WASHINGTON   –  “In the national debate over health care, few of the politicians and bureaucrats privileged enough to be part of the backroom discussions about the bill seemed very concerned to me about an important issue for the Eighth Congressional District of Missouri.  Rural health care in general was largely overlooked by the powers-that-be as they instead brokered special deals with special interests.

In rural parts of the country, the health care challenges are much different from those in urban areas.  In a big city, the hospital might be a few blocks away; the barrier to accessing its services is probably not distance but a lack of insurance.  In Southern Missouri and places like it, problems of access are almost always accompanied by barriers caused by sparser populations and the sheer number of miles between health care providers and the Americans who need them.

We have some innovative solutions: a few good policies which encourage rural providers to stay in our communities, considerations for health care professionals who choose to practice here, and creative thinking to overcome the distances that prohibit access.

One of those innovations is the S.H.O.W. Mobile (Southeast Health On Wheels).  Instead of a patient leaving his or her community to travel to the doctor 30, 50 or 100 miles away, the S.H.O.W. Mobile brings basic medical services in to the cities and towns where we live.

The latest effort by the S.H.O.W. Mobile is one that merits the attention of policymakers at every level of government who represent rural America.  The traveling doctors office is bringing an overlooked segment of regular and preventative care to our Missouri communities – dental services.

Twice each month, the S.H.O.W. Mobile and its dedicated staff bring dental services into the communities they serve.  As part of disease prevention, oral hygiene and dealing with acute health issues, dental services are indispensable.  In the continuum of care, however, the dentists working in rural America are often overwhelmed by patients, unable to serve the uninsured, and tough for a widespread population to travel to.

Worse, the dentists in our rural areas often have more patients than they can handle.  They’ve been working in our rural communities for a long time, and they seldom have been able to identify a young replacement to take over their practice when they retire.  Statewide, only 165 students graduated from dental school last year, and few of them are headed to practice in rural areas. 

Most of those who do are still saddled with more than $200,000 of educational debt.  The best-paying jobs are located in urban areas, and it’s a matter of necessity for most students to take those jobs as their college loans come due.

The answer is to examine the reimbursements for dental providers in rural areas, to establish work-study programs that show aspiring dentists the high quality of life and true need for their vocation in Southern Missouri, and to seriously pursue the establishment of an educational program to train dentists close to home just as we do for nurses, medical technicians, and health care professionals who are just as sorely needed in our part of the state.

In the meantime, we have innovations like the S.H.O.W. Mobile to bridge the gaps.  Let’s hope we won’t always need them as we work to make that day possible.”