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Rural‐serving primary care practitioners' and cardiologists' care adaptations for cardiovascular services: A qualitative analysis.

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Title: Rural‐serving primary care practitioners' and cardiologists' care adaptations for cardiovascular services: A qualitative analysis.
Authors: Miller, Susan G.1 (AUTHOR) sgmill@uw.edu, Burchim, Signe1 (AUTHOR), Beima‐Sofie, Kristin1 (AUTHOR), Spencer, Angela G.1 (AUTHOR), Wadden, Elena1 (AUTHOR), Selah, Brekken1 (AUTHOR), Jaffari, Adiya1 (AUTHOR), Suchsland, Monica Zigman2 (AUTHOR), Cole, Allison2 (AUTHOR), Elrod, Steven3 (AUTHOR), Gehring, Peg4 (AUTHOR), Gilles, Ryan5 (AUTHOR), Jose, Charles G.6 (AUTHOR), McGrath, Kelly4,7 (AUTHOR), Baker, Russell T.8 (AUTHOR), Longenecker, Christopher T.1 (AUTHOR)
Source: Journal of Rural Health. Winter2026, Vol. 42 Issue 1, p1-10. 10p.
Subject Terms: *Health services accessibility, *Qualitative research, *Research methodology, Cardiovascular disease prevention, Psychology of physicians, Medical personnel, Research funding, Primary health care, Medical care, Interviewing, Rural health services, Health equity, Cardiologists, Medical practice
Abstract: Purpose: Rural populations in the United States have less access to cardiovascular care relative to their urban counterparts while bearing a higher burden of heart disease. To understand rural patients' access to cardiovascular care services, we conducted a qualitative study investigating which cardiovascular services rural‐serving primary care practitioners offered, how they adapted care, and what factors influenced cardiovascular scope of practice and adaptations among rural‐serving primary care practitioners and cardiologists. Methods: We conducted semi‐structured interviews with rural‐serving primary care physicians, advanced practice providers, and pharmacists, as well as cardiologists, in Alaska, Idaho, and Washington state. Findings: Twenty health care practitioners participated in this study. We identified two themes characterizing cardiovascular services: expanded scope of practice (e.g., primary care physician prescribing a higher‐risk anti‐arrhythmic medication, dofetilide, for atrial fibrillation) and altered care (e.g., cardiologist ordering fewer cardiovascular imaging tests when needed technology was unavailable). Using a socio‐ecological approach, we found factors affecting care adaptations at four levels: local communities; individual practitioners; local clinics and health systems; and the broader health care, law, and policy environment. Conclusions: When caring for rural cardiovascular patients, primary care practitioners and referring cardiologists expanded their scope of practice and altered care. Multiple factors affected these shifts. Future research could address whether and how expansion of scope of practice (e.g., through team‐based care) may improve access to cardiovascular care among rural populations. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Rural Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Education Research Complete
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PubType: Academic Journal
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  Data: Rural‐serving primary care practitioners' and cardiologists' care adaptations for cardiovascular services: A qualitative analysis.
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  Data: <searchLink fieldCode="AR" term="%22Miller%2C+Susan+G%2E%22">Miller, Susan G.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> sgmill@uw.edu</i><br /><searchLink fieldCode="AR" term="%22Burchim%2C+Signe%22">Burchim, Signe</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Beima‐Sofie%2C+Kristin%22">Beima‐Sofie, Kristin</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Spencer%2C+Angela+G%2E%22">Spencer, Angela G.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wadden%2C+Elena%22">Wadden, Elena</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Selah%2C+Brekken%22">Selah, Brekken</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jaffari%2C+Adiya%22">Jaffari, Adiya</searchLink><relatesTo>1</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Suchsland%2C+Monica+Zigman%22">Suchsland, Monica Zigman</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cole%2C+Allison%22">Cole, Allison</searchLink><relatesTo>2</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Elrod%2C+Steven%22">Elrod, Steven</searchLink><relatesTo>3</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gehring%2C+Peg%22">Gehring, Peg</searchLink><relatesTo>4</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gilles%2C+Ryan%22">Gilles, Ryan</searchLink><relatesTo>5</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Jose%2C+Charles+G%2E%22">Jose, Charles G.</searchLink><relatesTo>6</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22McGrath%2C+Kelly%22">McGrath, Kelly</searchLink><relatesTo>4,7</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Baker%2C+Russell+T%2E%22">Baker, Russell T.</searchLink><relatesTo>8</relatesTo> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Longenecker%2C+Christopher+T%2E%22">Longenecker, Christopher T.</searchLink><relatesTo>1</relatesTo> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Rural+Health%22">Journal of Rural Health</searchLink>. Winter2026, Vol. 42 Issue 1, p1-10. 10p.
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– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose: Rural populations in the United States have less access to cardiovascular care relative to their urban counterparts while bearing a higher burden of heart disease. To understand rural patients' access to cardiovascular care services, we conducted a qualitative study investigating which cardiovascular services rural‐serving primary care practitioners offered, how they adapted care, and what factors influenced cardiovascular scope of practice and adaptations among rural‐serving primary care practitioners and cardiologists. Methods: We conducted semi‐structured interviews with rural‐serving primary care physicians, advanced practice providers, and pharmacists, as well as cardiologists, in Alaska, Idaho, and Washington state. Findings: Twenty health care practitioners participated in this study. We identified two themes characterizing cardiovascular services: expanded scope of practice (e.g., primary care physician prescribing a higher‐risk anti‐arrhythmic medication, dofetilide, for atrial fibrillation) and altered care (e.g., cardiologist ordering fewer cardiovascular imaging tests when needed technology was unavailable). Using a socio‐ecological approach, we found factors affecting care adaptations at four levels: local communities; individual practitioners; local clinics and health systems; and the broader health care, law, and policy environment. Conclusions: When caring for rural cardiovascular patients, primary care practitioners and referring cardiologists expanded their scope of practice and altered care. Multiple factors affected these shifts. Future research could address whether and how expansion of scope of practice (e.g., through team‐based care) may improve access to cardiovascular care among rural populations. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Rural Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/jrh.70129
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        Text: English
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      – SubjectFull: Health services accessibility
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      – SubjectFull: Qualitative research
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      – SubjectFull: Research methodology
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      – SubjectFull: Cardiovascular disease prevention
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      – SubjectFull: Psychology of physicians
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      – SubjectFull: Medical personnel
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      – SubjectFull: Research funding
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      – SubjectFull: Primary health care
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      – SubjectFull: Medical care
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      – SubjectFull: Interviewing
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      – SubjectFull: Rural health services
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      – SubjectFull: Health equity
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      – SubjectFull: Cardiologists
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      – SubjectFull: Medical practice
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