Live & Practice: Small Towns 2019

Small towns and rural areas are often characterized by their natural beauty and genuinely friendly neighbors, but they aren’t lacking in culture or history, either. In fact, they are brimming with it. 

With care centers that boast big-city amenities and multispeciality practices, these towns and regions fuse professional opportunity with great work/life balance. They could be called the best-kept secrets, but locals take such pride in their communities that there is simply no chance of that.

Gallipolis, Ohio

Small towns are known for neighbors and acquaintances who go the extra mile for each other, and Gallipolis, Ohio, is no different. The town sits on the scenic Ohio River, with the main medical facility positioned on the town’s rolling hills. History, culture and agriculture are all important to the people of Gallipolis, and the thriving hospital network serves the small, tight-knit community.

Joshua Bryant, D.O., grew up in Pittsburgh— so he knew living and working in a small town would be an adjustment. After earning his degree at the Ohio University Heritage College of Osteopathic Medicine, Bryant began residency at the Holzer Family Medicine Residency Program. Now in his third year, Bryant likes Gallipolis and Holzer so much that he has decided to stay.

“Holzer has a fantastic teaching and mentorship program that really helps to educate future doctors,” says Bryant. “I feel like I am where I am supposed to be.”

As a family medicine specialist, building relationships with patients is part of Bryant’s job. That is especially compelling work in a small town, where doctors have the opportunity to get to know their patients in the community, too. When he is not at work, Bryant teaches exercise and dance classes at the Holzer Therapy and Wellness Center.

“Our physicians feel appreciated and respected while wearing a white coat at the clinic or wearing a little league T-shirt while coaching a T-ball game,” says Ginger Canaday-Thompson, physician recruiter at Holzer Health System.

And when they are at work, physicians experience a similar tight-knit, supportive environment. As a nonprofit, physician-owned, community-led organization, Holzer Health System is focused on improving quality of life for its patients and physicians alike.

 

“Our community will continue to receive the very best health care in their own backyard,” says Canaday-Thompson. The phrase, “the patient is the center of all we do” was coined in 1909 by the organization’s founders, she says, and it still stands true over 100 years later.

Holzer operates a main hospital in Gallipolis with 266 beds, plus a critical access hospital in nearby Jackson with 24 beds. There is also the Holzer Center for Cancer Care, the new Holzer Therapy and Wellness Center, and 13 outpatient clinics, to name just some of the many care centers. A new wound care center will be built soon, and physicians also have access to a new linear accelerator in the cancer center and a da Vinci robot. Across its facilities, the system employs over 160 providers in over 30 areas of expertise.

The health system is currently recruiting physicians for endocrinology, family medicine/internal medicine, gastroenterology, hematology/oncology, neurology, OB-GYN, plastic surgery, urgent care and urology.

“We practice big city medicine in a small town,” says Todd Miller, vice president of satellite operations. Because of the organization’s multi-specialty focus, physicians can pick up the phone and ask other providers within the health system for assistance. “Working together and emphasizing a teamwork approach is highly valued inside the system,” adds Canaday-Thompson.

There are also numerous teaching opportunities available to providers, thanks to the organization’s GME program, which accepts medical students from both the West Virginia School of Osteopathic Medicine and the Ohio University Heritage College of Osteopathic Medicine.

There are also teaching opportunities in the Family Medicine Residency Program, which opened its doors three years ago. Four of the current family medicine residents, including Bryant, have signed on to begin permanent employment at Holzer once their residencies are complete, which is a testament to their positive experiences.

“Holzer takes care of their physicians,” says Bryant. “They’re very kind and supportive. There are some amazing teachers that have really helped me become the physician that I am today. They really want you to succeed.”

That same sense of support exists outside the hospital, too. Holzer Family Practice Medical Director Lance Broy, M.D., notes Gallipolis seems to embrace young families with open arms. When Canaday-Thompson talks to candidates, the family-friendly culture is something she emphasizes.

If you happen to be coming to the area on your own, do not fear. Your neighbors, who will often be willing to go out of their way for you, can become like family.

There is plenty to do in Gallipolis, especially around the holidays, when the Gallipolis In Lights event “takes you back to days gone by,” says Canaday-Thompson. There are also classic car shows, fairs and festivals, some of which celebrate the region’s farming culture.

Venues for the arts and history include the French Art Colony, the Bob Evans Farm and Homestead Museum, and the Ohio Valley Symphony at the Ariel Theatre. An undercurrent of history also runs through the town, with the fleur-de-lis adorning downtown architecture and serving as a reminder of the French and Welsh populations that settled the region in the 1790s.

Locals and visitors who want outdoor recreation do not have to go far at all. With just a quick drive, you can find “some of the best skiing and whitewater rafting in the eastern United States,” says Canaday-Thompson. The region also has opportunities for camping, kayaking, hiking, cycling, hunting and mountain biking.

