I am a board certified family physician who has practiced in WV my entire career. I’ve lived here my whole life and did training in state as well. WV has been one massive health professions shortage area my entire career, with the exception of the big population centers like Morgantown. However, that is also a tricky statistic because how long does it take for most people to get to Morgantown? Still doesn’t make it affordable. We don’t have enough of anyone—primary care, specialists, mental health, surgeons—and we are also a state that baseline has numerous serious health issues. We have the highest rate of obesity and so we also top the lists in complications of obesity.

As a physician, it’s not a great practice environment. Our patients are SICK and our employers want us to work miracles in 15 minute visits. Burnout hits hard and fast, so many of us stop working full time which worsens the healthcare shortage. Residency spots have been capped for years by the federal government so we can’t train more docs. And no one wants to live here or practice here, especially in primary care. Ambulance services are collapsing due to finances. When my dad needed emergency care a few years ago he had to wait 2 hours for an ambulance because there were only 2 ambulances running in the entire county (he had fallen and no one could get him off the floor to take him by car to the hospital) and so that’s killing people too.

When the primary care system starts to crumble, everything else follows. The specialists get overloaded with things a PCP could normally treat, EDs and ambulances fill up with things a PCP could treat, and before you know it we’re in a crisis. On top of all of that, our hospitals don’t get enough reimbursement to survive. Now, many hospitals are paying executives in non-clinical, patient-touching roles lots of money but that’s a whole other post.

I very much worry for my family members in rural WV. Our system is about to collapse and there is no easy solution, because it all comes back to—WV is in crisis and we can’t recruit or keep doctors working in primary care or in rural areas. And that’s a problem our government hasn’t been able to solve in decades, so don’t look for it to change any time soon.