Doctors within borders: the potential benefit of otolaryngology "medical missions" at home.

OBJECTIVES Describe the population, Medicaid, uninsured, and otolaryngology practice demographics for seven representative rural southeastern states, and propose academic affiliated outreach clinics as a service to help meet the specialty care needs of an underserved rural population, based on the "medical mission" model employed in international outreach clinics. STUDY DESIGN Needs assessment. METHODS Review of medical licensing and practice location data from state medical licensing authorities, together with population, Medicaid, and uninsured data from state health/human services departments and the U.S. Census Bureau. RESULTS Of the states examined, 38-74% of the population lives outside major state metropolitan areas, and 23-47% reside in a county in which there are no practicing otolaryngologists. These rural areas contain from 43-75% of the states' Medicaid recipients as well as 37-77% of the uninsured residents. CONCLUSIONS Borrowing design elements from the international outreach clinics which involve many US otolaryngologists, a similar "medical mission" model could be of benefit domestically. There are rural areas of the southeast where visiting outreach clinics could improve access to otolaryngology care, and facilitate effective use of existing "safety net" healthcare resources.