This article has been revised to include new and updated information on which services are available and planned for the future at various facilities.
In an era when hospitals, physicians’ offices, and other medical facilities in rural and less-populated areas of the country are reducing services or closing entirely, one organization is bucking the trend and expanding in the rural countryside of the Eastern Shore of Maryland — Choptank Community System.
In the 15 years from 2005 through 2019, over 150 rural hospitals closed across the nation. An additional 19 rural hospitals closed during 2020. That was the first year of the COVID-19 pandemic — just when we needed them most. Currently, about 600 hospitals, representing 30% of all rural hospitals, are at risk of closing. In the wake of these closings, many associated physicians’ practices and other services moved away, as they need or prefer to be near a full-service hospital. While a few small, limited-service facilities — clinics and urgent care centers, for example — have popped up in shopping malls and elsewhere, the rural parts of the U.S. are increasingly becoming medical deserts.
Enter Choptank Community Health System (CCHS). Choptank is that rare exception — a primary health care provider that is moving into rather than out of smaller towns and rural areas.
Back in the 1970s, a group of medical personnel and local residents on the Eastern Shore who were concerned about the lack of medical services founded what was to become Choptank Health. Originally called Caroline Health Services, the organization was incorporated in 1978.
Their first medical facility opened in Goldsboro two years later. Since then, the organization has steadily expanded, adding services and opening new centers.
Choptank is a private, non-profit, Federally Qualified Health Center (FQHC). They are part of a network of community-based health care center 1,368 in the country and 21 in MD, that strive to help meet the needs of an underserved area or population and receive federal funding from Health Resources and Services Administration.
Choptank provides a wide range of medical, dental, and behavioral health services. The 50-plus medical personnel include physicians, pediatricians, physician assistants, nurse practitioners, dieticians, and behavioral therapists. Additionally, the dental clinics have a total of 12 dentists and dental hygienists. The centers are welcoming new patients and accept most health insurances including Medicare and Medicaid. There is a sliding fee scale for those without insurance.
Today, in addition to the original clinic in Goldsboro, there are CCHS health centers in Cambridge, Denton, Easton, Federalsburg, St. Michaels, and Tilghman Island. Most recently, Choptank Health expanded into Kent County, opening its Chestertown office with a mobile unit traveling to Rock Hall and other nearby communities such as Galena, Millington, and Betterton later this summer.
Choptank Health’s newest School Based Health Center (SBHC) is at Rock Hall Elementary School and provides in-person, virtual, and curbside care during the school year and the summer months for students, faculty, and staff in the school system. The school based health center is now open to the community as a primary care facility and welcoming patients.
Also available through the school are urgent care, health education, physical exams, risk assessment, sports care, dietary support, and asthma management. There are also SBHCs in Caroline, Talbot, and Queen Anne’s County schools. These centers operate much like a regular doctor’s office. Any registered student can make appointments and receive care that includes diagnosing illnesses, writing prescriptions, exams for school sports, and lab tests such as for strep or COVID-19. Dental services are also available in many of the school centers. All the school based health canters are staffed by registered and licensed health practitioners.
With all this expansion, Choptank now provides health services in five of the nine counties on the Eastern Shore — Caroline, Dorchester, Kent, Queen Anne’s, and Talbot.
Through the medical centers, Choptank runs several much-needed health monitoring and educational programs. Women’s Health and Prenatal Care are offered in the Cambridge, Chestertown, Easton, and Federalsburg centers. Pediatric care for infants and youth to age 21 is available at the Easton and Denton locations. For those who need to go to a hospital or Emergency Room, Choptank refers patients to the University of Maryland Shore Medical Centers in Cambridge, Easton, and Chestertown.
Other health services include counseling and behavioral therapy for substance use disorder and mental health issues. These services are available at all CCHS centers.
Choptank policy places a priority on providing health care to the under-served. There are special services and outreach programs for immigrants, transient workers, and non-English-speaking people, with interpreters fluent in Spanish and Hatian Creole.
Probably one of the most unusual aspects of Choptank Health, especially for rural areas, is the combination of primary medical centers with dental clinics.
Dental care is one of the most neglected aspects of medical care for many people, mostly because dentistry is generally not included in health insurance plans. Yet dental health has been shown in multiple studies to greatly affect an individual’s overall health and quality of life.
Choptank’s plans include a new facility in Federalsburg toreplace its current building and a renovation of the Chestertown office to include dental services Both scheduled to open in 2024.
Choptank Health also runs a dental preceptorship program that provides both rigorous classroom and hands-on clinical training for dental students. There are three-month, six-month, and twelve-month dental preceptor programs.
Perhaps most exciting is the current development of a three-year rural medical residency for recent medical school graduates. The University of Maryland School of Medicine in cooperation with the Maryland Department of Health and CCHS will develop and implement the program. The medical residents’ first year will be at UMMS and Shore Health in Baltimore followed by two years of hands-on training in the Choptank Community Health System.
Choptank Community Health System is definitely a bright and growing oasis in the health care landscape on the Eastern Shore.
Choptank Medical & Dental Centers:
Goldsboro Medical & Dental Center
Federalsburg Medical & Dental Center
Fassett Magee Medical & Cambridge Dental Center, Cambridge
Easton Health Center
More information:
Choptank Community Health Services
Maryland Health Care Commission: “Options for Rural Health Care Delivery in Maryland”, January 21, 2020.
Jane Jewell is a writer, editor, photographer, and teacher. She has worked in news, publishing, and as the director of a national writer's group. She lives in Chestertown with her husband Peter Heck, a ginger cat named Riley, and a lot of books.
Title image: Pond at Pickering Creek Audubon Center, Talbot Co. Photo: Jan Plotczyk