Perspective: The Tailgate Medicine Model: A Proposed Integrative Method of Care Delivery for Rural Populations
McShane, Michael P; Kowalkowski, Jennifer A; Brant, Kristina; Segel, Joel; Visco, Ashley; Volpe, Philip; Stephens, Mark
Why this matters
Rural health planners looking for a delivery model should read this as a proposal rather than evidence. The authors describe a model blending mobile health and street medicine with field treatment methods adapted from the U.S. military, and state plainly that it has not yet been tested in a community.
Abstract
Social, environmental, economic, and cultural factors-social determinants of health (SDOH)-create structural barriers that limit access to health resources and negatively impact health outcomes, particularly for rural populations. Given the significant impact of SDOH on health and mortality, there is an urgent need to develop rural care delivery models that consider community-specific SDOH that currently drive structural inequities in health for rural populations. To propose and describe the Tailgate Medicine Model (TMM), an innovative health care delivery model that, by design, emphasizes assessment and impact of SDOH on health outcomes for rural populations. TMM blends existing strengths of both mobile health and street medicine clinics, with strategies adapted from the United States military to provide rapid medical treatment in field settings. The ability to reach underserved communities or groups, create bridges to existing health resources and social services, and scale to meet local needs make the TMM particularly well suited for rural contexts. Existing care delivery models fail to address many of the structural factors that perpetuate health inequities in rural communities. Despite being untested in the community, the highly adaptable TMM has potential to directly address SDOH, and holds promise for improving access to care, sharing available resources and reducing health disparities-particularly in rural settings.