The Upper Peninsula of Michigan is characterized by heavy snow fall and by the limitations associated with the long, harsh winter climate. Travel can be extremely tenuous and hazardous from November through May, with often severe weather conditions contributing to extending travel times, cancellations and high 'no-show' rates at health care clinics at remote sites. During the months of December '96 and January '97, six patient transfers were delayed or canceled because of the weather, two ambulance runs required snowplows to go out ahead of the ambulances, and another two ambulance runs had snowplow escorts at the time of dispatch at Marquette General Hospital in Marquette County. The length and harshness of the notorious winters of the U.P. also limits access and delivery of quality health care services for residents across the region. Long snowy winters can make travel around the region difficult.
Road closures can cause delays and cancellations in emergency transportation.
The aging of many of the existing health care facilities and the problems associated with retaining quality health care professionals and providing employment for their spouses in rural areas contributes to the serious problem of access to health care services in the Upper Peninsula. Many of 18 rural hospitals throughout the Upper Peninsula face down sizing or closure. It is difficult to recruit and retain health care professionals, who tend not to stay in this rural region because of isolation from specialists, patient expectation that the physician knows all areas of medical expertise, lower reimbursement rates, high malpractice insurance, and limited continuing education and consultation opportunities without long distance travel. Often they are relied upon to provide expertise beyond their base training, in the absence of medical specialists. The isolation of all residents of the Upper Peninsula, practitioner or patient, interferes with the access and delivery of health care.