Practicing medicine in rural areas

Haley Cahill-Teubert

Table of Contents

If you like the idea of practicing medicine in rural areas and smaller towns that still offer a robust quality of life, a strong sense of community and access to larger cities, consider GrandForks, North Dakota; Hot Springs, Arkansas; Cookeville, Tennessee; or Madison, Georgia. Each of these small cities has a great variety of cultural events, festivals,family-friendly activities, outdoor adventures, plus easy access to more metropolitan areas, making them perfect places to live and practice.

Grand Forks, North Dakota

GRAND FORKS MAY FEEL LIKE A SMALL TOWN, but this Midwest city with a population of 55,000 has plenty to offer physicians looking to plant roots—or return to them—in a robust community.

Ian Roche, M.D., was born and raised in Grand Forks. He attended Concordia College in Moorhead, Minnesota, for undergraduate studies, the University of North Dakota School of Medicine and Health Sciences for his medical degree and the University of Wisconsin-Madison for his residency in anesthesiology. After completing that, he returned to Grand Forks to work at Altru Health System. Today, Roche works as an anesthesiologist and clinical assistant professor of surgery at the University of North Dakota School of Medicine and Health Sciences. Having spent many years in different parts of the Midwest, he was happy to return to Grand Forks.

“I found myself drawn to the opportunities offered by such a vibrant small city,” Roche says. “Grand Forks has vast green spaces for outdoor activities available year-round, concerts, sporting events, a Division I university, a wonderful educational system and a safe community. Grand Forks is a great place to live, work, relax and spend time with family.”

With its location on the Red River, there is access to many water activities including fishing, canoeing, paddleboarding and kayaking. If you think all the great outdoor activities are limited to the warmer months, think again. Winters provide the opportunity for snowmobiling, snowshoeing and hunting.

In 2022, Grand Fork’s Downtown Development Association was selected as one of 100 recipients in the U.S. for the Lowe’s Hometown Grant, allowing the downtown district to grow. With the grant, downtown Grand Forks has been enhanced to provide an enjoyable experience to people year-round with various programming, activities, concerts and events.

Grand Forks is also home to the University of North Dakota, giving residents of Grand Forks access to a variety of Division I athletics, music and arts events. You will want to mark your calendars for annual events like Art on the Red (recognized as one of North Dakota’s best outdoor festivals), Rockin’ Up North Fest, the Greenway Ski Day, and Potato Bowl USA. Being right on the border of Minnesota and a relatively short drive to Canada, you have the opportunity to explore nearby regions within a short drive.

“In the summer, I enjoy running and biking on the 20-plus miles of paved trails, going to area state parks, and attending farmers’ markets, outdoor concerts and festivals. In the winter, I like to cross-country ski and snowshoe with my fiancé and dog, go to college hockey games and enjoy the indoor activity parks,” Roche says. “I am also a volunteer coach for a high school track and field team and a member of one of the local running groups.”

Altru Health System is bustling as well. Made up of more than 3,500 health professionals and support staff, Altru serves more than 230,000 residents in North Dakota and Minnesota. In 2011, it became the first affiliate member of the Mayo Clinic Care Network. Within the system is Altru Hospital, which is a Level II trauma center with 257 beds. Altru’s system also includes 14 Grand Forks practice locations and 11 regional clinics. Altru regularly receives awards and recognition, values the leadership of its physicians and invests in its facilities. Jennifer Semling, talent acquisition manager at Altru HealthSystem, says an exciting development on the horizon is the opening of their new state-of-the-art hospital in 2025.

“The amount of innovative technology within the walls is astounding,” she says. “Our physicians drive this innovation as shown by the unique services we provide, including cancer care, orthopedics and our heart and vascular services. There are numerous things we do at Altru and in Grand Forks that are rarely found elsewhere. It truly is a unique health system of which I am proud to be a part.”

“Also noteworthy,” says Semling, “is that Altru is a locally owned and physician-led health system.”

“I interviewed with and had offers from multiple health systems and private groups but chose to come to Altru Health System because of its size, history of success, continued growth, and its physician-led administrative system,” Roche says. “Resource availability and feeling supported in individualizing treatment protocols for each patient was also important in my selection.”

Semling said physicians are also attracted to the opportunity to see a broad variety of cases. “There are opportunities to be involved in numerous projects, collaborate with other physicians and to teach at the local university medical school.”

