All of this was accomplished outside of the traditional rural healthcare system of hospitals, clinics, and physicians' offices. "The nice thing is that it takes it out of the whole medical reimbursement arena and the other piece is you don't have to establish a new infrastructure. The kind of activities fit nicely with the mission of the extension services," Perri says.
This may makes perfect sense, but Perri says the idea is embraced neither by rural providers nor extension services.
"They are coming from totally different angles. We have people with different world views," he says. "The folks in cooperative extension are coming largely from the perspective of agriculture. They feel somewhat uncomfortable moving towards healthcare as part of their mission. The folks in hospitals and clinical care see cooperative extension as the folks who help farmers and run 4-H clubs. There hasn't been a concerted effort to bring the two groups together."
This has to change. I suspect that it will. A big motivator will be money.
Providers are entering a new world of disease management, coordinated care, quality outcomes, and smaller reimbursements. It behooves them to step beyond the confines of the healthcare establishment to find new and nontraditional partners who can effectively and cost-effectively educate rural families about nutrition.