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OMA Winter 2015 Magazine

THE POWERFUL CALL OF RURAL MEDICINE By Ken Cole, Oregon Medical Association KEVIN JOHNSTON, MD, isn’t looking to be a martyr, but he knows it’s a reputation rural physicians have to overcome as they try to recruit colleagues to practice in small, rural communities. It’s a reputation the Burns, Oregon, family practice physician is used to hearing from clinicians at the university where he occasionally teaches. “They would say ‘oh man, those guys out in Burns and Lakeview and John Day, they’re saints. They work all the time, they never make any money, they can’t pay their loans off, but they’re great guys. I say to them ‘how are you helping my recruitment by saying that?’ We are not martyrs, and I don’t want martyrs. I want the best of the best,” said Johnston. Johnston knows rural health care isn’t for everyone. He says you have to be a jack of all trades, and it’s not uncommon to take care of a trauma patient in the morning and deliver a baby in the afternoon. It’s why every doctor he recruits has to be at the top of their game. It’s also why he’s a big supporter of state-sponsored incentives to attract welltrained physicians to rural communities. Keeping the Options Open “The psychological part of it is enormous, because the students now are coming out of school $250–300K in debt. They are so fixated on that debt, so nervous about that debt and—right or wrong—the sense out there is if I go and practice in a rural area and I choose rural medicine, I will never be able to pay off my debt. So having repayment options at least keeps their minds open to the possibility of rural practice,” added Johnston. While only a limited number of rural physicians may qualify for some state incentives, Johnston says the program can attract additional candidates to his office. There he can pull out his Excel file to review the numbers and the cost of living data and show that rural medicine can be a realistic option for new doctors, even with debt concerns. Johnston says while that may or may not be true in every community, every underserved community benefits if potential candidates are reassured that through the practice, or through state incentive programs, they will be able to conquer their debt. Rural Liability Relief Fund Essential After more than 12 years caring for obstetrical patients in the Burns area, Johnston knows there’s a strong need to provide OB services locally. In 2011, he answered the Oregon Medical Association’s call to testify before a legislative committee on behalf of the Rural Liability Relief Fund, which was scheduled to sunset. “What we tried to emphasize is that women will still have babies in these areas. Without local prenatal care and delivery options, outcomes will clearly be worse (we had the studies that demonstrated this). Given the fact that 60–70% of the patients in our  Kevin Johnston, MD, with patient at Harney District Hospital in Burns, Oregon. 8 Medicine in Oregon www.theOMA.org


OMA Winter 2015 Magazine
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