Why we ALL have a stake in solving the rural healthcare crisis | Tee Faircloth | TEDxAtlanta

If you are looking for the
quintessential modern Norman

Rockwell town, McRae, Georgia,
would be a prime candidate.

Picturesque tree-lined streets,
a beautiful town square,

and the still-operating
Coca-Cola bottling company

give McRae its small-town charm.

Behind the facade, the
reality is not so pleasant.

The county is the
poorest in the state,

and the Husqvarna plant,
the town's largest employer,

is closing.

McRae is on its
economic deathbed,

and the beginning
of its decline can

be traced back to the closing
of the town's hospital, which

employed more than 150
people, served three counties,

and offered services ranging
from primary care to pediatrics.

Now, 1,200 jobs for the
people of McRae are gone.

To quote Lauren Weber, who
wrote the groundbreaking article

on the rural health crisis,
"If you want to watch a rural

community die,
kill its hospital."

We're in the midst of a
national rural health crisis.

There are 1,345 rural hospitals
designated critical access

hospitals, and they average
only four patients a day.

Think about it.

Four patients a day.

And a third of those are
in danger of closing.

In Georgia, which is ground zero
for the rural health crisis,

the average rural hospital
only has three days of cash

on hand, not enough
to cover payroll

if Medicare is slow
with reimbursement,

which is their primary
source of revenue.

How did it get to be so bad?

With medicine
advancing so quickly,

rural hospitals were
never equipped to do

complex, sophisticated
surgery like heart surgery,

knee or hip replacements, or
cutting-edge robotic surgery,

which makes sense.

They were never
designed to do that.

They were designed to provide
critical general health

care for the
communities they serve,

to set the arm of a kid
who fell from a tree,

to take care of a grandmother
who catches pneumonia,

or to help a farmer who has
had an accident in the field.

So the broader
health care system

evolved where if you needed
complicated, significant

surgery, you traveled to a
large hospital in a big town,

and then after you, after
a few days of recovery,

you come back to your
local rural hospital,

where they can
focus on your rehab.

You can be surrounded by
your family and friends.

And by the way, your
stay generates revenue,

keeping that hospital open.

Sounds logical and seems like
commonsense and pretty simple.

But if you understand
anything about health,

nothing is ever as
simple as it should be.

Somewhere along the way,
in this complex system

of just misguided focuses and
resources stretched too thin,

the system broke down,
leaving rural hospitals

desperate to keep
their doors open,

while urban hospitals remain
overcrowded and just can't

handle this excess demand.

But what does that
have to do with those

of us who live in big cities?

We've got hospitals
every few miles

and access to specialist care
pretty much whenever we need it.

Well, if you've been
to an emergency room

lately or tried to schedule
non-urgent surgery,

you've likely been affected
by the rural health crisis

more than you know.

Overcrowding in
the emergency room,

long waits to
schedule surgeries,

and the massive hospital bills
most of us have experienced

are all exacerbated by
the rural health crisis.

To give you an example,
let's talk about somebody

we're going to call
Great-uncle Bob.

Bob lives in Alma,
Georgia, and he

needs knee replacement surgery.

So he has to travel
two hours to Savannah

to have the procedure done
because his local hospital can't

provide it.

Once Bob is medically stable,
he should go to rehab.

However, due to a
complex system overloaded

with a giant game of telephone,
fax machines, and way too

much paperwork, Bob will
likely spend a few extra days

in that urban hospital
bed, where he's not

getting optimal treatment, since
that hospital doesn't specialize

in rehab, and where
he may be at a higher

risk of a hospital-acquired
infection.

Furthermore, Bob's extended
stay in that hospital

prevents that hospital from
caring from another patient.

Maybe it's you who
needs knee surgery,

or a coworker needs a
procedure on her heart.

Or your neighbor needs
a hip replacement

and he needs that bed.

So Bob isn't getting the care
he needs the optimal location.

The rural hospital
is missing out

on a desperately needed
revenue, and the urban hospital

stays overcrowded,
with a bed shortage,

which affects all their patient
care and their bottom line.

But there is another way.

Four years ago, a college
friend of mine who's a doctor

called me while I was
in Thomasville, Georgia.

He knew about my background
working with and turning

around distressed companies
like Regal Cinemas and US Steel.

He explained the dire
situation of rural health care

and suggested we
work on the problem.

I like a challenge.

So around three years
ago, I moved to Augusta,

and we began working
with the Medical

College of Georgia's
rural office

to try and find a solution.

We found one-- redesign
health care in rural hospitals

to focus on rehabilitation.

We're working with
rural hospitals

to develop specialist
rehabilitation

programs and the technology
to get them there.

So now, after Bob has
three days in the hospital,

he can then transfer back
home to his local hospital,

providing revenue for
that local hospital.

We call the rural
hospital and tell them

we have a patient who
meets their criteria.

After we handle everything,
Bob can be transferred back

to his home hospital,
where he can

stay as long as his medically
necessary, giving him the chance

to recover so he
doesn't have to readmit.

Because nobody wants to go
back into the hospital right

after you've just been in one,
no matter how old you are.

This new model of
rural health care

has been embraced by innovative
leaders within Georgia.

Here within Georgia,
specific hospitals

have come up with specific
methods of care to handle this.

If you go to Grady Hospital
in downtown Atlanta

with a respiratory emergency
and you need a ventilator, now,

once you're
medically stable, you

can be transferred to Clinch
Memorial Hospital, which has

introduced ventilator therapy.

This allows you to get
better and get home.

It's also taking Clinch's
census from two patients a day

to 12 in just nine months.

Not bad for a struggling
25-bed rural hospital,

and they continue to improve.

Geriatric psych patients
are getting treatment

at one of seven rural
hospitals who were focused

on their specific condition.

If you need
orthopedic rehab, you

can go to the rural hospital in
Hazlehurst, which just unveiled

a renovated therapy center.

There are 60 rural
hospitals in Georgia,

each with the ability to
develop specific-care cases.

Those who do that are able to
provide higher-quality care

for the patient, lower overall
costs for the health care

system, and clear up
beds in urban hospitals.

Medical center of Peach County,
a rural hospital in Fort Valley,

Georgia, was losing a million
dollars a month and losing

employees because they couldn't
schedule full 40-hour weeks.

Since they started focusing on
rehabilitation three years ago,

they've gone from three
patients a day to 20

and are now generating a
million dollars a month

and able to keep 180 employees
on a full-time schedule.

If we're able to increase
by even one patient a rural

hospital census, we can impact
their annual revenue by up

to $750,000.

What does this mean for you?

This means lower health care
costs and improved state tax

base and shorter waiting
times at the urban hospitals.

For this model to
work everywhere,

we need large health
systems to come on board.

With their support, this model
can help more people like Bob.

And for every Bob and
families like his,

this means shorter waiting
times and recovery periods,

meaning they can get back
to enjoying their life.

And ultimately, isn't that what
health is supposed to provide?

Thank you.

[APPLAUSE]