Bladen physician speaks to caucus regarding plight of rural health care

By: By Erin Smith -

ELIZABETHTOWN — One Bladen County physician had the honor of addressing the Primary Care Caucus held in Washington, D.C., recently and hosted by Rep. David Rouzer (R-NC) and Rep Joe Courtney (D-CT).

According to a release from Rouzer, the Primary Care Caucus will focus on educating Congress on the importance of a comprehensive and well networked primary care system for both patients and their communities.

“As we celebrate National Primary Care Week this week, we are reminded of the tens of thousands of families across our nation – and especially in my district which includes rural Southeastern North Carolina — that are affected by the shortage of primary care physicians,” said Rep. Rouzer. “As the co-founder of the Primary Care Caucus, I look forward to working with Congressman Courtney to advocate and promote policies enabling all communities – both rural and urban – to receive access to the best healthcare services and providers possible.”

Dr. Robert Rich Jr. of Bladen Medical Associates in Elizabethtown was one of the physicians asked to speak.

“We don’t have enough primary care providers (in rural areas),” said Rich.

He said one way to attract more primary care providers to rural areas is to improve the reimbursements for medicare and medicaid. Rich added the medicare and medicaid reimbursement is not a new issue, but it does have an impact.

“Adult medicare and medicaid patients are, typically, the sickest population,” said Rich.

He said in a rural setting, medicare and medicaid patients can make up as much as 90 percent of a clinic’s patients on any given day.

“Our roll for this clinic is 55 to 60 percent medicare/medicaid and the average on some days is 80 to 90 percent,” said Rich, who was the first speaker for the caucus.

“I talked about my role, what I do here at the clinic,” said Rich.

He said his role includes taking care of adults, some hospital visits, teaching medical students, working with some pediatric patients, just to name a few things.

Rich said he told the caucus about one specific provider in the clinic and how she networked a solution to help the patient.

Rich related how the patient had multiple medical problems and was frequently admitted to the hospital. He explained to the caucus how the provider began to pull in resources such as a nurse care manager who could actually visit the patient at home and helped arrange additional resources for the patient.

Rich related how a visiting pharmacist worked with this same patient to help the patient understand how to take their medicines correctly.

“We were able to reduce the number of hospital visits,” said Rich of the patient by pulling together some of the ancillary resources.

He noted that in rural areas patients also are often faced with transportation issues, they have difficulty in purchasing medicines, there are deficits in terms of available mental health care, and there are limited dietary services available.

Rich said another spoke about the challenges faced by physicians in under-served areas as well. rich noted the challenges were every similar to those faced by rural areas.

Rich said he enjoys practicing medicine in Bladen County despite the challenges faced by clinics in rural areas.

“I like the challenge and I feel a sense of dedication,” said Rich.

He has been involved with the N.C. Academy of Family Physicians in various capacities for several years.

Rich grew up in Sampson County and earned his medical degree in 1984, completing residency in 1987. He worked with the Indian Health Services via the National Health Corps from 1987-1991. Rich moved to Bladen County in late 1991 where he opened his practice.

Erin Smith can be reached at 910-862-4163.

By Erin Smith