Health Care in the Borderland

For over 30 years, Hidalgo County, a geographically isolated and financially stressed community in the southwestern corner of New Mexico, has struggled to develop a stable primary health care service.The retirement of the county's general practitioner in the 1970s was followed by several decades of misses, near-misses, and out-and-out failures, when the community found it difficult to attract and impossible to keep a physician. In order to organize and fund a stable medical clinic, the community had to adapt to the realities of a new era in medicine. Primary care physicians in rural communities need access to medical information and to specialists, help in coping with the economic pressures of medical care, and support that will enable them to develop a sustainable lifestyle. Hidalgo County now has a modern health care delivery system. The experiences that led to the creation of the present clinic provide insight into the problems for the delivery of primary health care in remote areas and suggest solutions that may be relevant to other communities across rural America.