Dr. Edwin Leap, Some Truths About Rural Healthcare

by | Aug 30, 2022 |

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Approximately 20 percent of the U.S. population is spread across 97 percent of the vast U.S. land area. Yet rural hospitals and patients have been largely neglected in articles about medical health and health care policy. We mainly hear about the disproportionate number of opioid problems in rural communities. But rural residents are about more than the opioid epidemic. These “flyover” citizens have families, jobs, heart disease, kidney problems, anxiety, and depression – just like people who live in the cities. But what they often don’t have is access to medical care.

Between 2008 and 2018, an estimated 500 out of more than 4,500 rural nursing homes closed or merged. Consequently, some 10 percent of rural counties had no nursing homes. This is a significant loss given that 17.5 percent of the rural population was 65 years and older compared to 13.8 percent in urban areas. 

According to the CDC, since 2010, more than 137 rural hospitals have closed, generally due to a lack of money, as many of the rural patients are uninsured or are on Medicare or Medicaid, resulting in less revenue than with commercial insurance. These closures force patients to travel as much as 2 or 3 hours for advanced medical care. During the peak of the COVID-19 pandemic and continuing today, many emergency departments needed to transfer sicker patients, but there were no beds at the larger, distant hospitals.

We hear about government programs “to apply a rural lens” to health policies, but the patients in the countryside continue to lack care. What is going on? We will discuss lives how to tackle these issues with Dr. Edwin Leap, who has worked in rural hospitals for over 20 years.

Dr. Edwin Leap completed his medical degree at West Virginia University School of Medicine and his emergency medicine residency at Methodist Hospital of Indiana. He has practiced emergency medicine for over 25 years and currently practices in Southern Appalachia’s small to medium-sized emergency departments. He is also an award-winning columnist and blogger who has written for the Huffington Post, Politico, the Atlantic, and Medpage Today. He is the author of The Practice Test and Life in Emergistan. He blogs at https://edwinleap.com and https://edwinleap.substack.com.


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Dr. Marilyn M. Singleton

Dr. Singleton is a board-certified anesthesiologist and past president of the Association of American Physicians and Surgeons. She graduated from Stanford and earned her MD at UCSF Medical School. Dr. Singleton completed 2 years of Surgery residency at the University of California at San Francisco Medical Center, and her Anesthesia residency at Harvard’s Beth Israel Hospital. She was on the faculty at Johns Hopkins Hospital in Baltimore, Maryland, before returning to California for private practice. While still working in the operating room, she attended UC Berkeley Law School, focusing on constitutional and administrative law. She interned at the National Health Law Project, and practiced insurance and health law.

Dr. Singleton has published numerous articles, given presentations on health policy, and had many radio and television appearances, and a monthly radio show, Health Freedom Now. She started a blood pressure screening clinic at her church and make-shift clinics in two rural villages in El Salvador. Dr. Singleton ran for Congress in 2012 with a message of personal freedom and limited government.

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