Issue link: https://beckershealthcare.uberflip.com/i/534828
Dr. Haynes: Well I grew up in a town of 500, so Vivian is a met- ropolitan area for me. It's not far from where I grew up, maybe 18 miles. When I graduated from medical school I was going into car- diovascular surgery, and my mom said, 'Stop in Vivian and see that new hospital they've got there.' I stopped by to appease my mother and sure enough, they grabbed me for 49 years, going on 50. Of course, I came back and talked to my wife and had a long discus- sion about if I should practice cardiovascular surgery, but we want- ed to rear our children like we had grown up, in small towns. It was the right thing to do and it's proven to be so. Now both my boys are physicians and my daughter is a pharmaceutical representative. Dr. Franklin: I was a hospitalist in Parker, Ariz., for five years and they needed an outpatient family doctor in Quartzsite, Ariz., (pop. 3,677), so I transferred from the hospital to a hospital-owned clin- ic. It was a lateral move. Dr. Bosl: In medical school, it became clear to me I wanted to be challenged each and every day of my practice, and in family medi- cine that occurs. I take care of people age-wise from prenatal care to 100 years of age or older. I've taken care of five generations of a fam- ily in the same week. Compared to a super specialist, it's so much more intellectually stimulating. I never know what's behind door two. Another reason I decided to be a rural physician is I'm somewhat of a Renaissance physician. I've been trained to not only do basic family medicine, but I also take out tonsils and do appendecto- mies, colonoscopies and C-sections. I'm skilled in a lot of proce- dural kinds of things that they don't need family doctors to do in the Twin Cities. I grew up in a fairly small town and recognized there are a lot of opportunities that children have growing up in a small town that they don't in a big city. It was a professional oppor- tunity to live in a rural area, it was intellectually stimulating, plus the advantages of raising my children in rural area convinced me. Q: Do you feel left out of the national healthcare discussion? Dr. Haynes: I feel like I'm part of it. I'm lucky enough to be part of state and national events and with technology as it is we can pick up the phone or iPad and see what the latest treatments are. Diagnoses and information on different diseases is at the tip of your fingers. It's made practice in a rural area much better and more fulfilling. We are also in close contact with our state repre- sentatives and congressmen, as well as our U.S. senators and congressmen. We interact with them quite often. Dr. Franklin: The Internet has brought big-city medicine to small- er towns. The guy in a rural area has the same opportunities for high-quality care wherever he's at. The Internet has made every- thing accessible. Dr. Bosl: I have had a great deal of input over the years through medical organizations. I've had input, but I'm a bit frustrated be- cause our physician-as-God complex has disappeared over the years. I have been accused by my patients, 'Hey, why did you doc- tors allow this to happen?' referring to things that as doctors we should have prevented and should have influenced, but we don't. It's very frustrating that we're now at the point where essentially the insurance company decides what we will be given for a ser- vice and we are told to take it or leave it. If you don't like it, don't take patients from that insurance company. When you really can't stay in business any longer, your choices are to merge with a hos- pital or health system, or just stop taking care of Medicaid patients or old patients, but most doctors don't feel it's an ethical option to limit practice by insurance. Q: Anything you would like to add about serving in a rural area? Dr. Haynes: We often take care of 90 percent to 95 percent of our people and illnesses here, and refer others to the tertiary hos- pital everyday. To me, it would be much better to take care of people where they live rather than have them travel into the cities for care. The key is well-trained family practice doctors who are trained in multiple areas, but medical schools are not producing that type of physician anymore. It is really important for medical schools to take a long look and provide special training for the family physicians who want and need to go into rural areas. As a rural physician, you have to make decisions and solve problems without specialty care and it's very important to train physicians to provide that care. I can say this: It's been 50 years and I've never experienced what they call "burnout." I was by myself for awhile — my partner died young with a brain tumor — and even though I was very tired and worn out, I never had burnout. I made the right choice. Dr. Franklin: It's a still rewarding career, and I would not change careers if I had to do this again. If a doctor says he wouldn't go into medicine again, he should probably change careers. This is a great profession. Dr. Bosl: The one question that always comes up when we talk about physician supply or stresses of practice is 'Would you want your kid to do this?' I'd say, 'Hell yes.' We get frustrated with insur- ance companies, rules and regulations and financial aspects. We get called in the middle of our golf game, but the bottom line is the enjoyment I get in taking care of my patients and the intellectual stimulation of doing that makes everything else minimal. n 72 Physician Affairs 72 "The Internet has brought big-city medicine to smaller towns. The guy in a rural area has the same opportunities for high-quality care wherever he's at." — Dr. George Franklin "We are losing the art of medicine with these machines. When the EMR was introduced it was supposed to be time-saving, but it's anything but." — Dr. John H. Haynes