What might the past suggest about rural emergency services amidst critical access hospitals’ decline?

What might the past suggest about rural emergency services amidst critical access hospitals’ decline? 
AMA Journal of Ethics, American Medical Association; by Siân Lewis-Bevan, MD, MPH, EMT-B and Stephen Powell, MD; July 2025
Critical access and other rural hospitals have struggled to remain open, which exacerbates inequity in rural residents’ access to routine and emergency health services and strains already-taxed rural emergency medical services (EMS). This article discusses the recent history of rural hospital closures and their effects on rural emergency care. This article also suggests modifications to EMS policy and practice that could improve rural community members’ access to health services and bolster EMS services in rural areas.