If the opportunity to have a fulfilling career at a robust health system isn’t reason enough to consider opportunities at Altru, Roche and Semling said physicians will love living in the area because Grand Forks is safe, has a strong sense of community and plenty of year-round activities for everyone.

Hot Springs, Arkansas

NESTLED IN THE OUACHITA MOUNTAINS OF central Arkansas is Hot Springs. It may not surprise you that this town of 38,000 is named for its naturally heated springs, but there is more that this quaint town has to offer.

“I love that Hot Springs has a small-town feel, but there are so many activities to do to keep you busy,” says Tasha Logan, provider recruiter for CHI St. Vincent. “HotSprings is surrounded by water, so during the warmer months, water activities are a favorite. We also have an amusement and water park, Magic Springs, that is a favorite for the locals. Oaklawn Racing and Gaming is another local favorite during the horse racing season. Our historical downtown area is rich in history, and there are always family fun events that are scheduled throughout the year.”

Logan adds that there is a vibrant food scene with unique options and excellent schools. Sports enthusiasts will appreciate the golf scene in the area or the opportunity to catch a race at Oaklawn Racing Casino Resort, which has been on the premiere thoroughbred racetracks since 1904. Hot Springs is also a hot spot for hunting, visiting botanical gardens, camping, cycling and atv riding. There are beautiful state parks with waterfalls and scenic hikes as well as Lake Ouachita, which covers more than 48,000 acres and is the largest lake in Arkansas. Of course, there are also the city’s naturally heated springs in Hot Springs National Park, which is the oldest park managed by the National Park System and sees more than 2 million people each year. Families will also love the Mid-America Science Museum. Sitting on 21 acres, this museum has a variety of interactive exhibits and activities. Hot Springs is host to a number of festivals each year including the Hot Springs Music Festival, Valley of the Vapors Independent Music Festival, Hot Springs Jazz Festival, Hot Springs Blues Festival, Hot Springs Documentary Film Festival and more. Less than an hour away, Little Rock offers even more events and activities.

Whether your needs are social, physical, educational, spiritual or something in between, Seth Barnes, M.D., says Hot Springs has it all.

Having grown up just about two hours away and visiting the Hot Springs area frequently as an adult with his family, he knew it was a great place–so great that he moved to Hot Springs five years ago.

Barnes is an internal medicine doctor with CHI St. Vincent in Hot Springs. He attended the University of Arkansas at Monticello for his undergraduate education and the University of Arkansas at Little Rock for medical school. He then completed his residency training at Vanderbilt University and moved back to Arkansas in 2018 to practice.

“I grew up with a sick father and was around doctors all the time, and that had a profound influence on me for the good—that’s really what attracted me to medicine,”Barnes says. “With internal medicine specifically, I liked the patients and patient problems and different things that come in the clinic.”

Within CHI St. Vincent, Barnes says he sees a diverse patient population, a large variety of cases and works with many subspecialists. He also says the administration at CHI St. Vincent makes the experience top-notch.

“From a colleague support and administrative support standpoint, it’s a great place to practice,” Barnes says. “The clinic administration is wonderful. I just show up and take care of patients, and they handle the rest.” CHI St. Vincent Hot Springs is a 280-bed faith-based, not-for-profit hospital with more than 300 physicians.

CHI St. Vincent is part of CommonSpirit Health, which is a nonprofit Catholic health system that employs 25,000 physicians and operates more than 140 hospitals and 700 care sites across the country.

The CHI St. Vincent regional health network has provided care to people of Arkansas since 1888, and many of the current providers have been with the health network for a large portion of their careers.

“We have longevity in the Hot Springs health care community, as the majority of our tenured providers have been practicing in our community for 20 to 30 years,” Logan says. “We take pride in the fact that providers choose CHI St. Vincent and Hot Springs as their home; they all plant roots with their families and within the community.”

Barnes is one of those providers. He and his family love life in Hot Springs and have no plans to leave.

CHI St. Vincent is currently recruiting for gastrointestinal, infectious disease, primary care and emergency medicine.

Cookeville, TN

If you’re looking for a small city with tons of outdoor activities, family-friendly events and close proximity to several larger cities, look no further than Cookeville, Tennessee.

