For many West Virginia residents living in rural counties, access to quality healthcare has become increasingly challenging due to factors that include an aging and shrinking population, fewer physicians within those communities and an increase in financial pressures on healthcare systems throughout the state. For many residents, getting the medical care they need isn’t just measured by the severity of their illness, but also by the miles they may have to travel to be seen by the nearest physician or hospital.
In 2025, the total population of the Mountain State was estimated at nearly 1.8 million, representing a 1.5% decrease from the 2020 U.S. Census records. Add to that, almost 22% of the state’s residents are 65 or older. The combination of a shrinking and aging population in West Virginia has the potential to place a tremendous strain on healthcare systems, due to fewer rural physicians and the frequency of doctor visits required to treat such chronic conditions as heart disease, diabetes and obesity.
Particularly for rural counties, the challenges of having fewer physicians for specialty services combined with patient transportation issues mean that the likelihood that a patient might delay treatment until a condition becomes an emergency is not a distant thought. However, recent efforts by major healthcare systems in the state are addressing this growing concern.
TRAINING PHYSICIANS WHERE THEY ARE NEEDED MOST
West Virginia School of Osteopathic Medicine focuses on rural healthcare
As West Virginia’s largest medical school, the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg, West Virginia, trains doctors to work in rural healthcare as an essential part of its institutional mission. In fact, every medical student is required to complete a rotation in a rural or underserved location in the state.
Through the School’s Rural Health Initiative, the WVSOM not only recruits students interested in primary care, but also ensures those physicians attain relevant experience by having them serve clinical rotations and participate in physician mentorship in rural communities. This approach provides them with additional exposure to the unique circumstances of practicing rural medicine and recognizes that recruiting doctors to practice in rural communities begins long before they receive their medical license.
WVSOM President James W. Nemitz, who holds a Ph.D. and has been a professor of anatomy at the school for more than 30 years, has plans to increase the number of West Virginia medical students there.
“We’re the leading producer of physicians in West Virginia,” Nemitz said. “Our doctors are treating patients in 51 of the 55 counties within the state.”
BRINGING CARE DIRECTLY TO PATIENTS
Marshall Health Network addresses patient transportation
Marshall Health Network (MHN) is tackling the problem by taking medical services on the road — literally. Through its Marco Mobile Medicine unit, physicians are able to provide quality care to rural and underserved communities across MHN’s 40-county service area in West Virginia, southern Ohio and eastern Kentucky. The nearly 38-foot mobile clinic has a waiting room, two exam rooms, a dedicated space for blood draws, telemedicine capabilities and a restroom.
The Marco Mobile Medicine unit offers more than convenient medical care. For many patients, it is a valuable lifeline to help them manage chronic conditions, receive health screenings and speak directly with specialists without having to travel a long distance to a larger medical facility. This becomes very important when you factor in the time and expense of a roundtrip visit to a doctor’s office or larger hospital system. Rural residents benefit from having access to care that literally meets them where they are.
To further remove the transportation burden for patients in rural communities, Marshall Health Network’s Tele-NOW Virtual Urgent Care program allows patients to schedule virtual visits for some routine, pre- and post-operative and follow-up care appointments.
“We are meeting patients and healthcare partners where they are and responding to the needs of each community we serve,” said Beth L. Hammers, chief engagement officer for Marshall Health Network and vice dean for administration at the Joan C. Edwards School of Medicine. “Our focus is on filling gaps in care, not duplicating what’s already available. By listening to local input and using real data, we can ensure the right services reach the right people through telehealth, mobile medicine and workforce development.”
Additionally, Marshall Health Network continues to invest in patient care outside of Huntington, including Rivers Health in Point Pleasant, which serves Mason County and neighboring rural communities. A major expansion and renovation of the hospital’s emergency department is underway, increasing treatment rooms and improving ambulance access. There is also a new outpatient psychiatric clinic that provides psychiatric evaluation and treatment for adults and children.
In an effort to positively impact the physician shortages in rural areas, MHN and the Joan C. Edwards School of Medicine work together in training physicians in the communities where they may end up practicing. Rural residency programs are now offered in general surgery, psychiatry and internal medicine.
VANDALIA HEALTH’S MEDICINE IN MOTION
Mobile fleet delivers care closer to home
As the model for delivering quality healthcare to rural communities across West Virginia expands, Vandalia Health is making a difference through its Medicine in Motion initiative, which focuses on reducing transportation and geographic barriers that often keep patients from seeking care.
Vandalia’s fleet of mobile units feature exam space as well as technology that allows rural patients to connect with specialists throughout the health system. From routine health assessments and vaccinations to more serious screenings for cancer, rural residents can receive quality care without traveling long distances. For example, in 2025 Vandalia’s mobile mammography team traveled to 32 locations in the state and provided nearly 850 screenings for women. It offers a private mammography suite and uses the same high-quality imaging technology available at Vandalia’s other health facilities.
“Our mobile fleet is designed to bring quality healthcare to rural and underserved areas of West Virginia, focusing on detection of life-threatening diseases for early intervention,” said Terry Cox, executive director of network development and program director of Medicine in Motion.
Vandalia Health also has a Mobile Lung CT unit that visited 16 locations and provided 85 lung cancer screenings last year. Oncology and infusion services have been expanded into rural areas of the state as well.
Beyond the most common medical care delivered to patients, Vandalia Health’s Community Connect program offers services related to wound care, urgent care, substance use and testing for HIV and hepatitis C. This approach to patient care reflects a commitment to ensuring that rural residents have access to healthcare when and where they need it most.
“We are committed to making high-quality, compassionate care available to everyone, regardless of where they live,” Cox said.
A DRIVING FORCE BEHIND BREAST CARE
WVU Medicine makes stops with Bonnie’s Bus
When it comes to making an impact on women’s health, WVU Medicine continues to broaden its services to rural patients for breast cancer screenings through its Bonnie’s Bus mobile units. As the most commonly diagnosed cancer among West Virginia women, breast cancer is also the Mountain State’s second-leading cause of cancer-related deaths.
These screenings not only provide an opportunity for women to have access to early detection but also help save lives. Since 2009, the program has performed more than 35,000 breast screenings in rural communities throughout the state, detecting over 200 cases of breast cancer. It has funded more than 2,500 mammograms for women who are either uninsured or underinsured. Led by the WVU Cancer Institute’s Cancer Prevention and Control program, Bonnie’s Bus is making a big difference, one stop at a time. A second mobile unit was recently added to the program, reaching even more women in need of breast screenings.
According to Jenny Ostien, director of mobile cancer screenings for the WVU Cancer Institute, traditions and culture throughout Appalachia can often impact health decisions.
“Some women may believe they don’t need care unless they have symptoms, while others fear what a screening test might uncover,” she said.
The importance of Bonnie’s Bus is underscored by the American Cancer Society, which estimates there will be 1,700 new cases of breast cancer among women and close to 300 deaths in West Virginia this year. Without a doubt, early detection could be the difference between finding cancer that is treatable and discovering it after the disease has progressed.
Addressing the challenges facing healthcare systems in rural areas takes a collaborative and
coordinated effort to ensure their long-term viability. No one hospital system can do it alone. If patients can’t travel long distances for the care they need, then the care must find its way to them. Fortunately for West Virginia’s rural residents, progress is already making a difference.
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Shelly Ridgeway is a freelance writer living in Huntington, West Virginia.