If Your Community Has Clean, Safe Water, You Can Have Optimal Medical Therapy
Especially if You Live in a Green State
If you have enough community leadership and spirit to develop a water system, then you can have optimal medical therapy (OMT) for chronic diseases. If your community has developed a critical access hospital, you too can have OMT. Your town or county can quickly change healthcare from a liability to an asset. New cardiology guidelines call for OMT first in patients with heart artery disease before a heart catheterization or a stent is considered. Here is the crazy thing. OMT is rarely available even to wealthy urban residents with insurance. It is even less common in disadvantaged and rural communities. Primary care can provide OMT, but they will need some help to consistently produce it.
In the green states, nurse practitioners can deliver care without physician supervision and that is a good thing. In Nevada, pharmacists can provide OMT up to 100 miles away from their collaborating physician. Nurses and pharmacists are especially well-suited to provide OMT. You may already have one or more primary care physicians in your community. That can be your resource, but no matter what the training, these individuals need support.
I was the only full-time internal medicine doctor in a small southern town. I was on call every other night, and every other weekend for 25 years. I have worked 36 hours at a stretch. That was not good for anyone. It was not good for me, my patients, or my family. Your provider needs help.
If your community engages a telemedicine company with an OMT team, that can really help make your OMT provider’s life much more liveable and you can extend their reach. The telemedicine company can provide as much of the OMT care as your provider wishes. A great practice in Alaska sees patients face-to-face for just 15% of the visits. Geography dictates that model in Alaska, but most OMT can be provided remotely. It can be more effective and more convenient. The telemedicine company can also provide some emergency coverage on nights and weekends so that your provider can get some rest.
OMT production also requires computer and information technology support. This could most logically come from the primary care and pharmacy training programs of state medical training facilities. That would be a spoke and hub arrangement. They would be the hub, and you would be the spoke. Your providers will need computer support to identify the high-risk patients with chronic diseases who need OMT. They will need protocols and systems to help them produce OMT and measure baseline and quarterly results.
If your community wants OMT, contact young people from your area who are nurse practitioners, pharmacists, family practice doctors, or internists and ask them if they would like to return. If young people from your community want to be in medicine, encourage them and help them. It is worth the investment.Talk with the nurse practitioner, pharmacy, and primary care traing programs at your state universities. Tell them you want OMT in your community and ask them to support you.
I have been working for a few years to identify work site clinics, nurse coaching operations, telemedicine companies, and information technology companies that can support your providers, make their lives more liveable, and improve OMT quality. This site and these efforts are all about making OMT more widely available. That will improve health and save money. I would be happy to put you in touch with these resouces and we can start planning right away. Please contact me if you have questions and spread the word.
wbestermann@congruityhealth.com
We need that in our community. We have a medical school now at the main campus at Prisma. They need to be teaching these students OMT. As well as the nursing schools. Thanks for such an informative article!