WITH DOCTORS SCARCE AS SKYSCRAPERS IN RURAL KANSAS, TWO NURSES ARE PROVIDING VITAL HEALTH CARE VIA

The Wired Praire

he people of Garden City, Kans., have always lived at the end of the world. In the 1870s and '80s, wagon trains plodded along the Santa Fe Trail for a month or more from Kansas City, on the state's eastern edge, to the scrappy little community near its western border. Even today the trip takes eight mind-numbing hours by car. No wonder Garden City (pop. 24,072) and hundreds of other rural communities in western Kansas have had a tough time persuading physicians to come and set up a practice. In fact, more than half the state's 105 counties are considered critically underserved for health-care needs.

For decades the state legislature tried to plug the gap with economic incentives. It offered scholarships to the state's only medical school, in Kansas City. It forgave hundreds of thousands of dollars in educational loans. But it was always the same story: no matter how generous the financial package, no matter how idealistic the students, after six or more years of advanced medical training, most newly minted doctors dropped any thought of hanging out a shingle on the prairie.

Now there's a group of Kansas nurses who think they have a better idea. Most of the time, they note, people seek a doctor for what is known as primary care: the aches and pains, the colds and allergies that are readily treatable. Those also happen to be the sorts of illnesses that nurse practitioners--registered nurses who have undergone an extra two years of medical training--are particularly adept at taking care of. So if doctors are scarce, then why not increase the number of nurse practitioners? And if moving to the city for training creates too many temptations to forget about home, then why not use interactive technology to bring the classroom to the prairie? Ideally, to complete their training, students who have strong ties to their rural communities would never even have to set foot on an urban campus.