Bryant says he particularly enjoys learning about the agricultural aspect of the community. He interacts with farmers and livestock owners and appreciates how knowledgeable they are.

Futhermore, he enjoys hearing the local lingo and being affectionately called “Bub.” He has gotten to know people in the community not only through the hospital and his dance and fitness classes, but also his church group. For Bryant, Gallipolis was the right place to do his residency, and now, it is the right place for him to live and work. He has a sense of purpose as a physician at Holzer.

“I feel that I can make a difference, and I am part of something special,” he says.

Asheville, North Carolina

A picturesque small city situated in the Blue Ridge Mountains, Asheville, North Carolina, is a draw for outdoor enthusiasts. With just under 90,000 inhabitants, its patient populations are both city-dwellers and residents of the surrounding counties. People flock to Asheville not only for the outdoors, but also for the burgeoning entrepreneurship opportunities, the farm-to-table food and the cultural offerings.

Asheville, North Carolina, was not a place Adam Kaufman, M.D., just ended up. Instead, it was a place he sought.

After attending medical school at Harvard University, Kaufman went on to do his residency at Duke University. Durham and Asheville are over three hours away from each other, but Kaufman says he and his wife spent a fair amount of time exploring the smaller city.

“Given the amazing access to outdoors, fantastic people and wonderful environment, we knew it was an ideal place to settle and raise a family,” he says.

 

An orthopedic trauma surgeon, Kaufman also completed an orthopedic trauma residency at the University of Maryland. Throughout his training, he was always drawn to the technical aspects of orthopedics; he likes the variety of patients he sees and the acuity of the problems.

“It is sometimes daunting to meet patients after a major injury, but it provides an amazing opportunity to help them reach their fullest potential for recovery,” he says.

Kaufman is employed by Mission Health, the state’s sixth largest health system. According to Misti Dixon, senior physician recruiter at Mission Health, Mission operates six hospitals, the region’s only dedicated Level II trauma center, and numerous outpatient and surgery centers, among other services. It has the distinction of being the only North Carolina hospital to be named one of the nation’s “Top 15 Health Systems” by IBM Watson.

Kaufman says he feels fortunate to be at a place like Mission, and that the people are “outstanding.”

According to Dixon, Mission’s ability to grow, thrive, and continue to serve the people of western North Carolina is what makes it attractive to candidates. There’s a new tower dedicated to advanced medicine that’s under construction, and she sees this as an emblem of Mission’s role in the community.

“I think providers are not only interested, but encouraged by this construction as this is a reflection of growth, stability, need and commitment,” she says. “All of these things make our health system even more attractive to the physician and advanced practitioner population.”

Mission Health is currently recruiting for community medicine, cardiology, anesthesia, trauma, pulmonology and critical care, emergency services, behavioral health and oncology, among others.

“The list goes on, which is another reflection of growth,” says Dixon.

Providers at Mission also have the opportunity to see a wide variety of patients from both rural and urban populations, given that the organization serves a wide geographic area. Mission’s size means that providers and their patients get the best of both worlds.

“Providers are able to work within a medical community that is patient-centric and sophisticated enough to handle all complexities of care, yet small enough to maintain that personal touch,” says Dixon.

Often, she does not have to do much convincing when she meets with candidates; they are already sold on Asheville. The city’s reputation as a great place to enjoy the outdoors precedes itself, but she likes to convey to candidates that Asheville has a lot to offer in addition to its natural beauty.

“We place a lot of emphasis on our schools, which have an excellent reputation,” she says. “We have quite a few breweries in town, which is fun for beer enthusiasts. Asheville is lively and it’s thriving, and there’s a lot of really good energy in this town.”

There is also an exciting culinary scene, thanks to a growing interest in the community around food, says Erin Leonard, director of communications at Asheville Area Chamber of Commerce. “We have a lot of small independent restaurants that have embraced farm-to-table,” she says.

Overall, the ability to have work/life balance in Asheville draws people to the area. And, says Leonard, when at play, you can easily explore both cultural and outdoor opportunities. “We have the city and all the great things it has to offer, plus easy access to hikes and outdoor activities in the mountains of North Carolina,” she says. Plus, with a river that flows through town, residents find recreational opportunities just footsteps away on the multi-use greenways.

Destinations within the city include the Folk Arts Center and Shindig on the Green, a folk festival that had its 52nd season this summer.

Asheville’s entrepreneurial spirit is another important aspect of the region. “People decide to move here and say, ‘let me figure out how to create a job,’” says Leonard. Because the city is an attractive place for multiple reasons, there is a mix of people who live there. That dynamic results in varied cultural opportunities with something for just about everyone.

