“We’re Not Just Poor, We’re Overlooked”: Dr. Ralph Carter Takes on Rural Healthcare and Raleigh Politics

Dr. Ralph Carter has spent years working as an orthopedic surgeon in rural North Carolina. Now he’s running for the state House to represent District 48.

During last week’s podcast, he shared with Sloan and Margo why he’s running and what he hopes to fix, especially when it comes to healthcare in small towns like his.

A Doctor’s View on Healthcare Problems

Dr. Carter sees problems with both cost and access to care. He says many people in rural areas wait months to see a doctor or specialist. One reason, he says, is North Carolina’s “certificate of need” (CON) laws. These laws make it hard to open new healthcare facilities like MRI centers or surgery clinics.

He believes these laws limit competition and make care more expensive. “If an entrepreneur wants to open an MRI clinic in a rural county, they should be able to,” he said. “We need to make it easier, not harder.”

The state recently ended CON laws in some counties, but Carter says more needs to be done.

Local Hospitals vs. Big Systems

Carter also talked about how large hospital systems are different from small local hospitals. He works at a 100-bed hospital that’s run by local trustees. He says that setup makes the hospital more responsive to the community.

“Big hospital CEOs make millions, and many don’t even live here,” he said. “At our hospital, we know our patients, and they know us.”

He thinks big hospital systems sometimes put profits first, while smaller hospitals stay focused on patient care.

Getting More Doctors in Rural Areas

One of the biggest problems in rural healthcare is the lack of doctors. Carter says many don’t want to move to small towns, but he believes that could change if more doctors were trained in those areas to begin with.

“There’s a lot of good things about living in the country,” he said. “If doctors spent time here during training, they might want to stay.”

He supports recent efforts to let doctors from other states practice in North Carolina more easily. He also mentioned a new medical school opening at Methodist University in Fayetteville, and says the state should consider doing something similar in western North Carolina.

“People love the mountains,” Sloan said. “If we had a medical school out there, it might help fill the gap in care and bring more providers to that region.”

A Voice for Overlooked Areas

Carter says his district often gets left out of major funding and development plans. He pointed out that a major highway project skipped right over Scotland County. He believes that’s partly because his area leans Democratic, while surrounding areas are Republican.

“We’re not just poor—we’re overlooked,” he said. “It’s going to take people willing to speak up to fix that.”

While he doesn’t plan to be loud or confrontational (as Sloan suggested), Carter says he’s ready to push for changes that help rural communities like his.

Dr. Carter’s campaign is focused on simple goals: more access to healthcare, more support for small towns, and more local control. He says he’s running because he still wants to help people, but now, from Raleigh instead of the operating room.