Discusses changes in contemporary health care services for rural Appalachians. Examines how rural services are affected by rising costs, technological advancement, aging population, system reorganization, and physician and nurse shortages. Profiles Appalachian Rural Health Program and National Health Service Corps. (TES)

Wayne Myers, director of the Office of Rural Health Policy, discusses Appalachian rural health and access to health care. The health manpower shortage in Central Appalachia still exists but is less severe than 10 years ago. The needs of underserved areas could be address by training local people in the community and through telemedicine and…

Quality on-the-scene emergency care for a rural area is provided by West Alabama's Emergency Medical Services. The success of this delivery system is attributed to a radio/telephone communications system that provides quick, direct contact between paramedics at the scene and medical doctors miles away. (DS)

A number of Appalachian initiatives aim to recruit rural doctors. West Virginia's three medical schools require all students to spend time working in rural clinics, where they develop an understanding of and connections to rural communities. In two rural Tennessee counties, East Tennessee State University maintains teaching medical practices…