Wilderness Medicine

NAME: Gregory H. Bledsoe, M.D., MPH

TITLE: Board certified emergency medicine physician; Founder and CEO of ExpedMed Expedition and Wilderness CME

EDUCATION/TRAINING:

Medical school: University of Arkansas for Medical Sciences

Residency: University of Arkansas for Medical Sciences; Two years in International Emergency Medicine

Masters of Public Health: Johns Hopkins Bloomberg School of Public Health

Bledsoe has been an instructor and medical consultant for the United States Secret Service. He was the personal physician to former President Bill Clinton during Clinton’s tour of Africa in September of 2002 and served in Uganda and Senegal on the advance team of President George W. Bush when the President visited the African continent in July 2003.

His international medical experience includes travel to 40 countries, serving as a field physician in Honduras, teaching disaster preparedness in Tanzania, leading a nutritional survey among the Beja tribe in northeast Sudan, working as a medical consultant in Beijing, and acting as the medical officer for ships in both Antarctica and the Arctic.

What do you like best about wilderness medicine?

I was able to go on medical trips overseas with my dad, who is a surgeon. In high school, I went to Haiti and when I was a resident and medical student, I went to Honduras. I finished residency in 2002 and had a two-year fellowship in international health from 2002 to 2004. I did a lot of international work and remote medical work from 2002 to 2009.

When I was in medical school, I was taught how to handle patients who were in the hospital. There was a certain amount of control.

In the field, however, a wilderness physician can’t control the weather or patient type. There isn’t the technology or stability. That really fascinates me.

How do you get the time off from your current practice?

That’s one of the reasons I practice emergency medicine. I choose my shifts and when I work. It gives me more flexibility than if I had an office-based practice such as a family practitioner or surgeon. It’s one of the benefits of working in emergency medicine.

Is there anything you don’t like about wilderness medicine?

For most of the trips, the difficulty is from the funding aspect. Even for the big trips that you see on the news, the expeditions to various places, often the physician on those trips has to pay for his or her own way.

Finding someone to fund your trip, even if you are the physician, can be very difficult. So I think that’s a downside and why more physicians are not involved in wilderness medicine. It’s not because physicians aren’t interested. It’s a fascinating way to practice medicine.

What’s your advice to someone who wants to practice wilderness medicine?

Even if you are an excellent physician in your area of expertise, working in the field is different. I always advise physicians to get some training. ExpedMed runs conferences so whether it’s our conference or another conference, make sure you know of the risks. It’s unfortunate but there are malpractice risks even out in the field.

Knowing the body of information depending on the trip or project you are working on is a must. You need to be educated and have significant field experience.

The way you get yourself known is like anything else. It’s by being there, participating in trips and projects. The fastest way to start is volunteer work. Then, if it’s something you enjoy, there are volunteer agencies, nonprofits, etc. that won’t pay you a salary but will cover your expenses.

There are a few jobs available for those who want to do it full time, but those jobs usually go to physicians who are fairly well-known and have significant field experience.

Was there anything that surprised you about practicing wilderness medicine?

What I’ve found in every community I’ve been to is that there are some good practitioners of medicine, maybe nurses or local physicians. They are very knowledgeable, however they don’t have the facilities, medicines and equipment necessary to diagnose and treat patients.

I’ve been impressed with the medical knowledge among the local physicians, but often the infrastructure is so poor that they can’t get the patients the medicines and treatments they need.

The other thing that surprises me is that it’s amazing how many Western travelers go to remote places without any thought as to what will happen if they get sick or injured. So many people have rose-colored glasses. They think somebody is going to come and get them off a mountain.

You need to have a plan. Many veteran travelers get into a lot of trouble because they think a cell phone or radio call will result in a rescue. It’s not that easy. There are some really remote places that, even with our technology, it’s difficult to reach people.

What’s your schedule like on one of these trips?

It depends on the circumstance. If you work as a ship physician, sometimes you’ll have another physician on the ship and you’ll be able to rotate call. However, if you’re the only physician on a trip, you are definitely on call for 24 hours. You just have to deal with whatever comes along. It depends on the project and your resources.

—By Marcia Travelstead