When the Mayo clinic announced plans to consolidate some services at its Austin and Albert Lea campuses in June, many in Albert Lea understandably panicked that they would now have to drive 22 miles east for important medical needs. The city’s former Naeve Hospital has been part of Mayo’s network since the 1990s and Albert Lea residents had come to rely on it.

But there is more to the story than a dispute between a large health system and a greater Minnesota community. Look beyond the surface and there are many critical issues affecting how smaller communities will have access to high quality health care in the future.

One of the reasons cited by Mayo Clinic for the consolidation is the difficulty recruiting and keeping medical providers in small communities. Recruiting and retaining medical providers in rural communities remains is an on-going challenge. A significant financial boost came from the Minnesota Legislature in 2015 in the form of a loan forgiveness program for doctors who practice in those communities.

Even with this program, shortages are severe. According to the Austin Daily Herald, 102 hospitalist shifts were unable to be staffed internally at both Albert Lea and Austin locations in the fourth quarter of 2016. There are also numerous physician positions that Mayo has been unable to fill, according to Dr. Annie Sadosty, the new regional vice president for Mayo Clinic Health System in Southeast Minnesota. The Austin campus will be short four physicians at the end of 2017.

New medical school graduates may have dozens of job offers and bigger facilities with larger patient volumes are often more attractive than a job in a small, rural community. The difficulty to attract young M.D.s combined with the declining reimbursement rate from all payers has led many health systems, including Mayo, to look at new models of care.

There are many opportunities for innovation in the health care system. New technology makes telemedicine easier and more useful than ever. An expanded use of telemedicine could increase access in rural communities by reducing commute time, making it easier to schedule time with medical professionals and manage ongoing care.

Many health providers are also advocating to responsibly and safely expand the roles of physician assistants, dental assistants and other skilled professionals. These providers are more than capable to deal with routine visits and help to manage care effectively, reducing the dependency on M.D.s by allowing patients to receive care even if an M.D. is not available.

Minnesota depends on the vitality of its small communities. Access to high quality health care is essential to the welfare and economic prosperity of communities like Albert Lea. That community – and others like it around the state – have legitimate concerns about the impact of decisions to close or contract health facilities.

But there also needs to be a significant effort to reduce medical costs and that will require hard decisions, including how we manage all facilities. Changes will come, and many will be difficult. We need to make sure that communications are early, open and involve all stakeholders; that decisions are made with the best interests of all considered; and, that we always keep one eye on how to make health care affordable, accessible and of the highest quality.