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Conclusion Board-certified EM-trained physicians provide some level of coverage in most emergency departments in WV but remain underrepresented in rural locations. This specialized coverage has increased by 20% in the last 15 years. Additionally, a majority of hospitals have access to basic consulting services (surgery and primary care); however, other specialists are rare in rural WV. Beta thalassemia is a congenital defect in the production of the beta globin chain. Patients with betathalassemia major will have higher levels of hemogl