Rural Family Medicine
I am passionate about providing comprehensive family medicine care, including surgical obstetrics, to my beloved community. I have been dedicated to this for nearly 30 years. I must admit, it's not easy being on call frequently or having unpredictable deliveries interfere with a clinic schedule or home life. However, the joy of bringing a life into the world and caring for the baby, mom, and the entire family throughout their life cycles far outweighs any challenges.
Freedom To Stop Working
For several years now, I have been envisioning my retirement next summer, and I owe a big part of that to achieving financial independence a few years ago. My arrival at FI was dramatically accelerated 10 years ago when I started my PC and transitioned to an employment lite contract. It restored my professional and personal autonomy and has brought newfound freedoms that have culminated in this beautiful plateau, where I no longer have to work. Now, I have the wonderful opportunity to pursue my passions, which include sharing my experiences with fellow doctors and helping you thrive with the incredible range of products and resources available at SimpliMD.
In fact, my experience reveals what is possible for you, and it embodies the most fundamental message and mission that I have at SimpliMD.
Your professional micro-corporation will preserve your personal and professional control over your life and significantly improve your financial well-being.
This message is the very reason why I embarked on this business journey - to reignite and inspire the possibilities within our profession. Instead of passively allowing the big 3 of government, corporate medicine, and insurance to control us, I am here to empower and help our profession regain control of our own destiny.
This opportunity is available to every one of you, and each should seriously consider starting your own professional micro-corporation.
As I prepare to retire, my plan is to continue living in my little town, with my home nestled along a tree-lined main street. My wife and I absolutely adore this community and have formed deep connections with many of the people who live here. Our house will continue to serve as our home base for fulfilling our dreams of traveling to experience the wonders of the world and visiting every national park.
In that context, we will transition from being providers of healthcare to becoming consumers of healthcare in our little town. I am personally motivated to ensure that there are quality healthcare providers in our community who can take care of me, my family, and the thousands of citizens I have shepherded over the years.
But I'm not just looking for any doctor or NP to come on board and replace me. I'm specifically seeking those who are willing to go the extra mile by providing maternity care. With that in mind, I have dedicated myself to diligently working on succession planning. My goal has been to identify and recruit family medicine doctors who are not only passionate about practicing rural medicine but also have a specific focus on obstetrics. This includes the challenging task of finding rare doctors who specialize in surgical obstetrics. Unfortunately, the pool of doctors who fit this profile is shrinking every year. Recruiting doctors can be challenging, and retaining them can be equally tough. I consider myself fortunate to have found two doctors who fit this profile. Over the past 4 years, I have worked diligently to mentor them and prepare them to eventually take over my role completely.
Granted, since I don't own the practice (I work under an employment lite contract), it's not my responsibility to make this happen. While it is ultimately my employer's responsibility, I also see myself as an ambassador of sorts in the process. Therefore, due to my long-standing passion for family medicine, obstetrics, and rural medical care, I have a mission to ensure that my little community has exceptional doctors to take care of its families.
Oma completed her OB fellowship in New York and was looking to relocate to Indiana to join her fiance, who works here. She has a great personality, loves delivering babies, performs surgical obstetrics, and has a strong desire to come to Indiana. I am so happy that she chose our site for her first job as an attending. I promised her that when she arrived, I would spend time teaching her the art of rural medicine, and mentor her in her role of being an attending physician.
It’s Lonely & Hard
Mentoring her involved learning the practical skills of surgical maternity care in a remote setting. It also included navigating the personalities and preferences of the many obstetrical and non-obstetrical doctors she had to interface with her professional network. For example, knowing whom NOT to call for assistance can be just as important as knowing whom to call. In other words, not all OB/GYNs, Perinatologists, or Neonatologists are fans of family medicine obstetrics.
