ABSTRACT
The last three decades have witnessed remarkable changes in medicine. Not only have we seen advances in the field, but we have also observed an evolution (some might say revolution) in the way healthcare services are delivered and received. We are challenged to make high-quality healthcare available to all, regardless of geographic, social, and economic barriers. While there may be an adequate number of physicians in this country, there is a maldistribution of providers, with most located in urban areas. Rural areas struggle to keep primary care providers, and subspecialty care is an even greater challenge; rural communities lack the patient base and financial resources to support specialty care. It is ironic that economic barriers to medical care exist in a country that spends 13 percent of its gross national product on healthcare.