Kaufman, who came to Asheville for the outdoors, says he has not been disappointed, nor has his wife or two sons. “Everything you could want to do, from whitewater kayaking to rock climbing, is all right here.” When he is not working, he enjoys hiking, fishing, trail running, camping and “tiring out my boys off the beaten path.” He and his family are also very involved in the religious community in Asheville, and he regularly volunteers at the Western Carolina Rescue Ministry.

Above all, he is happy he landed in Asheville and at a place like Mission Health.

“The road of medical training is long and brings a trainee to a number of different hospitals and clinics,” he says. “I have been extremely fortunate to work in great institutions with very talented staff. I can honestly say I have never been at a place where people are as caring as at Mission Hospital. I am privileged to be a part of this team.”

Walla Walla, Washington

Scenic Walla Walla, Washington, is known for its wine production, an aspect of the region that has been booming over the past couple of decades. Walla Walla is situated in a largely rural area, so you might not know about the robustness of the medical community or its higher education opportunities. Small town friendliness is a way of life here, and residents enjoy the area’s laid-back vibe while never running out of things to do.

While it might not look like a regional hub at first glance, Walla Walla was at one point the largest community in the territory of Washington. The gold rush brought many settlers to the area during the mid 1800s, and the Walla Walla of today reflects the historical significance it had over a century ago. It is a small city of approximately 32,000, but the cultural and professional opportunities are considerable.

“What struck me regarding the job here is that though Walla Walla is quite rural, it really had a rather remarkable medical community,” says Timothy Davidson, M.D., chief executive of physician services at Providence St. Mary Medical Center.

A Portland native, Davidson attended medical school at Oregon Health & Science University before completing his residency in internal medicine at University of Colorado Denver, when he decided to specialize in pulmonary and critical care. He then did a fellowship at the University of Washington. Though he was not set on a specific location for a permanent position, his wife, a California native, had some ideas. Seattle felt too gray, and when they moved back to Portland for a short time, that did not feel perfectly right for them either.

“In that time, I really developed a better understanding of what I wanted in a practice,” he says. “I was working at a multispecialty clinic owned by an outside, for-profit entity, and there were some aspects of the job that didn’t seem optimal. Likewise, we were looking for a little different type of lifestyle to raise our family.”

He found Providence Health & Services and Walla Walla, and he knew it was a fit.

“There is a very robust medical community here. It serves as a referral center for northwest Oregon and southwest Washington,” he says. “That attracted me, coming from bigger cities where I was used to having a lot of subspecialties around me. I was struck by that.”

In Walla Walla, Providence Health & Services operates the 142-bed St. Mary’s Hospital, which also has a 14-bed ICU and eight beds for in-patient rehab. There are also primary care and specialty clinics throughout Walla Walla, says Providence Provider Recruiter Amy Knoup.

The mission of Providence Health & Services is to care for the poor and vulnerable. Knoup says that the organization deploys system-wide initiatives to meet the needs of those demographics, and Davidson adds that Providence strives to make decisions based on values that support those populations. In addition to serving migrant workers in the wine industry and agricultural sector, the hospital also sees patients who are family members or loved ones visiting the nearby prison.

Davidson spent the first part of his career at Providence working as a pulmonary critical care doctor. He then transitioned into a leadership role, and for the past dozen years has led the medical group.

“As you talk to new providers, we strive to create an environment in which we want to partner with the physician to best support them so they can have a fulfilling professional career and an enjoyable life outside of medicine,” he says. “What I’m trying to get at is, some places, how you work is pretty well-defined. Here, we’re much more likely to say, ‘What fits your lifestyle?’”

As a result, many providers in Walla Walla work less than full-time. This flexibility, says Davidson, is part of the organization’s core beliefs.

In Walla Walla, Providence is currently recruiting hospitalists, as well as physicians specializing in primary care and internal medicine, hematology, oncology and neurology.

When Knoup talks to candidates, she emphasizes the importance of Providence being a mission-driven organization. “We want all the providers to be fully invested in that,” she says. She also underscores the amazing location, access to outdoor activities, unique dining options and phenomenal wineries, not to mention the work/life balance that is possible at an organization like Providence and in a setting like Walla Walla.

For a small town, Walla Walla gets its fair share of tourism, too, thanks in great part to the wine industry. “When we moved here in 2000, there were 25 to 30 wineries,” says Davidson. “Now there are approximately 150. It’s been interesting to watch the growth of the wine industry and with it, fine dining options and elegant hotels and bed and breakfasts.”

For those thinking about relocating to Walla Walla with their families, Davidson says he has been very happy with the school system. “Both of our kids were educated in the public school system and had opportunities for acceleration,” he says. Plus, Walla Walla also has three colleges, which brings differing perspectives into the town. “The colleges provide a broader base and views and consideration about topics,” he adds.

