The Voice of Rural Medicine in Oregon Medicine iS juSt different out here. When I say out here, I’m talking about rural Oregon and specifically Baker City, Oregon. When I say different, I mean remote and community-centered. For more than 24 years, I’ve had the honor of serving the health care needs of eastern Oregon families. First as the community’s only female primary care doctor and later as an emergency physician with Saint Alphonsus Regional Medical Center. Growing up in a small town in Rhode Island, I thought I knew what it was like to live in a small community. Size, I’ve discovered, is definitely a matter of perspective. If you’re a physician in Baker City, you occasionally practice “Safeway” medicine. It means you’re bound to run into someone at the grocery store that wants a diagnosis on the spot. I remember a time when one of my “neighbors” felt the grocery store aisle was the appropriate place to drop his pants to show me his rash. I referred him to my husband, one of the community’s few primary care doctors at the time. I also remember the time when one of my closest neighbors—just 80 acres away—broke his leg. Instead of calling an ambulance, they came to our house for a quick consult. I think these colorful examples point out the best and most challenging aspects of rural practices. First. Everyone knows you. Everyone relies on you. You’re a major part of the community, and there’s no such thing as anonymity. Whether that means being asked to help a fellow skier put his shoulder back in place after a bad fall up at Anthony Lakes or providing encouragement to someone at the gym, your relationships with patients are much more personal. They’re your neighbors, your church members, your friends, and a major part of the community. You are connected. As a doctor in rural communities, you also have to be more self-sufficient because you don’t have specialists available, making it necessary to manage diseases and perform procedures that your urban colleagues do not. Family medicine physicians are the only doctors available to do obstetrical care here and often perform C-sections normally reserved for surgical specialists. Unfortunately, small rural communities like Baker City, also have a shortage of primary care doctors. Many of the specialists that patients take for granted in urban settings are just not available or only occasionally come to visit. That can be problematic for patients needing a transfer to another facility especially when our icy winter weather puts a hold on ground and air ambulance transport. Our short supply of primary care doctors also means that a growing number of rural residents end up using the ER for their primary care needs because they can’t get in to see a family practice doctor without waiting weeks for an appointment. It’s because of the unique challenges and access problems we face, that I strongly support the Oregon Medical Association. The organization has fought hard to ensure that rural medicine has a voice in Salem. OMA lobbying efforts continue to support rural liability relief funding and loan repayment programs to encourage doctors to consider rural practices. The OMA is doing many wonderful things, and I’d like to do what I can to help promote the good work and the From the President Nancy Hutnak, DO President Oregon Medical Association nancneal@wildblue.net Your relationships with patients are much more personal. They’re your neighbors, your church members, your friends, and a major part of the community. You are connected. 4 Medicine in Oregon Oregon www.TheOMA.org
OMA Spring 2015 Magazine
To see the actual publication please follow the link above