Overcoming Geographic Barriers: Enhancing Pediatric Subspecialty Access for Rural Families

FC is a 3-month-old female infant referred from her local hospital emergency department for evaluation of a persistent rash and a failure to track in her right eye since birth. FC and her family are from a rural area approximately 4 hours from the nearest children's hospital, and, despite multiple attempts by her family and their primary care pediatrician (PCP), they were unable to secure pediatric subspecialty appointments for further evaluation of her symptoms because of availability constraints. She was ultimately transferred to a quaternary care pediatric center where she was diagnosed with a rare histiocytic syndrome. Her family continues to struggle to access appropriate subspecialty care after hospital discharge and ultimately travels far from home frequently to receive care. We examine FC's case using the socioecological model to highlight the disparities in access to subspecialty pediatric care for geographically isolated children and provide tangible steps to support high-quality and equitable health care for rural families and children.