When physicians are looking for permanent employment, Davidson encourages them to think about their lifestyle as a whole—not only what they really enjoy about medicine, but what they really enjoy outside of medicine, too. “Our training leads us to believe that medicine should be done a certain way and we’re so immersed in that environment that we don’t really ask ourselves, ‘So what about the other things beyond work that are important to us?’”

“If you can go through that exercise then I think you are more likely to get something that’s probably going to be a better long-term fit.” For Davidson, Walla Walla was just that.

Staunton, Virginia

With a Main Street that was recently named by Architectural Digestas one of the 30 most beautiful main streets across America, Staunton, Virginia, epitomizes small-town life. Situated between the Blue Ridge and Allegheny mountains, the small city of 24,000 is in the heart of the Shenandoah Valley. The outdoors are a vital part of the culture here, but equally so are heritage, the arts and a sense of community.

Working in a rural, community hospital, Frank Johnson, Jr., M.D., began his career in family medicine practicing just about every kind of care. As he puts it, he enjoys managing a wide variety of medical conditions in a variety of age groups, and in the early years, he was even delivering babies.

As a physician with Augusta Health, which operates a 255-bed hospital along with numerous primary care offices and specialty practices, Johnson’s areas of practice have developed over time.

For the past 20 years, he has specialized in geriatric medicine and preventive medicine with an emphasis on managing lipids in complex patients. In addition to being certified in family practice and geriatric medicine, he has also earned board certification in hospice and palliative medicine.

Johnson trained at the Medical College of Georgia and completed his residency at Spartanburg Regional Medical Center in South Carolina. He chose to practice at Augusta Health due to both the quality of care, and the opportunities present in Staunton and the surrounding areas.

“Augusta Health offered a vibrant medical community with excellent specialty coverage,” he says. “It’s located in a beautiful setting with great proximity to surrounding major universities, while still having the benefits of a smaller town lifestyle.”

“It’s a very collegial group of physicians,” says Dawn Funkhouser, physician recruiter at Augusta Health. The organization is currently recruiting for an interventional cardiologist, a critical care pulmonologist, an advanced gastroenterologist, a neurologist, and physicians specializing in primary care, rheumatology and urgent care. According to Funkhouser, the hospital is doubling the size of its emergency department and just opened its third cardiac catheterization lab.

The hospital’s state-of-the-art equipment includes the da Vinci robot. As Funkhouser puts it, “we have a lot of the amenities that you would find at a larger hospital.” The Augusta Health Cancer Center has an affiliation with Duke Cancer Network, a partnership that allows the hospital to provide a broad range of cancer services for Staunton’s population.

When Funkhouser talks to physician candidates, she emphasizes the highly livable quality of the area. “You can live in a not-so-densely populated area but have that small, tight-knit experience of community,” she says.

City of Staunton Director of Tourism Sheryl Wagner says that Staunton’s location in the heart of the Shenandoah Valley allows for a meeting of recreation and culture. “It’s the perfect base for hiking, biking, golfing, horseback riding and fishing,” she says. “After a big day in the big outdoors, come back to civilization, great restaurants, wine bars and craft breweries.”

Originally founded in 1747, Staunton has a rich heritage, too. According to Wagner, the Frontier Culture Museum displays a series of authentic historic farms, each moved from their country of origin and reconstructed at the museum site. It’s a living-history museum, so visitors interact with costumed interpreters while viewing a blacksmith’s forge, period crop-raising methods and more.

In the downtown, you will also experience something you can only otherwise see in London: an authentic recreation of Shakespeare’s playhouse. Since 1988, The American Shakespeare Center “has worked to create an atmosphere that closely recreates the theatrical experience of Shakespeare’s time,” says Funkhouser.

Staunton also has two city parks that are loved by locals. Among the two parks, facilities include a public golf course, football and baseball stadiums, a public swimming pool, a bandstand, a dog park, a disc golf course, a soccer complex, and fitness, mountain biking trails and more.

When in doubt, simply walking through downtown and enjoying the city’s historic districts and beautiful, varied architecture can make for a lovely afternoon or evening, especially when paired with a musical event, a dinner at a new restaurant or a night of theater.

“I personally enjoy golfing, going to the Augusta Health Fitness Center, which is truly outstanding, or taking a nice walk after dining with my wife,” says Johnson.

It is a similar sentiment to how he feels about his time at Augusta Health, where he enjoys establishing long-term relationships with his patients and working alongside excellent colleagues.

“Augusta Health focuses on health care for the community, with a focus on quality of care,” he says. Equally as important, they are “passionate about training tomorrow’s health care providers.”