There
are
many
TV
medical
dramas
that
make
healthcare
professionals
crazy
because
they’re
not
even
close
to
depicting
what
really
goes
on
in
a
hospital.
Most
of
us,
however,
can’t
get
enough
of
“The
Pitt.”
As
an
anesthesiologist
and
leader
of
one
of
New
England’s
largest
healthcare
providers,
I
find
the
series
to
be
the
most
accurate
depiction
of
what
goes
on
in
an
emergency
department
(ED),
whether
in
New
Hampshire
or
Vermont
—
or
Pittsburgh,
where
“The
Pitt”
is
set
—
that
I’ve
ever
seen.
One
of
my
favorite
characters
is
Dr.
Dennis
Whitaker,
a
first-year
resident
who
grew
up
on
a
Nebraska
farm.
Whitaker
grows
in
confidence
and
competence
as
a
doctor,
without
losing
his
“Midwestern
nice”
persona
amid
the
chaos
of
an
inner-city
ED.
In
one
scene,
we
see
Whitaker
treat
a
gravely
ill
renal
failure
patient
rushed
to
the
ED
by
his
teenage
son,
arriving
in
the
nick
of
time.
Whitaker
learns
the
family
lives
an
hour
and
a
half
away
in
rural
Pennsylvania,
and
because
the
family’s
local
hospital
had
closed,
the
boy
had
no
choice
but
to
make
the
long
drive
to
the
city
to
save
his
dad.
This
reaffirms
Whitaker’s
desire
to
return
to
Nebraska,
where
he
can
help
families
like
his
patient’s
and
his
own.
“Are
you
still
thinking
rural
emergency
medicine
when
you’re
done
here?”
an
intern
asks
Whitaker.
“Not
thinking,”
Whitaker
replies.
“Doing.”
To
me,
this
representation
of
a
talented
young
doctor
aspiring
to
practice
rural
medicine
was
powerful.
That
recognition
can
be
hard
to
come
by.
Young
doctors
who
love
the
challenge
and
rush
of
emergency
medicine
often
gravitate
toward
cities,
but
I’d
argue
more
residents
should
explore
practicing
in
remote
areas
if
they’re
looking
for
an
adrenaline-charged
career
to
keep
them
on
their
toes.
I
say
this
from
the
vantage
point
of
the
health
system
that
I
lead,
Dartmouth
Health,
which
is
the
most
rural
academic
medical
system
in
the
U.S.
Headquartered
in
New
Hampshire’s
Upper
Valley,
we’re
the
state’s
only
academic
system
and
home
to
its
only
Level
1
trauma
center,
children’s
hospital,
and
National
Cancer
Institute-designated
Comprehensive
Cancer
Center.
We’re
also
New
Hampshire’s
dominant
care
provider
overall.
With
our
Ivy
League
academic
partner,
Dartmouth’s
Geisel
School
of
Medicine,
we’re
training
medical
students,
residents,
and
fellows,
and
conducting
research
that’s
transforming
medicine
and
improving
patient
outcomes
worldwide.
That
said,
you
won’t
see
our
flagship
1.9
million
square
foot,
525
inpatient-bed
Dartmouth
Hitchcock
Medical
Center
campus
from
the
adjacent
state
highway
because
it’s
surrounded
by
dense
forest.
Just
2
hours
northwest
of
Boston’s
world-renowned
hospitals,
it
feels
worlds
away.
While
the
backdrops
couldn’t
be
more
different,
I’ve
held
leadership
roles
up
and
down
the
Eastern
Seaboard,
and
I’d
put
the
top-notch
care,
medical
innovation,
and
first-class
clinicians
at
our
health
system
up
against
any
system
based
in
a
major
city.
To
put
it
another
way:
We
don’t
play
small,
and
rural
medicine
is
not
for
the
faint
of
heart.
While
many
of
us
jokingly
describe
this
region
as
“old
and
cold,”
there
remains
a
deeper
misconception
about
what
“rural”
means,
particularly
in
urban
America.
At
one
end
of
the
stereotype
spectrum,
rural
communities
are
sometimes
viewed
as
less
sophisticated,
less
educated,
and
more
backward
than
their
urban
counterparts.
And
some
in
rural
America
view
city-dwellers
as
elitist,
lazy,
and
out
of
touch.
Both
stereotypes
miss
the
mark.
While
I
respect
the
strengths
and
complexities
of
urban
communities,
I
want
us
to
recognize
the
unique
grit,
intelligence,
innovation,
and
sophistication
that
define
rural
America
—
including
world-class
medicine
delivered
in
rural
counties
every
day.
Many
rural
health
systems
are
the
first
line
of
defense
for
critically
ill
and
injured
patients
in
their
regions.
And
the
role
of
each
of
those
systems
that
are
still
standing
has
become
increasingly
critical
in
recent
decades:
according
to
The
Commonwealth
Fund,
since
2005,
nearly
200
rural
hospitals
have
closed
completely
or
partially,
and
over
400
—
more
than
20%
of
rural
hospitals
—
are
at
risk
of
closure.
Without
a
community
hospital
nearby,
people
in
rural
communities
across
America
are
traveling
hours
for
care
—
an
inconvenience
at
best
and
dangerous
at
worst
(like
we
saw
in
that
scene
in
“The
Pitt”).
Rural
trauma
hospitals
often
must
be
prepared
to
(and
frequently
do)
take
on
extremely
complex
and
urgent
cases
requiring
highly
specialized
care.
Adding
to
the
challenge
of
rural
care
is
the
difficulty
of
transporting
patients
through
winding
back
roads
and
mountain
ranges.
Our
region’s
stunning
but
unforgiving
terrain
influences
the
kinds
of
patients
we
see
—
devastating
ski
accidents,
stranded
hikers
—
and
it
shapes
our
responsibility
for
training
residents
to
care
for
such
injuries.
It
takes
grit
to
do
what
we
do.
Grit
to
remain
confident
and
in
control
when
a
severely
injured
patient
is
literally
dropped
from
the
sky
by
an
air
ambulance,
when
every
second
counts.
Grit
to
treat
practical,
no-nonsense
rural
folks.
Grit
to
advocate
every
day
for
our
patients.
Rural
health
systems
might
not
have
bustling
nightlife,
abundant
public
transportation,
and
other
urban
comforts,
but
I
can
assure
you
any
healthcare
professional
seeking
a
busy
and
exciting
caseload
will
find
no
shortage
in
rural
healthcare.
And
the
hardworking,
kind
people
in
rural
America
deserve
the
same
talented
providers
and
high-quality
care
as
anyone
else.
It’s
my
hope
that
reframing
the
reality
of
practicing
rural
medicine
—
as
well
as
using
innovation
to
change
how
and
where
care
is
delivered,
and
empowering
healthcare
workers
as
advocates
of
their
patients
and
communities
—
can
help
solve
one
of
the
most
critical,
unmet
healthcare
needs
of
our
nation,
by
better
serving
the
82
million
people
living
in
rural
America.
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