Gundersen’s mobile medicine team provides health care to rural residents

Ryan Henry Gundersen Health System

On Monroe County’s rural roads, usually reserved for tractors, pickup trucks, and Amish vans, the vehicle is out of place, while welcome, for cruising through rolling hills. She pulls out the cobblestone lanes of pre-selected farms, opens their doors, and invites workers—usually migrant workers from Central America—in if they have any kind of physical ailment.

Last fall, physicians and residents from the Gundersen Health System joined St. Clair Health’s mission to provide healthcare services on-site with the Rotary Mobile Clinic of St. Clair, a full-service, full-service family medicine unit that was unveiled in August. Its purpose was to better equip the two organizations to meet the needs of the homeless population of La Crosse, which has been visited on a weekly basis since 2020.

But this team discovered another need—one from those living and working in rural areas who are new to the US healthcare system and face many barriers to receiving much-needed treatment. So, beginning in October, the team hits the country two Fridays each month—what they call Farm Fridays—stops rotating between several farms in Gundersen’s service area that employ a predominantly immigrant workforce.

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Led by Dr Sarah Brown, MD, attending physician and program coordinator, and joined by residents from the Family Medicine Residency Program at Gundersen and Executive Director of St. Clair Jason Larsen, the team sees anywhere from four to 15 patients at each visit, providing acute care and disease management services, Including things like diabetes checks and cholesterol levels. They also deal with unexpected injuries that occur while working on a farm.

“Injuries to the musculoskeletal system used to be very common,” said Dr. Brown. “We have other unique conditions such as rare neurological conditions and a number of chronic conditions as well.”

She said many of the rural patients she encounters have access to care at a local hospital or clinic, but mostly on an emergency basis. The idea behind these visits is to treat the condition early in hopes of avoiding those trips to the emergency room.

“We’re getting to know a lot of people gradually,” said Dr. Brown. “We’re trying to keep people connected to health systems or build a bridge back to health care, if possible.”

But this is not the only goal of the program. As a training tool for residents, they are able to work in an environment that helps foster a deep understanding of the social determinants of health – those constraints in an individual’s daily life that limit their access to the healthcare system.

“It forces us to be creative in using our knowledge and skills to select appropriate medications and appropriate care plans, while keeping these limitations in mind,” said Dr. Brown. “There are a lot of people in marginalized communities for whom best practices in medical care do not apply because they are unable to shape their lives around the treatment plans that we are trying to create.”

Sophomore resident Dr. Kate Edsall took her second trip to the farm on Dec. 2. She was on a rural surgical course, which gave her time to accompany Dr. Brown and his mobile medicine team on visits. For her, farm tours allow her to get to know people in the community she would otherwise not see.

“This is our society,” said Dr. Edsall. “It’s part of our society, but when we stay within the walls of our clinic, we don’t always see all of that. We kind of have to scratch under the surface a little bit.”

She said the people she sees are doing an admirable job of taking care of themselves, despite the barriers they face to health care.

“There are a lot of patients here, they are very proactive about their care, and they are very knowledgeable about family history,” said Dr. Edsall. “Being able to deliver care to people and help break down some of these barriers is a really amazing opportunity and what we need to do if we want to have healthy communities.”

Dr. Edsall said the work helps remind her why she got into medicine.

“Most of us, especially those in family medicine, have gotten into this because we care about healthy communities and helping everyone get quality health care and closing those gaps in health care inequality,” she said. “It helps get you back on target and fuels you through the rest of your tough runs and the tough stuff we do during our training. It’s very key.”

As an organization, Gundersen makes caring for people and their communities a top priority, and as members of the community, farm workers deserve the same care.

“We view health care as a basic human right,” said Dr. Brown. “Not only is caring for people ethically the right choice, but we also hope that caring for people regularly can help prevent complications from diseases in the long term, prevent overuse of emergency services and even reduce hospitalization rates.”

And thanks to the fundraising efforts of the Gundersen Medical Foundation, this mobile medical work will continue, as the foundation has raised enough to fund the program through May 31, 2024. However, the need continues, so if you’d like to contribute to the program, go online to Foundation.gundersenhealth org/donate-now, select “Other” in the drop-down menu and flag Ambulatory Medicine, or stop by the Foundation’s office at 201 Third St.

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