Why we do the things we do!

A few weeks ago one of our patients arrived early in the morning not feeling well, looking dehydrated with a glucose monitor reading of HHH, or too high to read. He had no insurance and just could not face the expense of the Emergency Room. If I told him to leave and go to the ER he would not go. If I called the EMS he would not agree to transport. If I did nothing then he would get worse. So we kept him for six hours in the Sigmoidoscopy room on IV fluids and hourly glucose fingersticks with insulin coverage. At the end of the day he walked out of the center smiling without assistance with insulin and syringe samples in hand. Today his sugar is under control and he is smiling walking through the center.

What happens when you are not there

Being the Medical Director and feeling protective of our 24 staff members, you feel as though you need to be at the office at all times. But this is not practical. Anyway, the work of a good leader is how well others are prepared. This is why I spend a lot of time preparing and reviewing with the staff Policies and Procedures concerning practical issues. One such issue occurred of course when I was not at the center. A male patient became loud and aggressive, but not physical. Thank goodness the staff is trained on our Disruptive Patient Policy. The incident ended with no one hurt and the proper authorities notified. The staff talked calmly while clearing a path to the way OUT for the patient. No one confronted him or threatened him. The front door did not fend as well, but we fixed the door immediately. As the staff looks back on that day I sense relief but also pride on how well they handled the situation. Good thing too, as we are 20 miles away from the Police Station.

Clinch River's beauty

Rural Medicine & Community Leadership – Never Boring!

Yes, Rural Medicine is a way of life, with friendly, thoughtful, thankful patients and an area full of the community spirit. It is a calling with the sounds of nature everywhere, a need to help others in need, and to be part of something bigger - a family of community. You are at the top of the class when you are asked to be the President of the Head Start Council, on the School Health Board, chosen as the local Rotary Professional of the Year, or even the Virginia Community Healthcare Association Physician of the Year. And life is freer and easier as you are not owned by anyone (a Hospital practice), not competing with the group down the street, you make the practice as much or as little as you are able, and be home with your family. It is a challenge to be without an Echocardiogram machine or CT scan, but it makes you a better skilled Clinician to make the diagnosis without these. You have an IV running in the back room, a chain saw injury in the Treatment Room, and a nebulizer treatment started in Room 1. Let’s say it is never boring! And with modern technology you are only a connection away from Tele-Medicine services, Tele-Psychiatry Services, Internet Libraries, and colleagues.

Rural Medicine Work-Life Balance

I cannot say it is an easy life was my twenty plus years of experience found me as the County Coroner, Director of the local Health Department clinic, Utilization Director of a Nursing Home, running two offices, and even a full hospital practice with Obstetrics and Critical Units. But, I can say you can make it as much or as little you want it to be, from doing everything to making your schedule so you can be the coach of your children's basketball team. Little League Baseball, or Football team. I never missed my son's High School Football games, ( he was a four year starter) nor my daughter's Dance Competitions and her recitals since she was three years old. There is the challenge with the isolation from the Academic world, so I precept in a nearby city at the Residency Program. There might be limited or no hospital resources, limited or no ancillary services, but you learn the connections in nearby cities and Universities. Better yet, being in a small area everyone knows you, but you know them; you cannot walk through Wal- Mart without someone (or a dozen) waving at you.


Gary

Rural Medicine IS for excellent scholars

There is this misconception that rural medicine is for those who are low on the ladder and not stellar academically. As for the bottom of the class I do not know what that is as I neve was there. From graduating number one in my High School for Advanced Placement, to being the top male Graduate at my University, to finishing in the top of my Medical School Class the bottom was never seen. Even though we do not have a Higher Education facility in the county and not everyone has Internet Access, the richness of personal experience, knowledge of the land and survival, creativity, and just the shear beauty of the countryside makes everyday a rich experience.


Gary