by Jamie Mendez Leonard, recipient of TRP’s NP/PA Incentive and now working in Sevierville
When I moved from Florida to Tennessee to start South College’s PA program, I was always fascinated by the communities of rural Appalachia. I could not imagine what it was like to live so far in the mountains that there is no cell or Internet service and no neighbors close by. As a physician assistant (PA) student, I wondered how caring for these patients would differ from caring for patients in a city so when I learned of the Tennessee Rural Partnership’s incentive for rural practice, I was eager to apply and have the opportunity to complete a clinical rotation in rural Tennessee.
The Tennessee Rural Partnership (TRP) is a private nonprofit organization that aims to overcome the health care challenges of rural communities and underserved areas in Tennessee. Applying for the TRP Physician Assistant Incentive Program (nurse practitioners are also eligible) was relatively simple. The online application was short, and I wrote a one-page essay explaining my connection and commitment to practicing medicine in a rural or underserved area. After being granted the stipend, I was required to complete a rural rotation so I chose to go back to Rogersville where I had shadowed a PA prior to beginning PA school.
If you are like me you might imagine a rural clinic in an old cabin off a dirt road with primitive instruments, but this is not at all what the Rural Medical Consortium (RMC) is like. The people of Rogersville are blessed as the RMC is a brand new, state-of-art facility that not only offers primary care, pediatric care, mental health services and many other specialists but it also has its own pharmacy, diagnostic laboratory and X-ray center so patients can see their provider and get any additional testing ordered in the same facility. The ability for patients to receive all their needed services in one place is critical, as the majority of the patients in Rogersville have difficulty with transportation, so they would not be able to go to multiple places. Another way the RMC helps the people of Rogersville is it offers all services on an income-based sliding scale so patients without insurance and very little income can afford medical care.
Everyone at the RMC is warm and friendly. It was amazing to me how many patients we had that had struggled with curable ailments for years because of their lack of access to health care. Among the advantages of a rural rotation is that you will see a wide range of pathology and have a lot of hands-on learning experiences. I saw patients of all ages, but the majority of patients were middle to old-aged with multiple comorbidities. Most patients had never received regular medical care in their lifetime. I learned how to accommodate patient’s limited resources by choosing medications carefully and making sure patients had help accessing patient assistance and other resources. We would also make sure the patient has printed handouts or whatever they may need as most patients did not have the ability to go home and find more information on their own.
Overall, my rural rotation was one of the most rewarding experiences of my clinical year. I met very king people and treated exceptional patients with histories that would have been unbelievable had I had heard it myself. I learned how to make medicine work for the patient regardless of income or education level, and perhaps most importantly I was able to experience rural Tennessee and help extend health care to those who thought it was out of their reach.