What’s Another Two Minutes for a Knee Replacement?

We watch a lot of home improvement and home-buying shows here in the Burda household. That is, when we’re not watching British murder mysteries or food shows. If the home shows are based in reality, there are many people who want to buy a new home in a remote area and get away from urban and suburban life and other people in general.

My first thought is always, “Wouldn’t that be cool?” The second thought is, “But what if we got hurt or sick?” How far would we have to go for medical care? That’s how my wife and I think now that we’re in our mid-60s.

That’s why a short research letter published Feb. 12 in the Journal of the American Medical Association should be in every real estate agent’s back pocket. The study, by five researchers from the University of Michigan, Texas Tech University and the University of South Carolina, calculated car travel times for 16 surgical procedures using Google Maps.

The study pool was about 12.4 million Medicare beneficiary admissions for 16 surgical procedures done in 2010 and 2020. About 2.7 of those beneficiaries lived in rural areas. The rest lived in non-rural areas. Eight procedures were low-risk like hip and knee replacements, appendectomies and hernia repairs. The others were high-risk like aortic valve replacements, coronary artery bypasses and liver resections.

The researchers found that the median drive time for all 16 procedures was significantly longer for rural beneficiaries in 2020 — 55 minutes compared with 23 minutes for Medicare beneficiaries living in non-rural areas. That’s not a surprise at all. If you live in a rural area, by definition, you have to drive longer to get certain things that aren’t available locally.

The researchers, God bless them, made a big deal out of these meh findings: “These findings suggest a persistent and growing disparity in travel for rural patients undergoing surgical procedures. Contributing factors likely include ongoing rural hospital closures, workforce shortages, and rural patients bypassing local facilities to obtain care elsewhere.”

That last part is important. Rural residents are choosing to drive farther to get the care they need or the care they think is better. That’s called consumerism, and that’s good.

The one thing that was a surprise in the data, although the researchers didn’t call it out, is that the travel times for surgical procedures regardless of location didn’t change that much over the decade-long study period. That’s coming from someone, me, who drives a lot in urban and suburban traffic.

For example, rural beneficiaries drove two minutes longer to get their knees replaced in 2020 compared with 2010, 46 minutes versus 44 minutes. Non-rural beneficiaries drove a minute longer to get coronary bypass surgery in 2020 compared with 2010, 24 minutes compared to 23 minutes. It’s true. For most beneficiaries, according to the study, the drive was slightly longer but not by much.

That, in turn, confirms what we all know to be true: Healthcare doesn’t change that much. We like to say at 4sight Health that healthcare will change more in the next 10 years than it has in the past 100 years. I believe that to be true. But it’s going to take a customer revolution in healthcare to make it happen.

Meanwhile, if you’re thinking about moving to a remote location to spend your golden years off the grid with no one around and no one to bother you, you’re still only 91 minutes away from a pancreatectomy.

Thanks for reading.