Last updated on March 17, 2019
There is a shortage of doctors in rural community practice in the U.S.
Medical oncology, is but one of many specialties where the shortage is especially glaring.
In oncology, I think there is perhaps a fear of practicing outside the walls of a large tertiary center. Leaving the established framework and boundaries between the doctor and patient.
There are many challenges to practicing in a resource-limited area. But there are also hidden rewards for doctors in rural areas.
The boundaries may be softer, but I find they are still well-respected by the vast majority of my patients. With the softer boundaries also come surprising rewards.
I wanted to share some of the rewards I have experienced from practicing in a small community:
1. We see the huge impact our care has on our patients by seeing them with their families and in the community. Not just in an isolated clinic visit.
In a large urban/metro practice, when we see our patients who are cured — months to years out from their chemotherapy — it makes our day.
The bright light of a survivor several years out renews and rejuvenates us. Especially as we see our other patients who may not be doing as well.
But after they leave the clinic, those survivors are then out of sight, out of mind. Until their next 6-month visit.
However, in a small community, I might glimpse one of my patients out walking their dog, or with their family at a restaurant, or simply out at the grocery store.
Or a recent example that hit me deeply, seeing them pick up their children from school.
Wow, I thought. I did that. I saved that person. Which saved that family.
To glimpse a moment in their daily life and realize the impact you have had.
There is no other word than humbling.
It occurred to me that this is what medicine must have been like decades ago. The doctor is part of the community, and is seen around town in other roles. Not just an aloof person in a white coat working in an ivory tower.
I enjoy being part of the community. I don’t mind being seen in my sweats in the grocery store, my kids trailing behind me. In other words, as a real person.
It’s not intrusive at all.
It’s a sense of connection that has, I think, been nearly lost in modern medicine.
2. People come together as a team to make things happen for the patients.
In a resource-challenged area, sometimes the healthcare team has to be creative to think of ways to accomplish the necessary care.
I have found working with a small team to be incredibly receptive. We work together to often think outside the box to figure out how to take care of the patient.
For doctors in rural areas, there is not as much ‘red tape’ as with large healthcare systems, bogged down by policies made by people far removed from the actual patient care.
Or if there is red tape, I can find the right person to meet with. And explain what might need to be changed in order to deliver the needed patient care.
There are actual 2-way conversations between the providers and administrators.
3. A five-minute commute to work.
Enough said.
(also published on KevinMD.com on 4/6/17)