When it comes to family physicians, Scott County enjoys a position that most communities envy. The western Kansas county of about 5,000 boasts five family physicians - all graduates of the KU School of Medicine. They see patients in a two-year-old $24 million hospital and outpatient clinic, whose exterior resembles a lake lodge as much as a medical facility.

"We've never been better served than we are now," says Dr. Daniel Dunn. "For 30 years, we were always recruiting physicians."

Dunn (class of 1974) is retiring soon, but the oldest of the county's remaining family doctors is 40, and none show signs of leaving any time soon.

A couple of things helped the county attract physicians. One was voters' decision to approve a bond issue to pay for the hospital, which has 25 beds for acute care in addition to the clinic and departments for surgery and rehabilitation.

Another is the physician pipeline that the KU School of Medicine-Wichita has provided. Scott County's newest physician, Matthew Lightner (class of 2010), chose it in part because of what he heard from Dr. Josiah Brinkley (class of 2008), who'd been a resident at Via Christi in Wichita, right before Lightner went through the same program. Brinkley, in turn, was recruited by the county's other two family physicians, Christian Cupp (class of 2000) and Libby Hineman (class of 2003).

"Who your partners will be is the biggest thing I looked for," Lightner says. "Being with people you trust, and being able to bounce ideas off them."

Because of the new facility, Cupp says, "It's an easier sell than it used to be, but you've still got to find the right person. It still helps to have somebody with western Kansas ties."

That's what all but one of their family physicians has in one form or fashion. Cupp grew up in Scott City, the county seat, and became interested in medicine after getting to know the town's doctors. "My mom would say because I spent time in the emergency room," he jokes.

He returned home after medical training and a year practicing in nearby Tribune, Kansas. "I felt this was where the need was - out west," he says.

Cupp has served as president of the Kansas Academy of Family Physicians and will be the hospital's senior physician after Dunn retires.

He recalls that before the arrival of Hineman and the other physicians, the county's doctors were usually on call every other day. "That's not a good long-term model for the future," he says. Today, the doctors are on call one day a week and one weekend a month.

Prospective recruits are told they'll have plenty of opportunities to use their skills in Scott City. The "really tough" nature of area residents can make medical practice challenging, Cupp says. "It's usually about ten issues you're dealing with every time you enter an exam room. These people don't come in unless there's something really wrong. One guy limped around on a torn ACL for six months until he could get his crops in."

Hineman, who grew up in Iola in southeastern Kansas, followed her husband to Scott City. She loves the "full scope" of family medicine: by 9 o'clock on a recent morning, she'd seen a baby with a respiratory virus, a middle-aged patient with pneumonia, and an elderly woman with cellulitis in her leg.

A daunting challenge, she says, is handling patients whose condition requires them to be transferred to a bigger hospital. Those transfers can take up to four hours. "You cancel everything else and handle that while it's going on."

Hineman remembers a night when the town's doctors dealt with a broken back, a high school football player's concussion, and three C-sections. "Dr. Cupp, Dr. Dunn, and I were up here all night."

Hineman and her husband, a farmer, have three children. She says being a mother and a family physician can be a challenge. But she can count on help from community members any time she needs it.

How does she relax from the rigors of the job? She's part of what her husband calls "five at five" - a group of women who get up at 5 o'clock each morning to run five miles.

Lightner is from Garden City, about 40 miles to the south. He took an unusual route to medicine, having first studied computer science and Spanish. "I wanted something that had more personal involvement in people's lives," he says.

For Lightner, "it's a privilege" to serve patients at critical junctures in their lives. One of those is at birth. "I also feel that about the death process. It can be a very rich time." His goal is to help families of elderly patients decide "what to do and how to honor their loved one."

Dr. Dunn grew up in Wichita, but had relatives in western Kansas. He did his residency in Long Island, New York, "just to see something different," spent two years in Colby, Kansas, and then settled in Scott City. He's a pilot who flies his wife to their cabin in Colorado, as well as to games played by the local high school's athletic teams. (And yes, Wichita State University basketball star Ron Baker was his patient when he was growing up.)

He says his younger colleagues have made a good choice. "I thought western Kansas looked like a good place to be a family physician. It's been a great career."

Mark Burnett, the hospital's administrator, agrees and adds this message for KU School of Medicine-Wichita graduates as they contemplate their future: "Make sure they know we're looking for another one."