Outdoor enthusiasts will flock to the variety of adventures available right at their fingertips. Emily Vaughn, physician recruiter at Cookeville Regional Medical Center, says the city is known for its outdoor activities due to the 16 state parks and more than 100 waterfalls within a one-hour drive. Hike, bike, run or take in the beautiful scenery along the numerous trails in the area. With several rivers and lakes, there is ample boating, kayaking, fishing, swimming, skiing and tubing available.

Cookeville is great for fitness lovers, too. Home to Rich Froning, who has been named the “Fittest Man on Earth” four times and won the 2011- 2014 Crossfit Games, Cookeville is a great city for physicians looking to level up their fitness at Rich Froning’s gym or other local exercise centers and sports complexes. Beyond outdoor and fitness opportunities, the cultural offerings in Cookeville are robust as well. You can catch a show at the Cookeville Performing Arts Center, peruse antique stores in the Westside Cultural District or dive into the past at one of the city’s several museums.

With several annual events, there is always something to look forward to in Cookeville. StoryFest in the Park, the Upper Cumberland Wine Festival, After Dark Movies in the Park, CityScape’s Taste of the Town and Fall Fun Fest are just a few offerings available.

Another perk is that Cookeville is just one hour from Nashville, making it easy to catch a concert, professional sporting event or an international flight for vacation. Knoxville and Chattanooga are both less than two hours away.

Cookeville not only has something for everyone to help find fulfillment in their personal lives, but in their professional lives as well.

“It’s a small town where you can bring your family and know you’re in a safe community and still practice big-time medicine,” said Vaughn.

Originally from Cookeville, Vaughn returned to the area to complete an internship in college. She was impressed with the leadership at Cookeville Regional Medical Center and knew she wanted to return after completing her college requirements. Luckily, an opportunity became available, and she has been at CRMC for the last 14 years.

“I was born in this hospital, and now I have the joy and pleasure of recruiting for this hospital,” Vaughn says.

Cookeville Regional Medical Center is a 269-bed hospital with more than 220 physicians offering more than 40 different specialties. Two floors are currently being renovated, which will give the hospital more than 309 beds. CRMC has been given national accolades and awards for its cardiac care, hip fracture and orthopedic services, along with numerous other awards and recognitions for stroke, diabetes, chest pain and sepsis care.

Vaughn says that though CRMC is a community hospital, they have all the technology, resources and providers needed to practice big city medicine.

“Candidates are always surprised when they come here and tour all the equipment we have. We are not-for-profit, so all money we make goes back to facilities so physicians have the equipment they want and need,” she says. “People typically think of a community hospital as not having what they need, and we exceed having what they need.”

When you have access to all of the technology and resources you need, you can help more people — and helping people is exactly what Michael Sywak, M.D., strives to do daily.

Sywak is a vascular surgeon at CRMC who got into medicine because he had a desire to help people. When it came time to choose where to practice, he said there were several factors that led him to Cookeville. First, Tennessee is one of only nine states without a state income tax.

“If you are a young physician wanting to set yourself up for long-term financial success, that’s important,” Sywak says. “Every paycheck, you’re throwing away money, and that’s not what a lot of people think about when looking for jobs.”

Next, Sywak considered where there was the greatest concentration of vascular disease within those states. Finally, among those options, Sywak said he and his wife decided on Cookeville, Tennessee and CRMC.

Sywak completed his medical degree at St. George’s University and his vascular surgery residency at Buffalo University. He was drawn to vascular surgery because it is an evolving field with highly dynamic and customized medicine for each case. He said pushing the edges of innovation combined with the need for technical excellence made vascular surgery a perfect fit.

He lived in a variety of places before coming to Cookeville, from California to the United Kingdom. Something that he says is truly unique about Cookeville is the strong sense of community and ability to truly know your neighbors.

“I’ve lived in so many areas where the word ‘community’ gets thrown around, but the community here really is so strong,” Sywak says. “We had a tornado rip through here a few years ago. There were probably 400 people immediately responding to help save people and activate, and no other place I’ve seen or lived in activates like that when those things happen.”

Additionally, Sywak says when he goes to a restaurant, a grocery store or an event in Cookeville, he knows people because they work at the hospital, are patients or friends of patients. Everyone knows and values you, which wasn’t his experience living in other cities.

The structure of CRMC is different from what you may find in other cities as well, as CRMC is a city-owned hospital and nonprofit.

“I also came here because there’s not a lot of layers between me and the administration of the hospital, so when I have an issue, we get it sorted out,” Sywak says. “I can control my environment…Here, there are no barriers. We get it done.”

