If you want to learn about rural medicine, listen to those who practice it. This has been the guiding principle behind the annual panel discussion hosted by Rural Health Education and Services since 2001. The event offers medical students a rare opportunity to hear directly from health care providers who work in rural and underserved communities across Kansas.

This year’s panel, titled "Life as a Provider in Rural Kansas," took place on Oct. 3 at Distillery 244 in Wichita. The event kicked off the largest health care career fair in Kansas, held down the street at The Vail event venue, and drew third-year medical students from the University of Kansas and first-year physician associate students from Wichita State University. Moderated by Garold Minns, M.D., dean of KU School of Medicine-Wichita, the hour-long discussion gave students an inside look at what it’s like to serve in rural areas.

“I think we got some valuable information about the importance of being a health care provider in rural medicine,” Alexa Harlow, a first-year WSU PA student, said after the panel discussion. “I think we got a lot of good tips, and I hope that some people got encouragement to move into rural medicine.”

Support Structure ‘Vital’

Dr. Dan Kuhlman, a family medicine physician who works at a critical access hospital in Colby, Kansas (population 5,570), stressed the importance of building strong connections with other health care providers.

“It is vital to have a good support structure around you,” Kuhlman said. “Because in the era of additional paperwork, in the era of additional billing struggles, the administration and the business side of medicine, it is very difficult to still be a doctor at the end of the day. And so, you need someone around you who can support you. I would look to find that more than anything.”

Kuhlman, who often treats geriatric patients and specializes in managing chronic pain in his practice, shared how much residents value having a local provider and how they express their gratitude in everyday places, like Walmart and church on Sunday. Kuhlman encouraged students to visit clinics and hospitals in rural Kansas to see if they are a good fit.

Stabilize & Transfer

Krisha McLaughlin, a physician associate providing coverage in the emergency department at Patterson Health Center in Harper County, works long shifts: 24- to 72-hours. She sees between eight and 15 patients a day. After they have been stabilized, many patients must be transferred to facilities with more resources.

The facility serves about 7,000 people in the surrounding communities southwest of Wichita on the Oklahoma border.

“I'm glad that we're there because the people who come to our hospital, if they had to travel with their problem, they would be going more than an hour in the middle of nowhere trying to get help, trying to get to Wichita,” McLaughlin said.

‘Know Who You Are Working With’

Dr. Robert Thomen is a family medicine physician in Chanute, Kansas, at the Ashley Clinic, which was started in 1938 by a father and his two sons. His advice to students considering rural medicine?

“I think it’s best to know who you are working with,” Thomen said. “The providers you are working with, get to know them if you can, and spend some time with them before. You’ll be spending a lot of time with those people. You’ve got to know them and like them and be able to work with them.”

Thomen, 65, has been practicing for 37 years and is nearing retirement. He plans to work another four or five years, at which time some medical students in the audience will be looking for a position.

“There'll be an opening about the time you're ready,” Thomen quipped.

Adapt to Community Needs

The fourth member of the panel, Dr. Kelly Gabel, a general surgeon based in Minneola three days a week, is an avid pilot who flies to outreach hospitals and is currently providing trauma center coverage in Vail, Colorado. Gabel discussed the need to adapt to a rural community’s needs.

“What your community’s needs are, you kind of adjust your practice to and really what your passions are, too,” Gabel said. “I came out thinking I was going to do a lot of things, you know, because I was trained really well at it. And the community environment really didn't need those things. So, I had to adjust. Each place that I go to in a rural setting has a different core group of people, and I see that the types of procedures I do changes depending on where I’m at.”

It’s easy to feel isolated as a rural provider, and Gabel urged attendees to expand one particular type of network: fellow providers you are comfortable calling on the phone for guidance.

Lifelong Learning

Gabel’s final piece of advice to students was to take the time to educate their patients on better health care. “That takes time to listen to what their needs are. So be an excellent teacher to your patients. Be an excellent teacher to your colleagues and pass it on when you guys get into the positions that we are in,” Gabel said.

Dean Minns wrapped up the discussion by reinforcing the importance of lifelong learning.

“Never stop being a student,” Minns said. “You will never know it all. And you have to keep learning along the way, because most of the stuff we're learning now wasn't even in the books when we went to medical school. I mean, it's brand new, so you got to be a teacher, but you also have to be a student for the rest of your life.”

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