Perspectives on Rural Medicine

Hello Alex,

Greeting from Nebraska. I just received my copy of ENTtoday. I enjoy it as well as your editorial notes. I read the one today (“Otolaryngology Should Think About Population Health in a Broader Context,” October 2019) with more personal interest.

When I came back to Nebraska there had not been one new otolaryngologist for over 20 years in rural areas. Many larger communities were begging for help. Aging docs were moving away or retiring. Since my arrival, our department has placed seven of our residents in central or western Nebraska. Three more are thinking about it. I’ve been most pleased. Three of my faculty wrote a very well-written paper about how other departments can accomplish what we have done, yet three different journals rejected it, saying it was interesting but not of interest to their readership.

Our program also started an extensive telehealth program with our patients who were driving two to seven hours to see us. This included wound checks, tonsillectomies, sinus care, and head and neck cancer patients. It works great and is most beneficial. Insurance carriers now even pay for documented notes of face-to-face telehealth visits. We can also, as attendings, telehealth with our residents at night so we don’t have to go in, in many circumstances. Again, a couple of my faculty wrote an excellent paper on all of this, showing results and benefits of the program, and the paper was rejected by three journals, saying how interesting it was, but [that it] wouldn’t be of interest or benefit our readers.

My very best,
Dwight T. Jones, MD
Chair, Department of Otolaryngology
University of Nebraska

Dear Alex,

I read your editorial (“Otolaryngology Should Think About Population Health in a Broader Context,” October 2019) and it brought to mind my 2004 Ogura Lecture [at the Triological Society Combined Sections Meeting]. I agree with your message and also believe our Academy is unlikely to make a significant move. I think the most promising way forward is state-by-state activity in healthcare education. In my opinion, we don’t need more ENT physicians in rural areas. We need well-trained family practitioners or physician extenders.

Thanks for your thoughtful editorial.

Ernest Weymuller, Jr., MD
Professor, Otolaryngology Head and Neck Surgery
Associate Medical Director, Head and Neck Surgery Center
University of Washington