[Sustaining rural maternity and surgical care: Lessons learned].

T he slow and steady erosion of rural maternity and surgical services over the past 2 decades has been met with a determined push back from care providers, administrators, and those living in rural areas, underscored by efforts to create an evidence base to inform policy and planning.1 The loss of rural maternity care programs in particular has resonated deeply with stakeholders and has attracted a substantial body of research and policy initiatives. Regardless, beyond stimulating meaningful interest and understanding of these maternity care issues, these research and public policy efforts do not appear to have reversed, or even stemmed, the service closures. The recent “Joint Position Paper on Rural Surgery and Operative Delivery”2 represents some original thinking on these matters, based on an appreciation of the mutual dependence between the rural surgery and maternity care programs. The physician stakeholders are offering both a window through which to better understand the rural health care infrastructure and a reset opportunity—an opportunity to redirect the research and public policy issues around family physicians with enhanced surgical skills (FPESSs) going forward.