Appalachian OBGYN: Practicing in a Rural Setting

The episode begins with Dr. Branham describing her day-to-day work schedule. As she shares the workflow of her clinic and OR days, as well as call shifts, she emphasizes how her patients’ care is typically subject to herself as their sole medical provider (e.g., handling a postpartum hemorrhage without access to Interventional Radiology). Due to this, Dr. Branham routinely thinks multiple steps ahead in regard to her patients’ care in order to decide if she can continue herself or if the patient has to be transported to a higher-acuity center.

Dr. Branham then transitions to discuss the challenges that she faces as a physician practicing in a rural setting. Using personal anecdotes and published data, she emphasizes barriers such as decreasing numbers of OB/GYNs choosing to practice in rural areas, as well as the weather conditions dictating whether or not a patient may be transported via helicopter or ambulance to an alternative hospital. In addition, she covers the impact of the opioid use epidemic that largely impacts the Appalachian region.

Lastly, Dr. Branham ends the episode by sharing why she passionately chooses to practice in rural Kentucky, despite the challenges she may face: her dedication to serving patients who are often in the most need of medical care. She also describes current systems in place to help improve care for her patients, including the Blue Angels Program, which provides telehealth visits with Maternal Fetal Medicine specialists at the University of Kentucky and traveling ultrasound clinics to specific areas in rural Kentucky counties.