In rural America, physician shortages exacerbate the spread of health misinformation, straining doctor-patient relationships. Oncologist Dr. Banu Symington in Wyoming describes hostile encounters with patients distrustful of vaccines and science. Experts warn that these challenges are shortening lifespans in underserved areas.
Dr. Banu Symington has practiced oncology in Rock Springs, Wyoming, for 30 years, drawn initially by the area's vast landscapes and community respect for physicians. Today, as one of only five full-time oncologists in the state, she runs the sole cancer center in the southwest region, with the nearest alternative a three-hour drive away in Utah. However, patient interactions have soured amid rising misinformation and political divisiveness.
Symington recounts patients cursing her for recommending masks or vaccinations during chemotherapy. One patient's husband called her "a liberal bitch" for suggesting masking. At a local county fair, she offered free sunscreen but faced rejection; a woman claimed doctors add cancer-causing chemicals to enrich themselves. Patients have labeled her a "pharma whore" to her face. A former leukemia patient, once friendly and sharing hobbies like rock hunting, refused vaccination, died of COVID-19, and believed the disease was a political fabrication.
Misinformation extends to treatments like ivermectin, an anti-parasite drug promoted by actor Mel Gibson on Joe Rogan's podcast. Symington notes patients secretly taking it end up in intensive care from complications. She fears retiring at 65 sooner than planned due to the hostile atmosphere, doubting a replacement can be recruited.
Alan Morgan, CEO of the National Rural Health Association, links the acute doctor shortage—fewer than 5% of physicians from rural backgrounds—to declining lifespans. He emphasizes local clinicians' role in countering online falsehoods with trusted science. Immigration policies under the Trump administration have reduced foreign-born doctors, who comprise half the oncology workforce, making rural staffing harder. Thirty years ago, Rock Springs had Canadian immigrant physicians; now, none remain.
In Fredonia, Kansas, Dr. Jennifer Bacani McKenney, born to Filipino immigrants recruited there in the 1970s, faces racism masked as COVID-19 skepticism. Patients called it the "China flu" or "Kung flu" to her face, then exempted her as a local. As an associate dean at the University of Kansas, she addresses medical students' safety concerns during rural rotations, where racist jokes occur. She adapts vaccine discussions, starting with familiar ones like tetanus to build trust, amid Robert F. Kennedy Jr.'s role as Health and Human Services secretary amplifying unsupported views.
Bacani McKenney stresses persisting in conversations: "If I don't have those conversations, I'm not doing my job." Rock Springs, with a population of about 23,000 per the 2020 census, exemplifies these broader rural health struggles.