Cougs Care: The Lure (and Challenges) of Rural Medicine
By Doug Nadvornick
For about two years, Garfield County, a rural agricultural county in southeastern Washington, went doctor-less. In 2007, the county's only physician moved to Atlanta. It wasn't until 2009 that the local hospital district was able to replace him with a Washington native who had been working in Montana.
The county's medical situation wasn't as dire as it might seem. Garfield County has only about 2,000 residents and one incorporated town, Pomeroy. At the time, the district also employed two nurse practitioners and a physician assistant.
"People picked up the slack," said Mallory Beale, a Pomeroy native who was then a WSU student. She volunteered at the town clinic. The mid-level practitioners there "did as much as they could. They covered basically everything a family practitioner would do."
In addition, two physicians from Clarkston -- 30 miles away -- made periodic visits and were available by phone for consultations.
Still, "it's a problem in that, for really serious things, you have to go to Lewiston (across the Snake River from Clarkston) or you have to come to Spokane (a two-hour drive)," said Beale.
Rural medicine: not for everyone
Garfield County is a textbook case of the challenges of rural medicine.
"We really struggled to find someone who wanted to practice in a very rural community," said hospital district CEO Andrew Craigie. He concedes the county's remoteness means the district often must rely on local people to fill its medical needs. For example, he says his physician assistant is a Pomeroy native who trained in the University of Washington's P.A. program.
That puts Mallory Beale in an interesting position. She's now a third-year medical student based in Spokane. She says she has thought a lot about whether her future employment plans will include her hometown.
"I get asked that all the time and...I don't know," said Beale. "I can honestly say I love small towns. I loved growing up in one and I have a very realistic understanding of what a small-town doctor needs to do."
On one hand, "I love that continuity of care idea," she said. "You see families and generations of families over years and help them through different problems in their lives."
On the other hand, "I think it's a daunting idea. You're the gatekeeper to all of the specialists and you need to determine whether something is serious or not."
For now, Beale is working through her required third-year clinical rotations. She started medical school in Pullman, studied her second year in Seattle and is now in Spokane. Before she graduates in June 2013, she'll have plenty to do, including applying for a residency program where she'll work after she collects her medical degree.
On her to-do list: decide where she'll eventually practice medicine. She's interested in staying in Washington, particularly east of the Cascades.
"I could see myself maybe a little bit bigger than Pomeroy, not as big as Spokane, just somewhere kind of in the middle, but it would just depend on the right situation."
By Doug Nadvornick
For about two years, Garfield County, a rural agricultural county in southeastern Washington, went doctor-less. In 2007, the county's only physician moved to Atlanta. It wasn't until 2009 that the local hospital district was able to replace him with a Washington native who had been working in Montana.
The county's medical situation wasn't as dire as it might seem. Garfield County has only about 2,000 residents and one incorporated town, Pomeroy. At the time, the district also employed two nurse practitioners and a physician assistant.
"People picked up the slack," said Mallory Beale, a Pomeroy native who was then a WSU student. She volunteered at the town clinic. The mid-level practitioners there "did as much as they could. They covered basically everything a family practitioner would do."
In addition, two physicians from Clarkston -- 30 miles away -- made periodic visits and were available by phone for consultations.
Still, "it's a problem in that, for really serious things, you have to go to Lewiston (across the Snake River from Clarkston) or you have to come to Spokane (a two-hour drive)," said Beale.
Rural medicine: not for everyone
Garfield County is a textbook case of the challenges of rural medicine.
"We really struggled to find someone who wanted to practice in a very rural community," said hospital district CEO Andrew Craigie. He concedes the county's remoteness means the district often must rely on local people to fill its medical needs. For example, he says his physician assistant is a Pomeroy native who trained in the University of Washington's P.A. program.
That puts Mallory Beale in an interesting position. She's now a third-year medical student based in Spokane. She says she has thought a lot about whether her future employment plans will include her hometown.
"I get asked that all the time and...I don't know," said Beale. "I can honestly say I love small towns. I loved growing up in one and I have a very realistic understanding of what a small-town doctor needs to do."
On one hand, "I love that continuity of care idea," she said. "You see families and generations of families over years and help them through different problems in their lives."
On the other hand, "I think it's a daunting idea. You're the gatekeeper to all of the specialists and you need to determine whether something is serious or not."
For now, Beale is working through her required third-year clinical rotations. She started medical school in Pullman, studied her second year in Seattle and is now in Spokane. Before she graduates in June 2013, she'll have plenty to do, including applying for a residency program where she'll work after she collects her medical degree.
On her to-do list: decide where she'll eventually practice medicine. She's interested in staying in Washington, particularly east of the Cascades.
"I could see myself maybe a little bit bigger than Pomeroy, not as big as Spokane, just somewhere kind of in the middle, but it would just depend on the right situation."