for other rural health systems.

Dr. Dhondt: Almost daily, somebody comes in because they need stitches or something. Many will say, “If you can’t do it, I’m not going anywhere.” I have a lot of patients who don’t have cars, so they can’t get to the next bigger town.

We offer everything right there — X-rays, labs, etc. OB care is something that we offer. All of the research shows that you have a much healthier pregnancy if you have local care than having to travel long distances to get to it.

Anyone who’s ever lived someplace away from town understands the need for essentials, which is what I consider medicine to be. I have patients who haven’t seen somebody in 20 years because they don’t trust somebody in another town. Once I’m there and well established, and everyone else knows me, it’s easy for them to come in and see me.

A leader in rural health care

As a member of the Board of Directors of the National Association of Rural Health Clinics, I see the great work that health providers are doing across the country. And I can truly say that CMH is a leader in rural health care. Our providers and staff go above and beyond to fill the unique needs of each community.

Michael Calhoun shares the latest happenings at CMH in his monthly CEO Updates. He is the CEO/executive director of CMH and the Citizens Memorial Health Care Foundation.