Continuity. Communication. Compassion.
These are the pillars of rural healthcare – and they’re winning over patients in ways that might surprise even the most seasoned clinicians. As a hospitalist working in rural hospitals for nearly a decade, I’ve had the privilege of treating patients across multiple admissions, sometimes over several years. This continuity of care is the hallmark of rural medicine – and it’s not just anecdotal. Increasingly, the data supports what many of us in the field have known all along: patients prefer rural hospitals – and for good reason.
When Bigger Isn’t Better
Every few months, a familiar story unfolds: a patient demands transfer to a larger hospital. Sometimes, the reason is clinically sound – certain specialties or technologies simply aren’t available locally. But often, the request is driven by the belief that “bigger must be better.” When the transfer is approved, we coordinate everything – ambulance, handoff, documentation. But what happens next? Often, those same patients return to us – sometimes months, sometimes years later – and their feedback is strikingly consistent.
Patient: “I’m not going anywhere this time, doc.”
Me: “Why not?”
Patient: “At the big hospital, every day brought a new doctor, new nurses, new therapists. I felt like a number. Every day, they had to relearn my story.”
I’ve had this exact conversation more than 50 times in my career. And it’s not just my experience. A 2024 study by Vu et al., published in Public Health Challenges, analyzed patient satisfaction across 3,248 hospitals – over half of them rural. The results were clear: rural hospitals outperformed larger centers across every single metric of patient satisfaction, including:
- Nurse and physician communication
- Staff responsiveness
- Medication and discharge education
- Cleanliness and quietness
- Care transitions
- Overall hospital rating
- Willingness to recommend the hospital
Let that sink in – every single metric.
Why Rural Hospitals Excel: It’s All About Continuity
So why do rural hospitals do so well? The answer lies in the way care is structured. At Rural Physicians Group (RPG), where I practice, we implement a model designed specifically to enhance continuity. Our hospitalists live in the hospital during 5–10 day shifts. We care for patients throughout their entire stay, building relationships, understanding their nuances, and avoiding the fragmented handoffs so common in larger centers.
Consider this: A patient hospitalized for four days at a major medical center might see eight different hospitalists due to shift changes. That’s eight handoffs – and eight chances for miscommunication. In contrast, at a rural hospital using the RPG model, that same patient might only see the same one doctor throughout the hospitalization. Fewer handoffs mean fewer communication errors, better care coordination, and far greater patient trust.
And it’s not just about the doctors. Rural patients are more likely to interact with the same nurses, respiratory therapists, physical and occupational therapists, social workers, pharmacists, and nurse aides throughout their stay. This consistency reduces friction, fosters familiarity, and ensures that care plans are communicated clearly and accurately.
When teams work together repeatedly, something powerful happens: We become more than a collection of professionals – we become a high-functioning team. We anticipate each other’s needs, support one another, catch mistakes before they reach the patient, and work seamlessly toward a shared goal: exceptional care.
Teamwork, Trust, and Patient-Centered Care
This depth of teamwork, trust, and mutual respect is only possible through continuity – and continuity is what rural hospitals do best. Patients can feel the difference. They notice when the nurse knows their name without checking a chart, when the doctor remembers their daughter’s wedding, or when the therapist picks up exactly where they left off the day before. These small details build trust – and trust builds satisfaction.
Even outside of work, I’ve seen this firsthand. Our first child was born in a large hospital, and the experience left much to be desired – a story for another time. For our next two children, we chose rural hospitals. The difference was night and day: personalized care, familiar faces, and a team that felt like family.
The Rural Advantage
The perception that bigger hospitals always provide better care is outdated – and dangerously misleading. Of course, some medical situations require advanced capabilities only available at tertiary centers. But for the vast majority of inpatient needs, rural hospitals provide not just comparable care – but superior patient experiences.
As clinicians and administrators, we must recognize and amplify the value rural hospitals bring. Let’s move beyond the myth that size equals quality. The data – and the stories – tell a different story.
Rural Hospitals = Better Continuity = Better Communication = Fewer Errors and Happier Patients
Caring for rural America is more than a profession – to me, it’s an honor and a privilege. I take great pride in knowing that my patients get the best possible medical care. The next time someone questions whether rural hospitals can offer the same level of care, I encourage them to take a closer look. They might just discover what so many of our patients already know.
Thank you to all the teams making rural healthcare extraordinary — For more articles like this check out RPG’s FREE digital magazine, ‘Fields of Care‘!
Article Author: Bill Brandenburg, MD
Hospitalist, Rural Physicians Group
References
Vu S, Reese L, Patel N, Hung M. Patient Satisfaction in Rural Versus Non-Rural US Hospitals. Public Health Chall. 2024 Jul 17;3(3):e219. doi: 10.1002/puh2.219. PMID: 40496535; PMCID: PMC12039732.