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It's another busy day at the Bernstein Community Health Center in Pitt County. Hundreds come here every week. About 78% are uninsured.
The center's director Dr. Thomas G. Irons says, "The health status indicators of folks in eastern North Carolina are bad. They're almost uniformly worse than the rest of the country, and the rest of the state. There are many reasons for that; some are socio-economic and educational."
Often patients put off preventive care, waiting until they are terribly sick to see a doctor.
Dr. Ken Steinweg with the Brody School of Medicine explains, "Access to care in rural communities is a tremendous problem now. In eastern North Carolina, there is a high level of poverty, inability to be able to pay. And so many primary care facilities have a hard time existing. It's tough making ends meet."
There's no shortage of patients. It's the number of doctors at rural clinics like this one that's the problem.
"It's just held together by a thread. There is not a single community health center that is not recruiting for at least a physician or one midlevel provider. It's a very fragile system with a lot of people doing really good work," says Irons.
With record high unemployment in the state, education and medical jobs are the only professions showing slight growth, according to the State Department of Commerce.
The Federal Office of Rural Health reports that every dollar spent on rural health care is recycled in the community one and a half times.
The Brody School of Medicine, according East Carolina University, is an economic engine for the region and state with an estimated 14 billion dollar impact.
Dr. Steinweg says, "Often access to health care is considered a requirement for a company to open an office or that sort of thing. Health care is a fundamental infrastructure, sort of like roads are to attracting business."
But it is often difficult to attract enough doctors willing to go to rural areas.
Dr. Ricky Watson is the Assistant Residency Director at the Brody School of Medicine. Watson warns his students that family doctors usually make much less money than most specialists do. Still, Dr. Watson instructs his students to consider what a rural community can offer. When it comes to quality of life he says, "You're not going to have access to the opera, but you may have access to some marvelous fishing."
Dr. Steven Manning must decide soon what kind of medicine he wants to practice. He is from a small community but wonders if he should return. Dr. Manning says, "You're pressed to make money. And I really don't want that as my primary goal. I want to be with my patients and care for them. I can't say which way I'm leaning, time will tell."
About two-thirds of ECU graduates stay in the state, Watson says. But, most will practice in more populated areas. He says, "In the past if we got one or two of physicians to settle east of 95 we were doing good."
Dr. Steinweg says, the new heart center, medical school building, and dental school will help rural communities. "This will fundamentally change primary care in eastern North Carolina for the next 50 years. Earlier access will help future physicians train in a state-of-the-art facility. And create an attitude and statement about primary care and this family medicine facility."
Electronic medical records and telemedicine will also help some doctors in outlying areas feel more connected. Dr. Steinweg adds, "That means the doctor who is seeing you has the most relevant information he can get."
The doctors tell us they're hoping to improve the medical prognosis for the area and perhaps improve the health of the local economies at the same time by attracting more desperately needed doctors.
Watch the NC Now Feature
Interview with Thomas Irons