The Dwindling Access to Medical and Legal Care in Rural America

By: Ragan Morrison, Spring 2018 Intern, HeLP Legal Services Clinic

Before I began working in the HeLP Clinic, I was vaguely aware of what is a growing crisis in our country—the lack of access to medical services in rural communities.  This issue has received at least some news coverage, and I knew the medical community has been seeking solutions, but it is still a rather hidden problem.  Given the urban-centric awareness of the American “intelligentsia” and the fact that most people in the U.S. do live in cities or metro areas, this is understandable, but as the baby-boomer generation grows older this problem will only get worse.  What I had not considered before, but have come into direct contact with through the clinic, is the parallel loss of access to legal help.

Over the last century, there has been an ongoing trend of people moving away from rural agricultural areas and into urban ones.  This migration, however, has left the nearly 20% of Americans who still reside outside cities with shrinking job opportunities—and shrinking access to the services those jobs provide.  More and more, when someone from a small community falls ill, they must travel quite a distance to receive the medical care they need.  There simply are not enough doctors in rural America.

Having grown up in midtown Atlanta, I’ve never had to worry about going far to find a hospital or doctor’s office when I get sick, but for many folks this is indeed a concern.  I encountered this phenomenon directly when my student partners and I met several of our clients through the clinic.  Even though they are technically still within “metro” Atlanta, some of our clients must drive an hour each way (or sometimes much longer, thanks to notorious Atlanta traffic) to take their kids to the doctors they need to see in town.

We have been coordinating with our clients to try and time their visits to our clinic with the doctors’ appointments which are already bringing them in town.  Every time they must make this journey, it is clearly a real burden—the kids have to miss school and the parent or parents have to miss work since all the meetings take up most of the day.  Thus, I’ve had a first-hand glimpse at how difficult it can be for people who live outside cities to receive the care they need, and this added hardship is not just in access to healthcare—it evidently also affects access to legal services.

Most people will need legal help for something in their lifetime, and of course, legal issues are stressful enough on their own.  The extra concern for rural Americans about where to find a lawyer and, more likely than not, about the travel required to see one, is just an additional strain in an already difficult situation.  Like doctors, attorneys are increasingly disappearing from the rural parts of the country.  Most law firms are located in cities, so most recent graduates will gravitate there (or rather stay there, since they are typically graduating from a law school located in a city).  The venerable small-town attorney, epitomized by the likes of Atticus Finch, is increasingly rare.  The ones that do remain are nearing retirement and are not being replaced by young lawyers.

The Georgia bar has acknowledged this looming crisis, as have other state bars, and there is some positive movement towards trying to solve it.  A few states, taking inspiration from medical programs, have instituted financial incentives to encourage new attorneys to take over or set up practices outside the cities.  There has also been some experimentation with ways to utilize new technologies to at least provide better virtual connection between rural clients and urban lawyers.  All of these solutions cost money, however, and like with so many things it is a serious challenge to get funding for them.  Until this growing shortage of lawyers in rural America receives more attention, I fear little progress will be made, and clients like ours will have to continue bearing the hardship of traveling far just to get access to the services that those of us living in cities can at times take for granted.