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There are numerous specific challenges of providing health care resources in rural areas. Among issues that affect the practice related to competence in medical care are geographical, social, economic and ethical problems. There are often difficulties in identifying exact issues that affect standards of medical care practice, however, there have been many mechanisms developed that help bring out such issues.
One of the issues that influence medical care in rural areas is ethical dilemmas that often arise. The main problem of the good delivery of health care in rural areas is that hospitals receive their funding from more than one source. If urban hospitals have an influx of privately purchased insurance plans, then rural medical centers are more vulnerable in this area because most of patients come from low-income families that mostly rely on government insurance programs. Therefore, hospitals are not adequately funded and there is a negative distribution of services that are available to the public. In turn, the following ethical questions become outstanding: appreciation issues, medical competency, privacy issues and other work-related conflicts. The ethics resolving boards have been created in rural medical centers, but they do not possess essential well-developed components as urban centers do. The appreciation problem that persists in rural hospitals is characterized by the distribution of health care reserves according to the need and not to the aptitude of the patient to attain it. The main reasons for this issue in the countryside areas are financial and location problems. Also, if more hospitals receive inadequate resources to keep their doors open, then the geographical issue will become more evident. Thus, older patients who do not have access to transportation are the most vulnerable to the issue of receiving necessary health care. Moreover, financial problems that some members of the community may face are prime factors that affect the standards of practice in the medical field. Even though local doctors at times try to help indigenous members of the community, there are often conflicts between the doctors motive to help and the hospitals financial budget (Ricketts et al., 1994).
Another issue that predominantly contributes to ethical concerns in health care is competency of medical services. The main concern of competency arrives with the fulfillment of specialty care. Specialty care demands certain specialists in the area of the given interest; however, the rural setting does not have such kind of doctors. There are only primary care doctors, whose number is often insufficient, who are not competent in performing specialty medical needs such as oncology or surgery procedures. However, these primary care doctors along with nurses and other medical personnel are forced to perform medical practices that are not at their skill level. At any rate, this type of medical practice carries a wide range of negative issues for doctors as well as nurses. The most frequently occurring complications are the absence of supervision on a regular basis, the stability of the correct kind of care and the responsiveness to sudden issues that may occur. Therefore, it is crucial even for small medical centers to have access to transportation, specialty doctors and other necessary tools when responding to a difficult case that requires action in a timely manner (Hewitt & Simons, 1999).
An important role in the achievement of excellent medical care plays the handling of patients private information and its confidentiality. Rural areas present a higher risk of keeping the patients privacy in tact because of the closeness that both patients and care providers live in. Therefore, in most cases patients and the hospitals staff are friends, neighbors, or even relatives, creating favorable settings for privacy and confidentiality of patients to be violated. Another instance when privacy of the patient is not fully respected is the time when information about the patient is exchanged via phone, fax or email. These methods are used especially when information has to be transmitted in a short period of time in order for the patient to be treated correctly. Hence, these particular issues are among the contributors to the poor practice of medical care (Lyckholm et al., 2011).
The best way to respond to frequent ethical problems that are occurring in rural medical centers is the institutionalization of ethics committees. These committees would be responsible for overseeing institutions regulations and policies. They are composed of people from the hospital staff, community representatives and church-affiliated persons who possess different levels of ethics competence. Most of members of such committees have acquired their knowledge through different training programs offered outside the hospitals boundaries. Moreover, committees are designed to serve as a learning source for doctors and nurses in cases when above-mentioned issues happen (Lyckholm et al., 2011).
Moreover, the use of correct standards of medical practice can help lead to the better organization of hospitals activities. Nurses can only perform their specific activities if standards are implemented at the right level and additional tasks are not dumped on a nurse.
Therefore, the implementation of necessary standards of practice and ethics in a medical institution will make everyones job duties easier and contribute to a better served community as a whole. Even though rural areas require a great deal of help and improvement, the use of well-developed ethical methods could substantially benefit and improve the quality of care that is available for these communities.