Journal

Living and Practicing in a Rural Community

A physician and a CRNA share what drew them to smaller towns.

July 9, 2020

Megan Taylor, a Certified Registered Nurse Anesthetist at Providence Kodiak Island Medical Center, already knew she loved Alaska when she and her husband flew there for her site visit in 2019. Before their three children were born, they backpacked in Denali National Park.

But she still wanted to visit Kodiak Island and see what it was really like. Off the southern coast of Alaska, it has a population of 10,000, and just 100 miles of roads. If you want to get anywhere else, you have to take a small bush plane. The nearest big city is Anchorage, a one-hour commercial flight or a nine-hour ferry ride away. The island has a big military presence, including the largest Coast Guard base in the country, a Walmart and a grocery store — and that’s about it.

“The week I was here, we had an earthquake, a tsunami warning and a couple of serious trauma accidents,” she says. “I still left feeling like the community was great and the people were great. We knew after that it was the right fit.”

There are times when Megan is the only CRNA on the island, but she says she loves it and that rural medicine has grown her career in ways that wouldn’t have happened otherwise.

“I think what practicing in rural environments does for providers, and what it certainly has done for me, is it allows you a broad scope of practice,” she says. “I order my own supplies. You don’t get to do that in bigger places. I sit on committees, because we need representation. I have a say on how things happen in our department. Small places really give you that opportunity to effect change in your institution.”

Megan, who was hired through PS&D, isn’t alone. Many healthcare providers have long understood the benefits of practicing medicine in rural areas, including the chance to:

  • Have a great work-life balance: Shorter commutes mean more leisure time with your friends and family. Housing, childcare, taxes and food all cost less in rural areas, making it possible to work less and spend less.
  • Benefit from financial perks: Higher starting salaries and larger patient volumes mean greater income potential. Many rural practices also offer incentives like generous signing bonuses and loan forgiveness.
  • Maintain a robust, varied skillset: Rural clinicians get to work on a wider variety of procedures and cases than their urban counterparts, partly because they don’t have a bevy of subspecialists on-site. Skills stay sharp and current in a rural environment.
  • Be a valued community member: Healthcare clinicians are needed, well-known and appreciated in smaller towns. In rural medicine, you’ll probably have a waiting list before you start, and be a respected and integral part of the community.

Rural hospitals and clinics, which have long struggled to attract clinicians, are experiencing an uptick in interest in the midst of the coronavirus pandemic. LinkedIn data shows people in cities hit hard by COVID — like New York, San Francisco and Seattle — are searching for rural work opportunities significantly more than the rest of the country.

Real estate trends support the shift as well. According to Redfin, a record 27 percent of home searchers on their site are looking to move into smaller metros areas. Its pageviews of homes in towns with fewer than 50,000 residents were up 87 percent year over year in May.

Dr. Claire Frost, a family practice physician also hired through PS&D, can relate to feeling safer in a smaller town, especially now. She moved from Seattle to Missoula, Montana, with her husband and 15-month-old daughter just a few months before America’s first coronavirus patient was diagnosed in Washington.

"The quarantine began not long after we moved to Montana," Claire says. "I felt so fortunate that we were here in Missoula. We’ve had a very low case number of COVID-19."

Megan, who gave birth to her third child in Alaska just before the quarantine started, and says she is grateful to be raising her family in a close-knit community with a slower pace of life.

"My husband and I joke about Kodiak time," she says. "For example, we just bought a house, and we had a guy come out and do an estimate for a fence. If we don’t hear from him for 10 days, that’s average. You go get coffee at a drive thru, you will probably wait 10 minutes, and nobody thinks anything of it.

“We have an ENT who flies in from Anchorage for surgeries. Not long after I started, the weather was bad one day, and we had to cancel eight patients. I was all upset, but the patients were fine. They were like, ‘It’s ok! He’ll get here when he gets here.'"

Megan says she does have days where she works 6 a.m. to 9 p.m., but “many, many days, I’m done by 3, and I can do a hike with my family. I’m home for dinner most nights.” She loves the variety of work she gets to do — from pain management to obstetrics to surgery to emergency room, and she also loves the diversity of her patients, of Native American, Filipino, Spanish and Russian ethnicities.

Things aren’t always quiet in the town of Kodiak though. Being a CRNA there is “a lot of bread-and-butter procedures, mixed with moments of sheer terror,” she says.

“My first year, the Navy SEALs and the Coast Guard were both running dark training missions, so it was at night, and they hadn’t told each other,” Megan says. “Their boats collided, and we had 13 patients in our five-bed ER. We were trying to medivac a patient to Anchorage. So yeah, those are the kind of things that can happen when you’re this remote.”

With 10 years of experience under her belt, Megan says she feels confident in those moments and during the times when her colleague is on vacation, and she’s the only CRNA on the island. She says she wouldn’t have taken the job right out of school.

The best thing about Kodiak? Megan says that’s easy — weekend camping and hiking adventures with her husband and three young children.

At 75,000 residents, Missoula isn’t as remote as Kodiak, but Claire says she was drawn to it for similar reasons.

“We picked this community because it was where we really wanted to raise our family,” she says. “It’s in the mountains, it has good access to hiking, biking and skiing. In Seattle, we’d be stuck in traffic for an hour just to get to a place where we could do a bike ride.”

As she starts to establish her patient panel as a family medicine physician, Claire says she’s getting to know the medical community and the families she will serve for decades to come.

"I’m at a clinic with a group of young women, which was really attractive to me," she says. "We all support each other and really value the work-life balance. I hope to be here a long time, so I’m excited to start seeing multiple members of families and grow my practice along with them. That’s why we moved here. This is the vision that I had."

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