CRMC is currently recruiting for cardiac anesthesia, neurohospitalists, surgical oncologists, general surgery and electrophysiology.

Madison, Georgia

If you’re looking for a small town with rich history, friendly neighbors, robust cultural and outdoor activities with easy access to metropolitan areas, Madison, Georgia, is for you.

“I often hear people call our small town ‘surprising,’ says Jennifer Rosa, executive director of the Madison Morgan County Convention and Visitors Bureau. “For such a truly small town with less than 5,000 residents, the wealth of truly outstanding restaurants, boutique shops, designer-led home décor stores, greenspaces and cultural attractions — almost all easily accessible within walking distance of just a couple of blocks—is incomparable.”

Downtown Madison is home to one of Georgia’s largest National Register historic districts and was named one of the “55 Most Beautiful Small Towns in America” by Architectural Digest and listed as one of “The South’s Prettiest Small Towns” by Southern Living magazine.

As a resident, you’ll look forward to all the annual events and festivals Madison hosts, including the annual Chili Cook-Off and Fall Festival, Caroling by Candlelight, Firefly Festival, Madison Fest and more.

There is also easy access to a number of golf courses, lakes and state parks for all of the swimming, fishing, hiking, biking and other outdoor activities you may want.

You can get to Atlanta within an hour and access all that the city has to offer, like professional sports venues, restaurants, shopping and a major international airport. Athens is also just about 45 minutes away.

The beautiful, rural setting of Madison and its close proximity to Atlanta and Athens is part of the reason Dan Zant, M.D., decided to plant roots in the city.

Zant is a graduate of the University of Georgia, attended medical school at Mercer Medical School and completed his residency training in family medicine in Macon, Georgia.

“We moved here in 2002. It was a small town on the route between Jackson, where I was from, and Athens,” Zant says. “I knew I wanted to come back to a small town, and I wanted to be close to Athens, close to my parents, so it was a good fit.”

Zant said he grew up with a positive role model who happened to be his family doctor. He described him as the model small-town country doctor who took care of the whole town. Zant decided that’s what he wanted to do as well, to give back to a small town and mean as much to his community as his doctor meant to him.

During residency, Zant was introduced to a physician in Madison who had practiced for 40 years; Zant took over that practice about 20 years ago. His practice is the largest family medicine practice in Madison. He is also the chief of the medical staff at Morgan Medical Center.

Morgan Medical Center is a recently-built 25-bed critical access hospital (the only one in the state). The more than $35 million facility is state-of-the-art and covers 74,000 square feet.

“We fought for a long time. There was opposition at times for financial reasons, and it was in a time when a lot of hospitals in Georgia were closing, but our hospital authority put together a good plan with an outside group and got financing through the usda Loan Program,” Zant says. “We did it at a time when a lot of hospitals were failing, but ours has become a model for other hospitals wanting to replace old facilities using the financial means we could through the government loans program.”

Zant says the exceptional leadership of the hospital has made it a strong, financially stable hospital with a lot of opportunity and growth. Since opening the new hospital, Zant says they have been able to offer a variety of new services, like surgery. Additionally, their swing bed program for inpatient rehabilitation is known as the best in that part of the state.

The hospital and its providers have a strong reputation and the trust of the community. If you are looking to practice at a state-of-the-art hospital in beautiful, rural countryside near a metropolitan area, consider Morgan Medical Center.

Morgan Medical Center is recruiting for primary care, internal medicine, family practice and pediatrics. •



Haley Cahill-Teubert

Easy to Register >> Control your visibility >> 100% free

Take control of your Job Search

Recommended PracticeLink Magazine Blogs

Learn some of the relocation basics and the relocation assistance you can expect to receive from your new employers. Learn some of the relocation basics and the relocation assistance you can expect to receive from your new employers.
PracticeLink MagazineSeptember 21, 2021
Relocation 101: What kind of assistance can I anticipate?
Relocation is more than a career change; it can be a lifestyle adjustment. When making the decision to start practicing
Ask yourself these relocation questions before signing your offer and deciding to move for a new position. Ask yourself these relocation questions before signing your offer and deciding to move for a new position.
PracticeLink MagazineMay 25, 2021
4 relocation questions to answer before you accept the offer
As you consider where you’d like to practice, there may be multiple reasons for you and your family to move