I’m not sure that I can fathom what 11,000 square miles looks like, let alone being the only physician to serve that entire area. But Saslow does an amazing job conveying the sense emptiness that Garner and Cummings might feel when being the only physicians available in a vast and desolate region in Texas. On a side note, I still don’t understand how their economy works?

“In the medical desert that has become rural America, nothing is more basic or more essential than access to doctors, but they are increasingly difficult to find. The federal government now designates nearly 80 percent of rural America as “medically underserved.” It is home to 20 percent of the U.S. population but fewer than 10 percent of its doctors, and that ratio is worsening each year because of what health experts refer to as “the gray wave.” Rural doctors are three years older than urban doctors on average, with half over 50 and more than a quarter beyond 60. Health officials predict the number of rural doctors will decline by 23 percent over the next decade as the number of urban doctors remains flat.

In Texas alone, 159 of the state’s 254 counties have no general surgeons, 121 counties have no medical specialists, and 35 counties have no doctors at all [emphasis mine]. Thirty more counties are each forced to rely on just a single doctor, like Garner, a family physician by training who by necessity has become so much else…”

Eli Saslow

Dossier

“‘Out here, it’s just me’: In the medical desert of rural America, one doctor for 11,000 square miles,” by Eli Saslow, September 28, 2019. https://www.washingtonpost.com/national/out-here-its-just-me/2019/09/28/fa1df9b6-deef-11e9-be96-6adb81821e90_story.html