One aspect of mentoring involves learning how to manage the pressures and tensions that come with working in a rural hospital, where one may often feel isolated and alone as the sole doctor on the unit. During the daytime when most of the medical staff is available, things are pretty straightforward. But the feeling is vastly different when it's 3 a.m. and you find yourself alone in the hospital, performing an emergency c-section while simultaneously providing medical care to both the mother and baby. Everyone in the operating room and nursery is looking to you for leadership and guidance. Doing this requires confidence, courage, and skill. It's certainly not for everyone. You must learn to lean into and trust the support of ancillary staff to assist you, while always maintaining your awareness of risk management and safety issues. It is a truly learned art, and having experienced colleagues available to provide advice and help process the events of the prior days is crucial for the professional development of all doctors. We are all humans after all and we need safe and caring physician mentors who genuinely care about the unique day-to-day experiences we have as doctors. We are not machines, nor are we superheroes!
During the past year, I dedicated my time to mentoring Oma, helping her embrace this community and develop the necessary skills to thrive in this unique rural setting. She has been embraced by everyone, from patients to staff, and quickly learned what was needed to thrive. Mentoring in a rural community involves more than just helping a new attending manage various aspects of a clinic and hospital setting. It also includes teaching them how to connect with the community at large. Oma has done this, and it's an absolute joy to work with someone who is a fearless, quick learner and has a strong drive to succeed.
But in the midst of all this, just a little over a year prior to my retirement, our employer began making changes due to "financial losses after COVID". This led to significant changes in both the clinic and the hospital, culminating in the difficult decision to close our hospital's OB unit just over 4 months ago. It was primarily a financial decision, but it was also influenced by the challenges we faced in recruiting and retaining OB/GYNs and 24-hour anesthesia services in our rural area. Of course, this is a national issue, and now we officially become just another of the growing maternity desserts in our nation. Our community was devastated by this loss, especially after nearly a century of having maternity care in the hospital. I was devastated after investing my entire career in rural maternity care here. Oma was devastated because her first job turned out to be a bust, and her dream of taking over my thriving family medicine maternity practice was now shattered. I couldn't help but feel a deep sense of guilt for bringing her here, only to have all of this unfold. It was a situation that was completely beyond my control, and it became an unimaginable chapter in the story of our community hospital.
The end result was the loss of two doctors whom I helped bring to our community to provide maternity care. Unfortunately, this has only exacerbated the physician shortage crisis that is already common in rural communities. My hospital is working hard to replace these two doctors, as well as myself. However, there are currently no prospects on the horizon, as younger doctors are simply not as interested in living in rural areas as they were in the past.
Over the past 30 years, I have learned many things as an attending physician, and one dominant theme that stands out is the necessity of adapting to market changes in modern medicine. That's how I ended up starting my self-employment journey as a long-term independent contractor a decade earlier, due to changes at the hospital and with my employer. Therefore, drawing from my past experiences with corporate medicine, I mentored Oma and guided her through her options to help her adapt to this sudden change. The bottom line was that we both knew she would need to find a new location to practice surgical obstetrics and ideally, it would not be extremely disruptive to her and her husband. Fortunately, she was able to find a new position nearby, working with another family medicine doctor friend of mine who specializes in surgical obstetrics. Even better, it was less than a 30-minute drive away.
Coach and Thrive
I am confident that she will thrive in her next job. She is a great young doctor. Her experience has taught her that she can't trust employers, as change happens all the time. Preserving control over your professional life is an important part of thriving as a doctor. I have mentored her and assisted her with the transition into her first year—including these unexpected changes.
Now, I am excited to take on a new coaching role with her and she moves away from my day-to-day influence. Although neither of us knows exactly how things will unfold for her, I am eagerly looking forward to guiding her through my SimpliMD coaching program.
I wholeheartedly believe that every doctor should have teachers, mentors, and coaches in their circle. Life is truly better when we have others to support and guide us.
I invite you to take the next step yourself and strengthen your professional circle with one of these options:
Grab my free e-book on Why Every Doctor Needs Teachers, Mentors, & Coaches
Become a Member of our SimpliMD community and actively partake in the many teaching resources we have for growing your micro-business competency, as well as imbibe mutual mentoring through our FB community “Every Doctor Is A Business”
Sign up to allow me to coach you through one of my SimpliMD Coaching programs
Sign up to join our live stream webinar on September 29th at 8:30 pm EST “Are You Ready To Take Control of Your Future?”
Don’t wait, take one of these steps now!