List date(s) this work was published or aired.
Oct. 1-3
Provide a brief synopsis of the story or stories, including any significant findings.
The series examined the lack of access to health care across Oklahoma, and particularly in rural areas, which leads to poor health outcomes and large health disparities. Fewer doctors practice in rural areas and specialists are even harder to find. Public policies aiming to correct this problem are rare and are having little effect.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
I began by requesting the list of all licensed medical doctors and doctors of osteopathy from their respective licensing boards. I requested name, address, date of graduation from medical school and specialty. I didn’t include physician assistants in the request because I wanted to look exclusively at physicians. I received the data in an electronic format and handed it over to the quite capable database editor. I asked him to create a list of all specialties and break those down by county. That way I could tell how many oncologists or cardiologists are in the state in general and in various regions of the state. I also asked the data team to clean up the addresses by geocoding them. The address field can be messy and incomplete, so in some cases we had to rely on the ZIP code. I put that data into a Google Fusion table to display the physicians as dots on a map. That provided an easy way to tell where physicians were concentrated and was a good visual element for the story in print and on the Web. I did the same thing with each specialty, so I could see where they were lacking.
Explain types of human sources used.
To find people to interview for this series, I spoke with social service groups and those in charge of the free clinics in the area. I waited at the closest bus stops to the clinics and rode the transportation system the local federally qualified health center uses. I asked doctors to point me to patients who had faced difficulty in receiving care. I talked to social workers who had clients that rarely or never saw the doctor and worked with medical and public health students who were in the field studying barriers to access. Experts, academics and health professionals were also key for getting information and patient perspectives in the story. I interviewed nurses, physician assistants, the head of the federally qualified health center and numerous professors and doctors now working in an academic setting. Although they were vital for basic information, it was also important to talk to them about the emotions they felt while realizing the trouble their clients faced. People who had trouble getting health care were an obvious part of the story, but those trying to fix the situation were important faces as well.
Results:
The series was well received by many in the local health care community. I heard thanks from doctors, administrators and current or former patients. A member of the Oklahoma State Regents for Higher Education distributed the series to other members and plans to have an ongoing discussion about the role of higher education in addressing the physician shortage and rural disparities. A fellow reporter told me the articles were also brought up numerous times at a state legislative committee studying health care reform. Through an agreement with the state press association, the series was distributed to smaller papers throughout the state, and several ran the series in its entirety, often on prominent pages.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
No corrections or clarifications published or requested.
Advice to other journalists planning a similar story or project.
Here are the questions I would encourage reporters to ask: – Where are doctors concentrated in your city or state? What about specialists? What’s the farthest someone might have to travel to see a cardiologist? – How many more people are poised to get health insurance when, assuming the individual mandate is left intact, Medicaid starts accepting those at 135 percent of the federal poverty level? Are there enough primary care providers to care for them? – What is the average age of physicians in the area? Are many of them close to retirement? – Are there any physician assistants or nurse practitioners trying innovative ways to increase access to primary care? Look for medical homes or offices that use mid-level practitioners heavily. – How do patients get to free clinics? Is there adequate public transportation in your area for those who don’t have a car? Are any clinics open in the evening hours for people who can’t get off work in the afternoon? – Has your state accepted or rejected money linked to federal health care reform? What could it have gone toward or what is it being used for? Is it actually helping the situation? – Are there enough residency slots for people graduating from medical school? Are there enough in fields that are experiencing a shortage? Are medical school class sizes large enough? – What solutions are being presented? Is there some technology that can help doctors connect to each other or new ways to coordinate care that could help with access?